What You Need to Know About: Group A Streptococcal Disease

A. "Strep" is short for Streptococcus - a specific type of bacteria. Strep bacteria are divided into groups. Most strep that can cause disease in people belong to Group A. The bacteria often are found in the throat or on the skin, but they don't cause illness. Group A strep (also known as GAS) can cause very different diseases like strep throat, rheumatic fever, scarlet fever, impetigo, ear infections, and pneumonia. Special types of Group A strep, known as types M-1 and M-3, can invade body tissues. This is why the word "invasive" is used with the name of the infection.

Q. How is strep throat different from invasive Group A Strep?

A. If Group A strep bacteria infect the throat, the patient will have strep throat: a severe sore throat with a fever and swollen glands. Doctors will usually test to see if the patient has strep throat. There are two reasons for doing this test. First, if strep are found, the doctor knows to treat the patient with antibiotics and to keep the strep from spreading to other parts of the body. Second, because strep throat is contagious, the patient can be told to stay home from school, work, or other activities until the antibiotics fight the infection. The Group A strep involved in strep throat are not usually the invasive type.

The M-1 and M-3 types of Group A strep, on the other hand, have specific characteristics that let them quickly infect and spread throughout the body. A massive infection can lead to a dangerous, life-threatening condition.

Q. What are the symptoms of invasive Group A Strep infection?

A. There can be many different types of symptoms of this disease because the bacteria can affect so many different parts of the body. Only a doctor can tell whether the illness is Group A strep.

Invasive Group A strep infection can feel like the flu, but the symptoms get worse instead of better after a couple of days. Invasive GAS can also begin in a part of the body such as a hand or leg and spread to parts of the body where bacteria are not normally found, like the blood, muscles, and lungs.

Two of the most severe kinds of invasive GAS disease are called necrotizing fasciitis and streptococcal toxic shock syndrome. But they are also the forms that people are least likely to get.

In necrotizing fasciitis, the GAS bacteria destroy muscle and fat. Because of this, people sometimes call it "flesh-eating bacteria." Streptococcal toxic shock syndrome is an infection that moves quickly, causing shock and injury to internal organs such as the kidneys, liver, and lungs.

Q. How is GAS spread?

A. The bacteria are spread when infected people cough or sneeze. However, people who look healthy and who carry the bacteria can also spread the disease. But this type of infection is not as contagious. The bacteria can also be spread by touching infected wounds or sores. Many people come in contact with GAS bacteria, but few get sick at all (not even a sore throat). Even fewer people will get invasive GAS disease.

Q. Is there any treatment?

A. Antibiotics are very effective in treating invasive GAS disease if they are given to patients early. However, even antibiotics can't always prevent illness or even death in some cases.

Q. What can I do to protect myself and my family?

A. The following steps will help prevent the spread of infection:

• Keep sores clean and covered.

• Cover your mouth and nose when you sneeze and cough.

• Wash your hands often using hot water and soap.

• Don't share toothbrushes or eating utensils.

• Vaccinate children over 1 year of age against chickenpox (Some children get invasive GAS infection right after they've had the chickenpox).

Consult a physician if

• You are an adult with a temperature of 101F or more or your child has a temperature of 103F or more.

• You have a sore throat with fever.

• You feel like you have the flu but feel worse after 3 or 4 days.

• You have pain for no known reason or a sore that becomes red, swollen, and painful.

• Your child has chickenpox and a fever that lasts more than 3 days.

• Three or 4 days after your child gets chickenpox, his or her temperature goes up, or the child has difficulty breathing, loss of appetite, or sores that look infected.

Q. Why are so many people getting Group A Strep?

A. About one-fourth of the population has GAS bacteria in their noses and throats during winter months. No one knows why some people get sick and others don't.

Most strep infections, including strep throat and invasive GAS, normally occur during December, January, and February. More cases are seen in some years than in others, however, invasive GAS infection is a very rare disease.