In south-east London, close to where a boy died from a Strep A infection, a sense of panic has set in among some parents about an outbreak which has now killed nine children across Britain.
One of those who died was a 12-year-old who attended the fee-paying Colfe’s School in Lee, in the borough of Lewisham.
Concern over a potential shortage of antibiotics has added to the alarm.
Rebecca White, 30, who lives in Eltham, has curtailed how many people her three-year-old son Rupert mixes with to try to protect him.
“We haven’t been doing playgroups for the past week,” she said.
“We are just taking a step back and mixing outside much more than we were. I will play it by ear for a little bit.”
It is not just London that is affected. The most recent death reported was of Stella-Lily McCorkindale, who attended Black Mountain Primary School in Belfast.
The school has spoken of its “tragic loss” and said “the thoughts of the entire school are with the pupil’s family and friends at this difficult time”.
UK Health Security Agency (UKHSA) officials have suggested that a lack of mixing due to the Covid pandemic plus susceptibility in children are probably “bringing forward the normal scarlet fever season” from spring to this side of Christmas.
Strep A is a group of bacteria that can cause skin, soft tissue and respiratory tract infections, which are treated with antibiotics. Illness caused by the bacteria is usually mild, but infections can become serious and systemic.
Group A bacteria can colonise the throat, resulting in an infection called strep throat, which is painful and can create red spots in the area at the back of the roof of the mouth, and white patches or streaks of pus on the tonsils. Other symptoms include fever, a headache and a rash.
The bacterial infection can also result in another illness called scarlet fever, which begins with a high temperature, a sore throat and swollen glands.
Another Eltham resident, Ala Diduh, whose daughter is four, said she is concerned about the infection.
Her daughter has been sick for five days and her school — not the one attended by the boy who died — has advised parents to keep children at home if their temperature is higher than 36°C.
Her daughter has been checked by a doctor and antibiotics were not thought necessary. But she is still concerned.
“My friend told me about this child who died in the school. There is a very big panic from the parents about it. It’s close by. We are scared because it’s not normal.”
A pharmacist in nearby Blackheath, which is also the borough of Lewisham, said the supply of some antibiotics is running low.
“There are shortages,” she said. “It’s just high demand at the moment. Compared to last year, this year we are a lot busier and a lot heavier on antibiotics.”
She said some antibiotics are out of stock, but alternatives exist.
“There are alternatives they can prescribe, like the lower doses. It varies depending on the area. Some people are having no problem at all. It depends on the suppliers.”
That is in line with the National Pharmacy Association’s view, that there are “blips” in the supply chain of liquid penicillin, which is often given to children.
Addressing the House of Commons on Wednesday, Prime Minister Rishi Sunak denied there were shortages of antibiotics.
“There are no current shortages of drugs available to treat this and there are well established procedures in place to ensure that remains the case,” he said.
“The UKHSA are monitoring the situation at pace and what they have confirmed is this is not a new strain of Strep A. So parents should be reassured about that. There is no reason to believe it has become more lethal or more resistant to antibiotics. So the most important thing for parents to do is look out for the symptoms and get the treatment that is available for them.”
A mother from England released a video of her daughter who was placed in an induced coma due to a Strep A infection.
Sarah Page's five-year-old daughter contracted the illness two weeks ago. She is now recovering in hosptial.
Ms Page told ITV: "Eva had a high temperature that wouldn't go down, muscle aches and a cough.
"I didn't think anything of it - just put it to a common cold. But by the Saturday Eva became really unwell, her temperature was spiking to 39.9 and she wouldn't eat.
"I took her to A&E where we were given antibiotics and sent home."
"That night she deteriorated very fast, and by the morning she was blue and couldn't move. We called an ambulance where we got blue-lighted to East Surrey.
"She again got worse as time went on, so they decided it would be best to put her in an induced coma."
On the internet forum Mumsnet, many parents urged calm, noting that there had been spikes in previous years. But some were concerned about the prospect of obtaining a GP appointment, or medicine.
“I think a lot of what's feeding into the fear on this is the knowledge we all have that it's now easier to get an audience with the Pope than it is to get a face-to-face with a GP, A&E is on its knees and there's a massive shortage of basic medication like penicillin,” wrote one parent.
“If we could all be sure of prompt and adequate medical care and free access to the right meds when needed, we'd all be breathing easier.”
Another said her daughter had scarlet fever which lasted for seven weeks. She wrote: “Yes people might panic, but we shouldn’t trivialise it. If in doubt get checked out.”
A third summed up the dilemma. “Every single child with a fever and sore throat cannot be assessed and given antibiotics,” she said. “But currently every local surgery has shut to everything else other than emergencies because of the huge deluge of worried parents. Overuse of antibiotics will cause harm. And other patients will now come to harm because they cannot be seen.”
Health Secretary Steve Barclay said on Wednesday the level of supply of antibiotics was “not a concern at the moment” and stock could be moved around if there was an issue with particular areas.
He told GB News: “We're in very close contact with our medical suppliers. They're under a duty to notify us if there are supply shortages. They have not done so as yet.”
He also told Sky News: “Obviously parents are concerned at the moment because they see the stories.
“One in five children have this — Strep A — naturally, and complications are very rare, but it's important that we're vigilant.”
Deaths have occurred in England, Wales and Northern Ireland.
The UKHSA has advised medics to have a low threshold for prescribing antibiotics for children who may be suffering from an infection linked to Strep A.
GPs should also “maintain a low threshold for prompt referral” to hospital of any children presenting with persistent or worsening symptoms, it said.
On Tuesday it was revealed antibiotics could be handed out to entire year groups in schools affected by the Strep A outbreak in a move contrary to the normal advice of doctors.
“The UK Health and Security Agency are monitoring the position and are considering those kind of issues in those schools where there is an infection,” schools minister Nick Gibb said on Tuesday.
“This is an ongoing situation. The UKHSA are involved very closely with those schools and they will be providing further advice later on.
“But that may well be an option for those particular schools where there is an infection.”