What are the symptoms of Strep A and how contagious is it?

During the winter months there tends to be a rise in cases of invasive Group A strep (iGAS) infections in the UK.

The last time there was a notable rise in deaths from Strep A was in 2017/2018 when 27 children under the age of 18 died and 328 adults died.

What is Strep A?

Both children and adults carry Group A streptococcus (GAS) on their skin and in their throats as it is a common bacteria. It doesn’t always cause infections but when it does, these can be mild. However it can be a lot more serious and even fatal if it gets into the bloodstream or lungs.

What are the symptoms of Strep A?

The most common symptom of Strep A is a very sore throat. This is known as strep throat. It may also cause a rash, fever and headache.

Group A streptococcus (GAS) can cause infections in soft tissue, skin and the respiratory tract and is linked to pharyngitis, scarlet fever, tonsilitis, impetigo and cellulitis as well as a host of other infections.

These tend to be mild and rarely become serious.

Symptoms for scarlet fever are:

• Flu-like symptoms including a sore throat, swollen neck glands and a high temperature
• This can be followed by a rash which begins on the chest and tummy as small, raised red bumps and then will spread.
• You need to treat scarlet fever early with antibiotics to cut down the risk of complications such as pneumonia or an infection in the bloodstream.
• If scarlet fever or strep throat is not treated properly, rheumatic fever may develop.

Can you test for Strep A

GPs can carry out tests for Strep A and you can also buy them from Tesco, Boots, Superdrug and independent pharmacies. Strep A tests have been made widely available and affordable due to the outbreak of the illness in the winter of 2022.

The outbreak led to a shortage of tests and lengthy waits for the results which ended up with GPs handing out antibiotics without a diagnosis after pressure from worried parents.

Is Strep A contagious?

People with Group A strep can infect others by coughing or sneezing or through a wound. It is highly contagious and the bacteria can live in some people without making them ill but they are still contagious. You should stop being contagious 24 hours after taking antibiotics.

People with Group A strep can infect others by coughing or sneezing or through a wound. It is highly contagious and the bacteria can live in some people without making them ill but they are still contagious. You should stop being contagious 24 hours after taking antibiotics.

Is Strep A dangerous?

The invasive Group A strep (iGAS) is linked to the most serious infections and can be fatal. iGAS infections are uncommon. They occur when the bacteria gets into the lungs or bloodstream.

This can occur if the person has open wounds or sores enabling the bacteria to enter the tissue or if their immune system is low, such as if they are having cancer treatment.

The infections caused by iGAS are rare but can be very severe and even fatal. They include necrotising pneumonia, Streptococcal Toxic Shock Syndrome and necrotising fasciitis also known as ‘flesh-eating disease’. 

Early symptoms can include high fever, a rash, confusion, dizziness, low blood pressure and pain in the abdomen.

 The UK Health Security Agency is advising parents to call 999 or go to A&E if:

•    your child is struggling to breathe 
•   there are pauses when your child breathes
•    your child’s skin, lips or tongue have turned blue
•    your child seems to be floppy and will not wake up or stay awake

Who is at risk of catching Strep A?

People who:

•    have been in close contact with a person that has Strep A
•   are over the age of 65
•   have HIV
•   use steroids or other drugs
•   have diabetes, cancer or heart disease

Why is there a rise in cases of Strep A in children in the UK?

Health experts are saying it could partly be due to children having lower immune systems because of lack of social mixing during the Covid pandemic coupled with a higher amount of bacteria circulating.

What should parents do if they suspect their child has Strep A?

It can be hugely worrying for parents when their child is ill and with Strep A currently being linked with deaths of children, anxiety is running high.

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

Dr Colin Brown, deputy directorat the UKHSA, said: “The bacteria usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics. 

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

“Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”

The UK Health Security Agency is advising parents to ring NHS 111 or their GP if:

•  your child has unexplained vomiting or diarrhoea
•  if your child has severe muscle aches
•  they are eating much less than normal
•  your child is very irritable or tired
•  if your child is under three months old and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher
• your child has had a dry nappy for 12 hours or longer or appears to be dehydrated
•  your baby feels hotter than is usual when you touch their chest or back, or feels sweaty to the touch.

What is the best way to prevent infections from spreading?

Just as with Covid, parents are being advised to make sure their child washes their hands properly with warm water and soap for at least 20 seconds, uses a tissue to catch any sneezes and coughs and keeps away from other people when feeling unwell.

The UKHSA is also advising children and adults who have Strep A to stay away from nursery, school or work for at least 24 hours after they start antibiotic treatment.

Can adults get Strep A?

Yes people of any age can get Strep A but most will only have a mild infection.

How do you treat Strep A?

Strep A is treated with antibiotics. Strep A infections that are invasive and have entered the bloodstream or lungs need to be treated in hospital with antibiotics.