Group A Streptococcus

Group A Streptococcus Patient Information

There has been an increase in child deaths as a result of invasive Group A Streptococcus over the recent months. This page will provide you with information on Group A streptococcus, the signs and symptoms and how to manage it. Please note that in any situation, if you concerned about your child’s health you should contact NHS 111, seek advice form your GP, call 999 or go to A+E depending on the severity of your concern.

The current rise in numbers is approximately 4-5 times that seen in the pre-pandemic season (2017-2019) and it is not currently thought that the rise in deaths is due to a new strain but rather an increase in circulating bacteria and in social mixing with subsequent transmission.

What is Group A Streptococcus?

Group A Streptococcus (GAS) is a common bacterium that we carry in our throats and skin. Usually, this bacterium causes a mild illness such as a sore throat but in some patients the disease takes a hold on the body and becomes aggressive. We call this invasive group A strep (iGAS). The disease becomes invasive when the bacterium gets into the blood stream or the lung tissue and in some of these cases it can be fatal.
GAS commonly causes infections in the skin, soft tissue and respiratory tract (throat, airways and chest). This results in tonsilitis, pharyngitis, impetigo, cellulitis and scarlet fever. Tonsilitis is one of the most common reasons for seeking medical help and once starting treatment most children will stop being contagious after 24 hours.

How is GAS spread?

GAS can be passed on by coughing, sneezing or from direct contact eg by touching. Some people will be classified as “carriers” where they are not unwell but can pass the bacterium on to others where it can cause disease and make them unwell.

How do we stop infections from spreading?

Good hand washing and avoidance of respiratory transmission is essential to minimise transmission. The use of face masks in situations where there is a lot of social mixing may also help.

How is Group A Streptococcus Treated?

Group A Streptococcus is usually very sensitive to antibiotic treatment particularly if given in the early stages of treatment. Antibiotics that are commonly used include Penicillin V (Phenoxymethylpenicillin), Amoxicillin and Co-amoxiclav. These drugs should NOT be used if you have a penicillin allergy. If you have a penicillin allergy there are alternatives that can be used such as Azithromycin or Cephalexin. Your doctor will help determine the best drug for you.

What should parents look out for?

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

Look out for symptoms which might include:
Sore throat
A fine, pink or red sandpapery rash on the body

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.

Contact NHS 111 or your GP if:

  • your child is getting worse
  • 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
  • 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

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


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