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Group A Streptococcus (group A strep) Children's Wisconsin

Invasive group A strep: What parents need to know about the infection

Parents may have read or heard about more kids being treated for invasive group A streptococcal (iGAS) infections. Increases of this bacterial infection have been seen across the world in 2022 and 2023, and a noted outbreak in the United Kingdom started in September 2022. You might be thinking, “Isn’t that just strep throat? Is this something I should be concerned about? What should I know?”  

Can it be treated? Is it rare?

Yes and yes. First, I want families to know that while iGAS infections have increased, they remain rare, and it is even more rare that cases result in serious long-term complications or death. As one of the largest health systems focused on kids, teams at Children’s Wisconsin have experience treating kids with iGAS, even recently. When a child is diagnosed with iGAS, antibiotics are typically successful at treating the bacterial infection and kids typically make a full recovery. 

What is iGAS?

Many families are familiar with strep throat, which is caused by a bacteria called group A streptococci (GAS). To learn more about strep throat, you can read this blog from Robyn Labarge, MD, a pediatrician at Children’s Wisconsin. While uncommon, it is possible for this same bacteria to invade deep tissue or the bloodstream. When this occurs, it is called invasive group A streptococci, or iGAS.

These more severe, invasive infections require medical attention, hospitalization, antibiotics and sometimes surgery.

The vast majority of children will have no complications from a GAS infection or strep throat. Once antibiotics are started, most children begin to feel better quickly. If your child is on antibiotics for a GAS infection, be sure to complete the antibiotics as prescribed.

 What Description Examples of diseases it can cause
 Group A streptococci (GAS)

Bacteria that can cause many different infections. There are more than 120 strains of GAS bacteria.

Most infections from GAS are mild and impact the skin and throat.

  • Strep throat
  • Tonsillitis
  • Cellulitis
  • Impetigo
  • Antibiotics
 Invasive group A streptococcal (iGAS)

When GAS bacteria enter the deep tissue of the body or the blood stream through trauma to the skin, puncture wounds or mucus, it becomes iGAS.

iGAS infections are more severe than GAS infections.

  • Toxic shock syndrome
  • Septic shock
  • Necrotizing fasciitis
  • Bone and joint infections
  • Severe pneumonia
  • Rapid medical attention
  • Antibiotics
  • Hospitalization
  • Surgery

For more information on iGAS complications, please refer to the Centers for Disease Control and Prevention (CDC) website.

What can parents look for?

Families should seek medical care immediately if they notice a change in their child’s mental state or alertness. Examples of this include: 

  • Talking incoherently

  • Not responding to you or their environment

  • Not being able to hold a conversation or answer questions

As a parent, these are changes you’ll likely notice even if you hadn’t read this blog. The symptoms are obvious signs that your child needs medical help. Medical professionals will determine what is causing these symptoms, which may or may not be iGAS.

Additionally, if your child has been diagnosed with a virus but does not improve, or gets worse, after five days, seek medical care. Signs to look for include pain of an extremity or inability to bear weight and skin redness or pain that is rapidly expanding.

What does iGAS have to do with viral season? 

Children are more prone to iGAS if they have recently had, or currently have, viral infections like the flu or chickenpox. This is due to the virus causing irritation of the nose, mouth, throat or skin, allowing the bacteria to more easily access the blood stream or lungs. Also, with a recent or current viral infection, the immune system is already working hard to fight off the virus, which puts the body at greater risk for other infections.

Unlike bacterial infections, viruses (like the flu, COVID-19 and RSV) are not treated with antibiotics because they do not respond to them — viruses have different structures and replicate differently than bacteria do. 

How can you prevent an iGAS infection? 

While there is not a vaccination for strep throat, there are viral illnesses you can be vaccinated for — namely the flu, chickenpox and COVID-19. Vaccinations help reduce the severity of the illnesses and keep people out of the hospital. The best treatment is prevention and that’s where vaccinations can help.

Like other illnesses in the community, strep throat (one of the GAS infections) is contagious. iGAS is a complication of a GAS infection, so to help prevent iGAS complications, we can all do our part to prevent the spread of GAS in the community. 

Here are some things you can do:

  • Wash your hands often with warm water and soap. Or, use an alcohol-based hand cleanser that contains at least 60 percent alcohol.

  • Clean all surfaces with a disinfectant cleaner or wipes.

  • Monitor your own health and that of family members and playmates. Try to prevent contact between your child and those with a fever. 

  • Do your part by keeping sick family members home from school or work.

  • Cough and sneeze into your elbow.

  • Don’t share eating utensils, dishes or drinking glasses, and be sure to wash them in hot, soapy water after each use.

  • Don’t share food, drinks, napkins or towels with sick family members.

As always, if you have questions about your child’s health, don’t hesitate to call your pediatricians’ office. Children’s Wisconsin is ready to answer any questions you might have regarding GAS or iGAS.