Strep A
What is strep A?
Strep A is a shortened name for a type of bacteria called Streptococcus (type) A. It is a species commonly found on our skin or in our throat. Sometimes, these bacteria can cause disease. Strep A is also often referred to as Group A streptococcus or GAS. There are other types of streptococci, and you may have heard of Group B streptococcus as it this can bring risks during childbirth.
General information about strep A can be found on the NHS website.
If I have strep A living on me, does it mean I will get ill?
We carry lots of bacteria on and in our body. For instance, between 15% and 20% of children will be carrying strep A bacteria at any one time. Only occasionally does this lead to illness.
What are the symptoms of strep A illness and is it serious?
When strep A causes illness, it commonly presents as a mild sore throat or as infections of the skin (such as impetigo). It can also cause flu-like symptoms such as a high temperature, swollen glands, or an aching body. It can also cause a reddish skin rash that feels rough like sandpaper. This is known as scarlet fever. On darker skin, this can be more difficult to spot but it will feel rough in the same way. In some cases, it can cause nausea and vomiting.
Most of the time, these strep A infections are mild and can be treated with antibiotics. However, on rare occasions these infections can cause serious problems. This is known as an Invasive Group A streptococcus infection or iGAS. This is caused by the bacteria getting into parts of the body where it is not normally found, like the bloodstream or the lungs. This can lead to bacteraemia (infection of the blood), meningitis, toxic shock syndrome and is potentially fatal.
Can Strep A be treated?
Most strep A infections can be treated easily by antibiotics. Serious strep A infections (iGAS) need to be treated in hospital. If you or your child has a strep A infection, you should stay away from work, school, or nursery for 24 hours after starting antibiotics to avoid the risk of infecting others.
How do I get a strep A infection?
Strep A infections are spread by close contact with an infected person. They can be passed on through coughs and sneezes, or by coming into contact with a wound where the bacteria are present. You are most at risk of becoming ill with strep A if you have a weakened immune system or are currently ill with a different infection. If you are carrying strep A but are not ill, you can still pass the bacteria on to someone else.
What should I do if I think my child is unwell with strep A?
If your child does not seem to be seriously ill, you can usually look after them at home. They should feel better in a few days. If they are uncomfortable, you can give them children’s paracetamol or children’s ibuprofen but do check the leaflet that comes with the medicine to make sure it is okay for your child and to see how much to give them.
It can be difficult to tell when a child is seriously ill, but you may have a good instinct as a parent when something is wrong. Even though it is rare, there is potential for serious complications from a strep A infection so you should seek help from your GP for your child if:
- Their symptoms are getting worse;
- They are feeding or eating much less than usual;
- They have had a dry nappy for 12 hours or more, or are showing signs of dehydration;
- They are under 3 months of age and have a temperature higher than 38 degrees Celsius;
- They are older than 3 months of age and have a temperature higher than 39 degrees Celsius;
- They feel hotter than usual when you touch their back or chest, or they feel sweaty;
- They are very tired or irritable.
You should phone 999 or go to Accident and Emergency if:
- Your child is having difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs);
- There are pauses when your child breathes;
- Your child’s skin, tongue, or lips are blue;
- Your child is floppy and will not wake up or stay awake.
How can I avoid getting or passing on strep A infection?
Strep A infections can easily spread to other people. You can help reduce the risk of this by washing your hands often with soap and water, covering your mouth and nose with a tissue when you cough or sneeze, and putting those tissues in the bin straight away after use. If you are prescribed antibiotics for a strep A infection, you should stay away from work, school, or nursery for 24 hours after starting them and do make sure to complete the full course of the medication.
It is also important to get the free flu vaccine for this year for anyone who is eligible. Having both a flu infection and a strep A infection at the same time increases the risk of serious complications.
Why am I hearing about strep A in news?
While strep A infections are common, the serious illness caused by iGAS is rare. We have seen larger than usual numbers of scarlet fever infections in children so far this winter and this has led to a higher than usual number of iGAS cases. It has also very sadly led to several deaths in children and adults. It is thought that part of the reason for the increased numbers of cases is that several viruses are also circulating in our communities now and people may be experiencing infection from these as well as strep A at the same time.
How is the NHS responding to this increase in cases?
Doctors and other healthcare professionals have been informed about the increased number of cases of scarlet fever and iGAS, and about how these cases are presenting. Guidance has been provided to healthcare professionals to be extra cautious where they see any child presenting with possible symptoms of iGAS and to prescribe antibiotics where there is any risk of development of serious complications. Any child seeing their GP with persistent or worsening symptoms related to strep A will be referred on to hospital services.
Schools have been asked to contact our local health protection teams if they are aware of cases of chicken pox or flu in a class where there is also a case of scarlet fever as this may potentially increase the risk of more serious illness. They are being supported by health protection specialists to manage any outbreaks.
I’ve been contacted by a health protection team who say I am a contact of a case. What does this mean?
When a case of iGAS has been diagnosed, health protection teams will try to work out who may have been in prolonged contact with the case in the seven days before their symptoms started. This will usually be people who have spent time in close contact in a household type setting. If the health protection team feel that you are at particular risk for severe illness from a strep A infection, they may prescribe you with antibiotic medication as a prevention measure.
I’d like to get some specialist advice from a health protection clinician. What can I do?
A helpline has been set up at the local health protection team which is dedicated to queries about strep A infection. It is available 8am to 6pm on Monday to Friday. You can call the general number for the North East and North Central London Health Protection Team on 020 3837 7084 and then press 9 for the helpline.
Is there any other information I can access to find out about strep A?
The Department of Health and the UK Health Security (UKHSA) have both created videos by medical experts on scarlet fever and strep A. You can watch them by clicking on the links below:
You can find more information at the NHS webpage for strep A.
