Since September, complications from strep A infections have led to the deaths of 21 children in the UK. Now, public health officials in the US are concerned after twostrep A-related deaths were reported in Coloradoboth of which affected young children.
Strep A infections are caused by a bacteria calledgroup AStreptococcus, and they’re actually really common: Strep A causes millions of non-invasive infections each year, like strep throat, scarlet fever, and a skin infection called impetigo, per the Centers for Disease Control and Prevention (CDC). What’s not so common, however, isinvasive group A strep (iGAS), which can lead to life-threatening complications.
The CDC says it is investigating an increase in these rare iGAS cases; it has not confirmed how many cases have been reported in the US this year. “It’s too soon to say whether iGAS case numbers are just returning to pre-pandemic levels or if they are rising beyond what we would normally expect based on what we know about GAS seasonal patterns,” a spokespersontold CNN. The numbers from these recent outbreaks are somewhat puzzling and jarring; per theUK Health Security Agencythe 2017–2018 winter was the last “comparably high” season for group A strep infections in the UK. Notably, Colorado hasn’t reported any strep A deaths since 2018, per reporting fromNBC News.
Officials don’t fully understand why this uptick in deadly strep A complications is happening,Cory Fisher, DOa family medicine physician at the Cleveland Clinic, tells SELF. However, there’s one predominant theory floating around the medical community, according to the experts SELF spoke with: “Some have postulated that high circulating viral infections likeRSV [respiratory syncytial virus]influenza, orCOVID may create enough baseline inflammation to make patients more vulnerable to complications,” Dr. Fisher says. Basically, if a young child is already sick, they’re pretty vulnerable if another infection hits, potentially increasing the risk of these rare but severe complications.
Below, experts explain what parents, in particular, should know about strep A, including iGAS, and how to stay as safe as possible through the rest ofcold and flu season.
What should parents know about strep A—and should you be worried?
First, it’s important to remember that strep A complications aren’t common, and the CDC is still investigating the reported deaths in Colorado. A spokesperson for UKHSA said in aDecember 22 statement that non-invasive infections, like strep throat, are often “easily treated with antibiotics and it is very rare that a child will go on to become more seriously ill.”
Sara Siddiqui, M.D.a pediatrician at NYU Langone, echoes this; she tells SELF that as long as a child is seen by a doctor once they start feeling unwell, the infection (if confirmed) can usually be treated successfully. It’suntreated cases that can become serious, she notes.
Though strep throat is most common in children 5 to 15 years old (and rare for children under three), it can affect people of any age, per theCDC. Children who have chickenpox or the flu are at higher risk of developing iGAS, per the World Health Organization (WHO). Like children, older adults may be more vulnerable to serious infection as well, Dr. Fisher says.
Signs of non-invasive strep A can includeflu-like symptoms like fever, swollen glands, sore throat, and body aches; a rough-feeling skin rash; scabs and sores; pain and swelling; and nausea and/or vomiting, per the UK’s National Health Service (NHS). Initially, it may be difficult to discern whether a person has strep A or one of the many other bugs going around right now, but extreme pain in the throat that feels scratchy or causes difficulty swallowing may signal strep, Dr. Siddiqui says.
Have your child checked out ASAP if they start showing signs of illness, as prompt treatment is vital for any number of infections. Since it’s possible to have multiple illnesses at once, it’s important to pay close attention to the possible progression of your child’s symptoms and report back to their pediatrician if you think they may be feeling worse; after all, because invasive strep A is not nearly as common, it may be easier to miss than RSV, flu, or COVID.
The CDC says parents should also be aware of the signs of iGAS. “While strep throat is a fairly common infection, invasive strep infections like necrotizing fasciitis, rheumatic fever, or toxic shock syndrome are quite rare,” Dr. Fisher says. “It’s unlikely to develop these complications of a group A strep infection, but I would suggest that parents monitor their kids closely.” For example,necrotizing fasciitisalso called “flesh-eating disease,” can cause warm, discolored, or swollen skin, which can then spread.Streptococcal toxic shock syndromeon the other hand, may result in dangerously low blood pressure and a rapid heart rate.Rheumatic fever can lead to tender or painful joints and unusual body movements. What they all have in common: They’ll look and feel more serious than your run-of-the-mill cold or flu.
The antibiotics penicillin and amoxicillin are used to treat a strep A infection, per theCDC. If a child starts showing any of the serious signs above, especially if they’ve already started treatment, it’s time to seek emergency treatment. “If [parents] feel like their condition is worsening despite medical management, they should contact their health care provider immediately,” Dr. Fisher says.
How to stay alert and safe this cold and flu season
Strep A primarily spreads through person-to-person contact, most often through respiratory droplets, per theCDC. Similar to COVID, flu, and RSV, you can do your best to prevent a strep A infection by taking certain precautions:
- Make sure your child is up-to-date on their flu, COVID, and chickenpox vaccines. Having one of these infections may increase their risk of developing iGAS from a strep A infection.
- Frequently wash your hands for at least 20 seconds with soap and water, and encourage your children to do the same, especially at places like school. (Hand sanitizer is better than nothing in a pinch.)
- Remind your children not to share food, drinks, or utensils at school (or anywhere else), since transmission can occur via saliva as well.
- Do your best to avoid people who are sick or very crowded indoor gatherings.
- Regularly clean and disinfect high-touch surfaces in your home.
- If your child is sick, make sure they stay home so they don’t spread their illness to others.
- Have a plan for where you’ll take your child if their pediatrician is unavailable. Research local urgent care centers or emergency rooms that are open 24/7.
These practices simply cannot be overstated enough, Dr. Fisher says, especially because the US is experiencing a shortage of amoxicillin, the go-to antibiotic used to treat strep A. The shortage is expected to last months, per the CDC.
Right now, awareness is key. Early diagnosis and treatment will be crucial in keeping everyone as safe as possible, Dr. Siddiqui stresses: “Our hopeful answer is that we do not see a worsening of fatal group A strep infections.”
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