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Worried mother checking daughter temperature

Understanding Strep A

By Dr. Douglas Mitchell, Norfolk Pediatrics

The Centers for Disease Control and Prevention announced in December that it is looking into a possible increase in invasive group A strep infections among children in the United States. While extremely rare, invasive group A strep infections can be life-threatening. Here's what parents need to know to put this information in perspective.

Understanding Group A Strep

Group A strep is a very common type of bacteria found in the throat and on the skin. It causes millions of mild infections every year. Two of the most common are impetigo, a skin infection that causes crusty skin sores, most often around the nose and mouth of children, and strep throat, which typically causes a sore throat and fever. Doctors have a rapid test for strep throat that can often confirm the diagnosis during an office visit. Amoxicillin (or an alternative antibiotic for those with penicillin allergies) usually gets children back on their feet in 24-48 hours.

Your doctor's office can tell you if your child's symptoms warrant a strep test. A simple sore throat without fever is not a reason to test. Children under the age of 3 and those who do not have symptoms do not need to be tested.

Invasive Group A Strep Infections

In rare cases, strep A bacteria can enter places inside the body where they are not typically found, such as the bloodstream, lungs, heart or the fluid that surrounds the central nervous system. These are called invasive Strep A infections or iGAS.

While infrequent, these infections can be very serious, and even life-threatening. They are most common in children under age 1, children recuperating from influenza or chickenpox, children whose skin has been disrupted by an injury or eczema, and in those with compromised immune systems. A child with an invasive group A strep infection will have symptoms. These are not illnesses like COVID-19, that children can have without seeming sick or showing symptoms.

Symptoms depend somewhat on the site of the infection, and include the following:

  • For skin infections: warmth, redness, swelling or severe pain of the skin, especially around a wound, and especially if the symptoms are spreading.
  • For other infections: fever, chills, headache, generally unwell feeling, rapid breathing and increased heart rate.

Parents should seek medical advice and care for children showing these symptoms.

Although it is unknown at this time why children in certain parts of the world may be experiencing more invasive group A strep infections, officials from the CDC and World Health Organization are investigating whether the recent rise in viral infections may be playing a role. Viral infections can affect a child's immune system, making it easier for a secondary bacterial infection to take hold. This is another good reason to make sure your child is immunized against influenza and COVID-19.

Preventing Illnesses

You can help prevent spreading group A strep by washing your hands often, especially after coughing or sneezing and before preparing foods and eating. Keep wounds clean and seek medical attention if you see signs of infection such as redness, swelling, pain or drainage.

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About CHKD Medical  Group Children’s Hospital of The King’s Daughters has been the region’s most trusted name in pediatric care for more than 50 years. As members of CHKD Health System, our pediatricians work closely with CHKD’s full range of pediatric specialists and surgeons. They also share a commitment to quality, excellence and child-centered care. With 18 practices in 29 locations throughout the region, a CHKD pediatrician is never far.

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