Group A Streptococcal infections

Group A Streptococcal (GAS) infections are caused by bacteria that are normally found on the skin or in the throat. Most illnesses are mild and may include strep throat, sinus infections, skin or wound infections or fever and rash (scarlet fever). Sometimes the bacteria get into areas of the body where bacteria are not usually found, such as the blood, muscle or the fluids surrounding the lungs, spine brain, or other internal organs. These infections are called “invasive” Group A Streptococcal Infections (iGAS) and are the most serious. These can include lung infections, such as pneumonia, flesh-eating disease (necrotizing fasciitis), which is a quickly progressing infection that destroys skin and muscle tissues or toxic shock syndrome, which occurs when the bacteria produce toxins that could cause organs in the body to stop functioning.

Diagnosis is based on assessment of clinical symptoms by a health-care provider and laboratory testing.

Some people can carry Group A Streptococcal bacteria with no signs or symptoms of infection. This is called asymptomatic carriage and may occur in five to 20 percent of the population. For those who develop symptoms, early signs of non-invasive invasive Group A Streptococcal infection may include sore throat, fever, rash or a skin infection that is red, swollen, warm and tender to the touch. 

The signs and symptoms of invasive disease are severe pain, swelling and redness of the affected area, dizziness and confusion, widespread red rash, nausea, vomiting and abdominal pain. The development of symptoms can be rapid in invasive disease.

Group A Streptococcal bacteria can be spread by direct contact with infected wounds on the skin or fluids from the nose or throat of infected persons, such as when an infected person coughs or sneezes.

Anyone can become infected with Group A streptococcal (GAS) bacteria. However, some conditions or factors may put you at higher risk of invasive GAS (iGAS) disease. These may include breaks in the skin (cuts, open sores, chickenpox, burns on the skin), having a chronic disease, living in a crowded or unsanitary environment, being ill or having a weakened immune system, substance abuse (including use of injectable drugs) or recent close contact with someone infected with GAS or iGAS. 

Antibiotics are used to treat both invasive and non-invasive GAS diseases. Early treatment can reduce duration of symptoms and prevent more serious complications. You can remain infectious until after 24 hours of antibiotic therapy. Taking measures to reduce contacts and practicing good hygiene while sick can reduce transmission of the bacteria.

Health-care providers, hospitals and laboratories, schools and childcare centres must report cases to Public Health. Public Health staff will interview the health-care provider and patient (or caregivers) to find out how the infection occurred, identify other people at risk of infection, implement control measures (such as immunization and restrictions on attending school, work or childcare) and provide other advice. 

Hand washing, especially before eating, before preparing food and after coughing and sneezing, helps reduce the spread of all types of GAS disease. To protect others, you should cough or sneeze into the bend of your arm, not your hand. Throw tissues away immediately after using them. 

There is no vaccine available for iGAS, but it is important to get vaccinated for respiratory viruses like influenza and chickenpox to limit the likelihood of serious infection. The risk of iGAS infection is known to be significantly higher in people with recent diagnosis of varicella infection or Influenza.

For additional information, contact your health-care provider, local Public Health office or Tele-Care 811.