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Group A Streptococcal infection

What is it?

Group A Streptococcus (GAS) is a common bacteria. Lots of us carry it in our throats and on our skin and it doesn’t always result in illness. However, GAS does cause a number of infections, some mild and some more serious. 

GAS causes infections in the skin, soft tissue and respiratory tract. It can be responsible for infections such as Tonsillitis, pharyngitis, scarlet fever, Impetigo and Cellulitis among others.

While infections like these can be unpleasant, they rarely become serious. When treated with antibiotics, an unwell person with a mild illness like tonsillitis stops being contagious around 24 hours after starting their medication.

Scarlet fever is a common illness associated with GAS. The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper. The rash will be less visible on darker skin but will still feel like sandpaper.

More information on scarlet fever can be found on the NHS website, including photos, and you’re encouraged to have a look and familiarise yourself with the signs and symptoms.

What is invasive group A strep?

The most serious infections linked to GAS come from invasive group A strep, known as iGAS.

These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. This can happen when a person has sores or open wounds that allow the bacteria to get into the tissue, breaches in their respiratory tract after a viral illness, or in a person who has a health condition that decreases their immunity to infection. When the immune system is compromised, a person is more vulnerable to invasive disease. Children who have had chickenpox or flu recently may develop more serious infection. In rare cases an iGAS infection can be fatal.

Whilst iGAS infections are still uncommon, there has been an increase in cases this year, particularly in children under 10 and sadly, a small number of deaths.

What should parents/carers do?

  • Be vigilant for the symptoms of GAS/scarlet fever and seek medical advice from your GP or by calling 111 if you or your child have any. 
  • Ensure your child takes the full course of any antibiotics prescribed.
  • Stay at home, away from nursery, school or work for at least 24 hours after starting the antibiotic treatment, to avoid spreading the infection (48 hours after starting antibiotic treatment in the case of Impetigo).
  • Children who have had chickenpox or flu recently may develop more serious infection during an outbreak of scarlet fever and so parents should remain vigilant for symptoms such as a persistent high fever, cellulitis (skin infection) and arthritis (joint pain and swelling). If you are concerned for any reason, please seek medical assistance immediately.
  • If your child has an underlying condition which affects their immune system, you should contact your GP or hospital doctor to discuss whether any additional measures are needed.
  • Encourage your child to wash their hands properly with soap and warm water for 20 seconds and use a tissue to catch coughs and sneezes. Keep them away from others when feeling unwell. This will help to reduce the risk of picking up, or spreading, infections.
  • Any cuts, sores or bites should be thoroughly cleaned and covered.
  • Keep your child’s school or nursery informed and updated on any diagnosis your child is given.

What to do 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.

Last updated: 07/12/2022 16:10

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