In 2022–23, over 50,000 people in the UK caught scarlet fever from StrepA bacteria, and nearly 500 died—yet no one fully understands why these sudden surges happen. This matters because StrepA causes everything from sore throats to deadly infections, and outbreaks hit hard every few years without clear warning. Current studies focus only on severe cases or scarlet fever, missing the full picture. This project will collect every StrepA sample from Sheffield’s NHS labs over five years, linking bacterial genetics to patient data. By tracking how the bacteria’s genes change over time, testing strains on human tissue in the lab, and mapping where infections cluster in the city, the researcher aims to pinpoint what drives outbreaks—whether it’s genetic shifts in the bacteria, new strains that spread more easily, or changes in human susceptibility. If successful, this could improve outbreak prediction and help design community-level measures to slow transmission. It may also guide vaccine development or treatment strategies. The work is fundamental science—it won’t produce an immediate product—but understanding outbreak drivers is the first step toward preventing them.
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Streptococcus pyogenes, also called group A Streptococcus or StrepA, is a bacteria that can lead to simple issues like sore throats and skin infections, or serious conditions like scarlet fever and deadly diseases. In the UK, StrepA cases usually go up during winter and spring. In the year 2022-23, there was a dramatic and sudden rise in cases with over 50,000 people getting scarlet fever and nearly 500 dying. Even though these outbreaks have a big impact, we do not fully understand what causes them, making it hard to stop or lessen the effects of outbreaks. Several factors may cause these outbreaks, including changes in the bacteria's genes, bacteria spreading more easily between people because of new or different strains, and people being more prone to infections. My research aims to figure out what causes these outbreaks of StrepA infections. In my study, I will collect all StrepA bacteria samples from Sheffield's NHS labs over five years, along with important medical information about individuals that suffered these StrepA infections. First, I'll look at how the bacteria's genes change over time and see if these changes are linked to specific patient or disease patterns. Next, I'll examine certain StrepA strains in the lab using human tissue infection models to see if specific features in the bacterial genes affect how the bacteria act or their ability to cause disease. Then, I'll look at the genetic data and where the bacteria were found in the city, to understand how strains spread in communities and whether some strains are more successful at doing this. My study is novel and thorough because it looks in a detailed way at StrepA strains from all types of infections in a large UK city across a long period of time. Previous studies have focused on severe infections or scarlet fever cases, which is only part of the picture. The findings from my research will help us better understand why StrepA causes outbreaks and help us improve how we manage StrepA, predict outbreaks, and find ways to lower the spread of bacteria in communities. My study aims to greatly reduce the overall future impact of StrepA disease in the UK.
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