Streptococcal Infections - Invasive Group A

Man holding his throatWhat is Group A Streptococcus?

Group A Streptococci (GAS) bacteria can cause many different infections that are mostly mild, such as:

  • Strep throat
  • Tonsillitis (infection of the tonsils)
  • Scarlet fever
  • Ear infections
  • Skin infections
  • Wound infections

Sometimes the bacteria can get into certain parts of the body and cause very serious infections (invasive). One way this can happen is if a mild infection is  left untreated. GAS can cause  invasive (or severe) infections like:

  • Bacteremia (infection in the blood)
  • Pneumonia (infection in the lungs)
  • Necrotizing fasciitis (flesh-eating disease)
  • Toxic shock syndrome

Symptoms usually start one to three days after being exposed.

What are the symptoms?

Mild infections may include:

  • Sore throat
  • Flu-like symptoms (fever, chills, muscle aches, nausea, vomiting, diarrhea).
  • Headache
  • Sudden fever
  • Painful, red swollen skin

Invasive infections may include:

Necrotizing Fasciitis:
  • Changes in skin colour
  • Flu-like symptoms like fever, chills, nausea, muscle aches, vomiting, and diarrhea.
  • Blisters on the skin
  • Painful, red, hot, and swollen areas.
  • Extreme pain or pain which seems too great for an injury.
Streptococcal toxic shock syndrome:
  • Fever.
  • Flu-like symptoms (fever, chills, muscle aches, nausea, vomiting, diarrhea).
  • Dizziness
  • Confusion.
  • Quick onset of generalized or localized pain, often in an arm or leg.
  • A flat red rash over large areas of the body.

How is it spread?

GAS bacteria are commonly found in the nose and throat and on the skin of healthy people, especially in children. These individuals are called carriers and are also able to spread the germs to others. Infected people such as people sick with strep throat or skin infections are more likely to spread the infection to others.

It is spread person-to-person by:

  • Breathing in the bacteria after a person coughs or sneezes the germs into the air.
  • Direct contact with a person’s saliva, nasal, or wound discharges such as wiping a child’s nose, kissing, mouth-to-mouth resuscitation, or through direct contact with infected sores on the skin.

It can also be spread by sharing contaminated needles.

What are the complications?

Most individuals who come in contact with GAS bacteria get a mild throat or skin infection; few will develop a severe invasive disease. People that are at a higher risk for developing an invasive disease are:

  • Those with chronic illnesses or who are immunocompromised.
  • People less than 1 year of age or over 60 years of age.
  • Those with skin lesions (such as cuts, chicken pox, or surgical wounds).
  • Injection drug users.
  • Alcoholics.

Is there treatment?

GAS infections are treated with antibiotics.

How can GAS be prevented?

Frequent hand washing with soap and water, or the use of alcohol-based hand sanitizers is very effective at removing bacteria on the hands. This helps to stop the spread of infections.

Always wash hands:

  • Before preparing, serving, or eating food.
  • After visiting public places (schools, shops, work, or others homes).
  • After giving first aid or touching an infected sore.
  • After using the bathroom.

Other tips to help prevent GAS:

  • Tissues should be used for runny noses, to cover coughs, or sneezes. Hands should be washed or sanitized after touching used tissues.
  • Coughing or sneezing into your elbow prevents spreading the germs to your hands.
  • Covering the mouth when sneezing and coughing followed by hand washing or hand sanitizing can also help to stop the spread of infections.
  • Be careful when handling knives, drills, saws, and other sharp objects. This may prevent breaks in the skin that could allow bacteria into your body.
  • Be sure to keep all wounds clean and watch for signs of infection (redness, swelling, pus or  pain). If you experience pain out of proportion to an injury or develop a fever, see your healthcare provider.

Health Care Providers

Suspected cases are reportable to the Health Unit immediately by telephone.