Group A Strep
Due to ongoing concern around group A Strep we have put together a quick guide to help understanding.
What Is Causes Strep Throat?
Strep throat is a common bacterial infection that can make your throat feel sore and scratchy. Viruses cause most sore throats. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep). Recently, invasive Group A streptococcus (iGAS) infection notifications remain unusually high for this time of year, particularly in children. Marked increases in scarlet fever notifications are also being seen (see below for Scarlet Fever).
Urgent UKHSA public health message to all GP practices
Investigations are underway following reports of an increase in lower respiratory tract GAS infections in children over the past few weeks, which have caused severe illness
A high burden of co-circulating viral infections may be contributing to the increased severity and complications through co-infection…early recognition and prompt initiation of specific and supportive therapy for patients with iGAS infection can be life-saving.
How do you get strep throat?
Group A strep bacteria are very contagious. Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing, which creates respiratory droplets that contain the bacteria.
- Respiratory droplets
- Direct contact
The incubation periods for someone exposed to group A strep bacteria is two to five days
What Are The Symptoms Of Strep Throat?
The most common symptoms of strep throat include:
- Sore throat
- Pain when swallowing
- Fever
- Red and swollen tonsils
- Swollen lymph nodes in the front of the neck
Do I need antibiotics for my sore throat?
Given the unusually high level of GAS, and viral co-circulation in the community, health care professionals are asked to have a low threshold to consider and empirically prescribe antibiotics to children presenting with features of GAS infection, including where secondary to viral respiratory illness.
However, traditionally, the use of antibiotics is guided by the Fever-Pain Score.
| Symptom | Yes | No |
| Fever in past 24 hours | 1 | 0 |
| Absence of cough or coryza | 1 | 0 |
| Symptom onset ≤3 days | 1 | 0 |
| Purulent tonsils | 1 | 0 |
| Severe tonsil inflammation | 1 | 0 |
| Score | |
| 0 – 1 | 13-18% chance of Strep infection |
| 2 | 30-35% chance of Strep Infection |
| 3 | 39-48% isolation of streptococcus. |
| 4 | 62-65% isolation of streptococcus. |
About 40% of throat swabs taken for a sore throat yield no growth. About 30% are streptococcal, 20% viral and 10% other organisms including Haemophilus.
What Are The Complications Of Strep Throat?
If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.
Can Strep Throat Cause Scarlet Fever?
Yes, group A Streptococcus (group A strep)can cause scarlet fever. These bacteria are also the cause of strep throat. The bacteria sometimes make a toxin (poison), which causes a rash — the “scarlet” of scarlet fever.
What Are The Signs Of Scarlet Fever?
One to 2 days after the illness begins, a red rash usually appears. However, the rash can appear before illness or up to 7 days later.
The rash may first appear on the neck, underarm, and groin (the area where your stomach meets your thighs). Over time, the rash spreads over the body. The rash usually begins as small, flat blotches that slowly become fine bumps that feel like sandpaper.
What tests do I need to investigate Strep Throat?
Consider taking a throat swab to assist with differential diagnosis or if the patient is thought to be part of an outbreak (to confirm aetiology), allergic to penicillin (to determine antimicrobial susceptibility) or in regular contact with vulnerable individuals
Additionally a full blood count and monospot may be helpful if glandular fever or blood dyscrasia is suspected
If you have any further questions or concerns about tonsillitis, or Group A Strep. please do book an appointment to discuss furthe
