Strep A has been making headlines in the U.S. and Europe after the United Kingdom Health Security Agency (UKHSA) announced higher-than-usual cases of invasive Group A streptococcus (iGAS), a rare but severe strep A infection, in children in the U.K this season. These severe cases have led to 60 deaths — 15 of them in children under 18 — since September.
The Centers for Disease Control and Prevention (CDC) is also looking into a potential spike in iGAS cases in children in the U.S. As of Nov. 1, two American children have died from strep A infections.
Although the news of severe strep A infections and deaths are worrisome, the vast majority of these infections are mild and can be treated at home, Dr. Tiffany Kimbrough, a pediatrician at Children’s Hospital of Richmond at VCU, tells Yahoo Life.
However, experts say it’s important for parents to know the signs of a strep A infection — and when to see a doctor.
First, how do you get strep A?
Strep A, also called group A Streptococcus (group A strep), is a type of bacteria that tends to infect the upper respiratory tract, causing infections such as strep throat but also skin and respiratory infections, Dr. Kiley Trott, pediatric otolaryngologist at Yale Medicine, tells Yahoo Life. These skin infections include impetigo and cellulitis.
Strep A is highly contagious, easily spreading from person to person, Katie M. Acquino, medical director of Baptist Health Urgent Care Express Palm Beach, tells Yahoo Life. “Some of the most common ways it can spread is through close contact with somebody that has strep, by sharing food, drinks or even breathing in their air droplets,” she says.
You can also get it from touching a surface with the bacteria, and then touching your eyes, nose or mouth, notes Kimbrough, or by touching the sores or fluid from the sores on the skin of a person with strep A.
What are the symptoms of a strep A infection?
The most common symptom of strep A is a sore throat, often referred to as strep throat, says Kimbrough. “It can be quite painful, especially when swallowing,” she says. Although strep throat can occur at any age, it’s most common in children and adolescents ages 5 to 15.
Other strep A infection symptoms include fever, headache, swollen lymph nodes in the neck, tiny red spots on the back roof of the mouth, red and swollen tonsils, white patches on the tonsils, nausea or vomiting (especially in young kids) and rash, according to Kimbrough. However, she points out that cough and runny nose are not typical strep A symptoms and are more likely signs of a viral infection.
Another sign of a strep A infection is a rough, red rash on the face that then spreads to other parts of the body. That can be a sign of scarlet fever, which typically appears within a few days of a strep A infection.
When is a strep A infection serious?
Most times, strep A only causes a mild to moderate illness, says Acquino. But in rare cases, it can become severe if left untreated or if the bacteria spread to other parts of the body.
Invasive group A strep, which causes the most serious strep A infections, occurs when the bacteria enter the body and evade its defenses, says Trott. This invasion can happen when a person has open sores or other breaks in the skin that allow the bacteria to enter the body.
Trott also notes that people with health conditions that weaken the immune system, such as diabetes, cancer or kidney disease, are prone to iGAS when they have strep A.
Serious and life-threatening illnesses such as necrotizing fasciitis (flesh-eating disease), meningitis (inflammation of the membranes covering the brain and spinal cord) or toxic shock syndrome occur with iGAS as well, according to Trott. Other severe strep A complications, says Acquino, include rheumatic fever and a kidney disease known as post-streptococcal glomerulonephritis.
Acquino recommends that parents get their child tested for strep when they have sore throats, to reduce their risk of strep A complications — particularly if the sore throat is severe and comes on suddenly and is also accompanied by fever of 101 degrees or more, difficulty swallowing or swollen lymph nodes.
If your child experiences symptoms such as swelling, decreased alertness, rapid breathing, changes in skin color, ulcers or blisters on the skin, severe stomach pain or decreased urination, Kimbrough recommends seeking immediate medical help.
How is strep A typically treated?
Many strep A symptoms look like those of viral infections, such as influenza, says Kimbrough. So before prescribing treatment, a doctor will take a throat culture with a quick swab along the back of the throat.
If the test returns positive for strep A, antibiotic treatment may be prescribed — typically penicillin or amoxicillin — for 10 days. Antibiotics are also used to treat scarlet fever. However, finding amoxicillin may not be easy — as Kimbrough points out, the U.S. is currently experiencing an amoxicillin shortage.
Acquino notes that the shortage primarily affects oral suspension of amoxicillin, which is mostly prescribed for children. “Currently, we have had a few pharmacies call us after prescribing an antibiotic, particularly amoxicillin, informing us that they don’t have the dose that we prescribed, but they have been able to change the dose or delivery method,” she says. That might mean having to “switch liquid medication to chewable or even tablets,” Acquino says. “Tablets can be crushed and sprinkled into liquids or food such as applesauce” to make the medicine easier for kids to swallow.
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