Group A Strep – What you need to know?

Jan 26, 2023

Thank you for reading this short article.

So, what is group A streptococcus (GAS)? Well, it is a bacteria, or a germ. The name is derived from the Greek words meaning ‘a chain’ (streptos) of berries (coccus), as can be seen above, it looks like a chain of berries. It is a common bacterium that is found on the skin of humans. It is also found in the throat, and rarely causes illness. However, GAS does cause a number of infections, some mild and some more serious.

We are seeing a higher number of cases of Group A strep this year than usual. The bacteria usually cause a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics.

In very rare circumstances, this bacterium can get into the bloodstream and cause serious illness – called invasive Group A strep (iGAS).

iGAS is still uncommon; however, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated, and we can stop the infection becoming serious. There has been an increase in cases this year, particularly in children under 10 and sadly, a small number of deaths.

What is important is to understand that GAS infections are common and normally mild. It is important however to be vigilant regarding the symptoms detailed below, and if you are concerned, call the Harvey Rhys Clinic and our team will advise you and arrange a prompt medical assessment.

How is it spread?

GAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound.

Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell.

What infections does GAS cause & how do you treat them?

GAS causes infections in the skin, soft tissue and respiratory tract. It’s responsible for infections such as tonsillitis, pharyngitis (sore throat), scarlet fever, impetigo and cellulitis among others.

While infections like these can be unpleasant, they rarely become serious.

When treated with antibiotics, an unwell person with a mild illness like tonsilitis stops being contagious around 24 hours after starting their medication and can return to nursery or school if well enough.

We are currently seeing high numbers of scarlet fever cases across England, and we are diagnosing and treating the disease locally at present.

The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper. The rash will be less visible on darker skin but will still feel like sandpaper. More information on scarlet fever can be found on the NHS website, including photos.

What is invasive group A strep (iGAS)?

The most serious infections linked to GAS come from invasive group A strep, known as iGAS.

This can happen when a person has sores or open wounds that allow the bacteria to get into the tissue, breaches in their respiratory tract after a viral illness, or in a person who has a health condition that decreases their immunity to infection. When the immune system is compromised, a person is more vulnerable to invasive disease.

Which infections does invasive group A strep cause?

iGAS can cause Necrotising fasciitis, a very rare infection whereby the bacteria multiply and grow along deep tissues of body, necrotising pneumonia, a chest infection, and Streptococcal Toxic Shock Syndrome are some of the most severe but rare forms of invasive group A strep.

What is being done to investigate the rise in cases in children?

Investigations are underway following reports of an increase in lower respiratory tract Group A Strep infection in children over the past few weeks, which have caused severe illness.

Currently, there is no evidence that a new strain is circulating. The increase is most likely related to high amounts of circulating bacteria.

It isn’t possible to say for certain what is causing higher than usual rates of these infections. There is likely a combination of factors, including increased social mixing compared to the previous years as well as increases in other respiratory viruses.

What should parents look out for?

It’s always concerning when a child is unwell. GAS infections cause various symptoms such as sore throat, fever, chills and muscle aches.

It can be difficult to know exactly when to seek medical advice, however, as members of The Harvey Rhys Clinic you have the knowledge that we will always see a poorly child on the same day. Not just children get infected of course, so can adults.

GAS can cause several different diseases. The main ones are listed below.

If your child is not drinking, eating, is lethargic, with high temperatures and is not passing urine as regular as normal we would advise you seek medical advice, the Harvey Rhys Clinic will always see an ill child on the same day*.

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. This is a Blog, as such is for guidance and medical advice should always be requested if you have any concerns.

We always advocate when a child is poorly you maintain fluids at least 50% of the child’s normally daily volume and ensure passing urine at least 6-8 hourly.

Contact Harvey Rhys Clinic if your child is getting worse despite paracetamol or ibuprofen if:

  • The temperature has lasted more than five days
  • Your child is feeding or eating much less than normal, especially if they are drooling or appear in pain when swallowing
  • Your baby has had a dry nappy for 12 hours or more, is crying without tears, or shows other signs of dehydration
  • Your baby is under three months and has a temperature of 38°C, or is older than three months and has a temperature of 39°C or higher
  • Your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • Your child is drowsy (much more sleepy than normal) or irritable (unable to settle them with cuddles, toys, TV or snacks – especially if they remain drowsy or irritable despite any fever coming down)

Parents should call 999 or go to A&E if:

  • Your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs or using their neck muscles to breathe
  • There are long pauses (more than 10 seconds) when your child breathes
  • Your child’s skin, tongue or lips are blue
  • Your child feels very cold or clammy to touch
  • Your child is difficult to wake up or keep awake
  • Your child has severe pains in their arms, legs neck or back
  • Your child has a painful, red area of skin, especially if it is getting bigger quickly

In summary, Step A infections are common, the germ can be carried in the throat and skin of humans with no adverse effects, research suggests that approximate 5% of us carry this bacterium on our skin. It can cause mild illness such as a sore throat, impetigo, scarlet fever. Only in very rare situations can it cause the invasive form iGAS which is serious. However, with vigilance and prompt treatment we can prevent iGAS. If you are worried about your child’s health, please contact our team who will be only too happy to assist.


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