A vaccine that protects against Step A could be on the horizon after scientists made a breakthrough in understanding how the body fights off the bacteria.
Strep A usually causes a mild infection, such as strep throat, impetigo and scarlet fever. But in exceptionally rare cases, it can lead to a deadly disease. It has killed 24 children in the UK in recent months.
As it stands, the infection can be easily treated with antibiotics if caught early. However, if the bacteria were to become resistant to the drugs, it would post a ‘major public health threat’, experts say.
But Swedish researchers have now found an antibody that fights off Strep A bacteria in an unusual way, which they believe could be key to developing a vaccine.
Swedish researchers have now found an antibody that fights off Strep A bacteria in an unusual way, which they believe could be key to developing a vaccine
Strep A is a bacterium which can cause infections in the throat, skin and respiratory tract. If an infection is left untreated it can cause serious complications. Ear infections, toxic shock syndrome and kidney inflammation are all complications that can occur
The researchers, at Lund University, studied the blood of patients who had recovered from a severe Strep A infection to determine how their immune system had fought-off the bacteria.
They mapped the antibodies that their bodies produced when they were unwell with Strep A.
This allowed them to spot those that could be harnessed for medicines or vaccines once an infection has occurred.
Until now, researchers using this method have failed to develop antibody-based treatments that work against Strep A, according to the team.
However, the Swedish group found an antibody that works in a ‘rare’ way against Strep A that has ‘never been described before’ and ‘could explain why so many vaccine attempts have been unsuccessful’.
Antibodies are shaped like the letter Y. The one they spotted, called Ab25, used its two ‘arms’ to hook onto two different parts of a protein on the surface of the Strep A bacteria – called the M protein.
Where this unique process was spotted, the body was able to mount a strong response to the bacteria.
Usually, antibodies use one arm to bind to a single site, the researchers said. But this process is ineffective against Strep A.
Dr Wael Bahnan, an immunologist at Lund and one of the study authors, said: ‘This opens up possibilities where previous vaccine attempts have failed and means that the monoclonal antibody we used has the potential to protect against infection.’
The team conducted further tests on the antibody in animals and found it was able to produce a ‘strong immune response against the bacteria’.
They have now applied for a patent based on their findings, published in the journal EMBO Molecular Medicine, and hope the antibody will eventually lead to Strep A treatments and vaccines.
Study author Professor Pontus Nordenfelt said: ‘Normally, an antibody binds via one of its two Y arms to its target protein at a single site, regardless of which of the two arms is used for binding.
While the vast majority of infections are relatively mild, in exceptionally rare cases the bacteria can cause invasive Group A Streptococcal (iGAS)
Strep A bacteria can cause a range of other infections, including impetigo, scarlet fever and strep throat
‘But what we have seen – and this is vital information – is that the two Y arms can recognise and hook onto two different places on the same target protein.’
It comes after the UK Health Security Agency confirmed last week that another five children had died from Strep A – bringing the total to 24 since September.
The vast majority occurred in England (21), followed by Wales (2) and Northern Ireland (1).
Although low, the number of children in Britain to have died from Strep A is higher than expected for this time of year.
Twenty-seven under-18s died from the bug throughout the entirety of the last bad season, in 2017/18.
Strep A bacteria can cause a range of infections. While the vast majority of these are relatively mild, in exceptionally rare cases the bacteria can cause invasive Group A Streptococcal (iGAS).
Two of the most severe forms of this invasive disease are necrotising fasciitis and streptococcal toxic shock syndrome. Both can kill.
Data suggests cases of iGAS are already up to five times higher than last winter — which was unusually quiet.
A surge in iGAS cases usually occurs every three to four years but social distancing during the Covid pandemic is thought to have interrupted this cycle.
Some experts have suggested that this has left some youngsters with reduced immunity to Strep A — with a high number of children never having encountered the bacteria in their lifetime.
High rates of other respiratory viruses — including flu, RSV and norovirus — may also be putting children at higher risk of co-infections with Strep A, leaving them more susceptible to severe illness, the World Health Organisation said.
Last week, experts revealed there were five times more prescriptions for penicillin being dished out compared with the previous three weeks.
They said some forms of antibiotics could be put on a ‘shortage protocol’ to allow pharmacists to give worried parents alternatives, instead of forcing them to traipse to various pharmacies or return to the GP to ask for a new prescription.
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From the ‘bubbly’ seven-year-old whose father desperately tried CPR to save her, to the four-year-old who loved exploring: The victims of Strep A so far
Muhammad Ibrahim Ali
The four-year-old boy attended Oakridge School and Nursery in High Wycombe, Buckinghamshire.
He died at home from a cardiac arrest in mid-November after contracting a Strep A infection.
He was prescribed antibiotics.
His mother Shabana Kousar told the Bucks Free Press: ‘The loss is great and nothing will replace that.
‘He was very helpful around the house and quite adventurous, he loved exploring and enjoyed the forest school, his best day was a Monday and said how Monday was the best day of the week.
Muhammad Ibrahim Ali, who attended Oakridge School and Nursery in High Wycombe, Buckinghamshire, died after contracting the bacterial infection
Hannah Roap
The ‘bubbly’ and ‘beautiful’ seven-year-old is the only child to have died from Strep A in Wales so far.
Her devastated parents told how their ‘hearts had broken into a million pieces’.
The first signs of the infection were mild. Hannah’s father Abul took his daughter to the GP after a cough got worse overnight.
She was prescribed steroids and sent home, but she died less than 12 hours later.
Mr Roap recalled how he desperately tried to resuscitate his child: ‘She stopped breathing at 8pm but we were not immediately aware because she was sleeping.
‘I did CPR, I tried to revive her but it didn’t work. Paramedics arrived and continued the CPR but it was too late.’
Mr Roap said the family was ‘utterly devastated’ and awaiting answers from the hospital.
The family believe she might have lived if she was initially given antibiotics.
Hanna Roap, who attended Victoria Primary School in Penarth, Wales, died after contracting Strep A last month. Her family say they have been ‘traumatised’ by her death
Stella-Lily McCorkindale
Five-year-old Stella-Lily McCokindale died following a Strep A infection, the first death from the infection in Northern Ireland.
She died on December 5 at Royal Belfast Hospital.
In a tribute on social media, her father Robert said the pair had ‘loved every minute’ of being together as they went on scooter and bike rides.
‘If prayers, thoughts, feelings and love could have worked she would have walked out of that hospital holding her daddy’s hand,’ he said.
Stella-Lily attended Black Mountain Primary School, which said she was ‘a bright and talented little girl’ and described her death as a ‘tragic loss’.
Five-year-old Stella-Lily McCokindale who attended Black Mountain Primary School in Belfast died in early December after contracting Strep A
Jax Albert Jefferys
A five-year-old boy who died of Strep A was misdiagnosed as having flu, his family has said.
Jax Albert Jefferys, from Waterlooville, Hampshire, died on December 1.
His mother Charlene told how she had sought medical advice three times during the four days leading up to Jax’s death and was told he was suffering from influenza A. She described Jax as a ‘cheeky little chappy’.
Later tests revealed he actually had Strep A.
Jax Albert Jefferys, a five-year-old from Waterlooville, Hampshire, died on , December 1, from Strep A
