Group A streptococcus (GAS) is a common bacteria. Lots of us carry it in our throats and on our skin and it doesn’t always result in illness. However, GAS does cause several infections, some mild and some more serious. The most serious infections linked to GAS come from invasive group A strep, known as iGAS.
These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. In rare cases, an iGAS infection can be fatal, if not treated quickly with antibiotics.
Read on to find out more about this infection and what to look out for if you’re concerned that your child could be affected.
How is it spread?
GAS is spread by close contact with someone who is infected and can be passed on through coughs and sneezes or from a cut or 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, it is more likely to spread when a person is unwell, through coughs and sneezes.
Which infections does GAS cause?
GAS causes infections in the skin, soft tissue and respiratory tract. It’s responsible for infections such as tonsillitis, pharyngitis, scarlet fever, impetigo and cellulitis.
GP Dr Stephanie Jen Chyi Ooi advises, “As with all infections, there is a spectrum of severity. More rarely, the bacteria can enter the blood stream and cause invasive group A strep (iGAS). There has been an increase in cases of iGAS this year especially in those under 10 years old and this is what has caused the deaths that have been reported recently.”
What are the symptoms of scarlet fever?
Rashes are common in newborns and young babies as their skin comes into contact with new irritants and environments, so as a parent, it can be difficult to identify even the most common baby rashes.
Stephanie says, “Scarlet fever is usually a mild illness, but it is highly infectious. The rash associated with scarlet fever is a fine pinkish/red body rash that feels like sandpaper, it usually develops 12-48 hours after starting to feel unwell.” The rash may be harder/more subtle to see on darker skin but it will still have a sandpapery feel.
Other symptoms include:
• Sore throat
• Headache
• Fever
Strawberry tongue – a white coating on the tongue that peels and leaves a red swollen tongue with small bumps.
“Seek medical advice if your child has scarlet fever symptoms,” adds Stephanie, “early treatment with antibiotics is important to reduce the risk of complications such as pneumonia and progression to IGAS.”
If your child has scarlet fever, keep them at home from school or nursery until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others. Brothers and sisters can continue to attend schools or nursery if they are well and do not have any symptoms such as sore throat, fever, chills and muscle aches.
How are people infected by the invasive group A strep (iGAS)?
Becoming infected by the more invasive group A strep, known as iGAS can happen when a person has sores or open wounds that allow the bacteria to get into the body, if it gets into their lungs after a viral illness, or in a person who has a health condition that reduces their immunity to infection. If people have compromised immune systems – because of other health conditions –they are more vulnerable to all invasive disease.
What should parents look out for?
According to a recent gov.uk report on the number of GAS infections, cases were at 2.3 cases per 100,000 children aged 1-4 (compared to 0.5 in 2019), so it’s important to be aware of the symptoms to look out for.
Stephanie adds, “Not all cases turn into iGAS and the number of iGAS cases are low, BUT we have to be vigilant of any signs of deterioration and worsening infection.”
GAS infections cause various symptoms such as sore throat, fever, chills and muscle aches.
The NHS advise to contact 111 or your GP if:
• Your child is feeding or eating much less than normal
• Your child has had a dry nappy for 12 hours or more or shows other signs of dehydration such as dark, strong smelling pee, feeling thirsty but going to the loo much less often than usual, or feeling dizzy
• Your baby is under 3 months and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher
• Your baby feels hotter than usual when you touch their back or chest, or feels sweaty
• Your child is very tired or irritable
• Your child is getting worse
And 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
• 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
“Trust your judgement,” says Stephanie, “If you as a parent feel something just isn’t right then contact your GP or out of hours. You know your child best.”
Treatment for Group A Strep
Since there are many viruses with similar symptoms at this time of year, local pharmacies, your GP or private GP clinics can offer throat swabs to confirm a diagnosis, but if a Group A Strep infection is suspected it’s most likely antibiotics will be started.
How can we stop infections from spreading?
Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap and warm water for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up, or spreading, infections.