The symptoms – and what to do

What is strep A?

The strep A bacterium can cause many different infections. It is commonly found in the throat and on the skin, and lots of people have it without even knowing and do not come to any harm.

However, they can spread it to others who may become ill. People can catch it through close contact and from coughs and sneezes. Outbreaks sometimes happen in places such as schools. Most health problems caused by strep A are mild, but in some cases they are serious and even deadly. Diseases include the skin infection impetigo, scarlet fever and strep throat.

What are the symptoms?

Strep throat is different from a regular sore throat and the pain can come on very quickly. Symptoms include pain when swallowing, fever, and red and swollen tonsils – sometimes with white patches or streaks of pus.

The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands.

A rash appears 12 to 48 hours later that starts on the chest and stomach, then spreads. A white coating also appears on the tongue that peels, leaving the tongue red, swollen and covered in little bumps, which is often called “strawberry tongue”. Impetigo starts with red sores or blisters that then burst, leaving crusty, golden patches. Very rarely, strep A can cause severe illness when the bacteria get into parts of the body that are usually free from them. This is called invasive group A streptococcal disease.

What is invasive group A streptococcal disease?

If bacteria invade lungs, blood or muscles the situation can be potentially life-threatening. Two of the most severe but rare forms are necrotising fasciitis and streptococcal toxic shock syndrome. Necrotising fasciitis is also known as the “flesh-eating disease” and can occur if a wound gets infected. Signs of necrotising fasciitis include fever – above 38C – severe pain and swelling, and redness at the wound site.

Streptococcal toxic shock syndrome is a rapidly progressing infection causing low blood pressure or shock, and damage to organs such as the kidneys, liver and lungs. Early signs may include fever, dizziness, confusion, rash and abdominal pain.

How can strep A be treated?

Strep A infections such as scarlet fever and impetigo are treated with antibiotics. After a full 24 hours of treatment, people are generally thought to no longer be contagious. Anyone thought to have invasive group A streptococcal disease should seek medical help immediately. Antibiotics and intensive medical attention are likely to be needed.

Why is strep A an issue now?

Health experts say that since the easing of Covid restrictions in the UK there have been more opportunities for other infections to spread. Cases have been rising in recent weeks. Microbiologists believe that reduced mixing among children over the past two years may have caused a drop in population-wide immunity that may result in an increase in transmission, particularly among school children.