Cases of Life-Threatening Strep Infections Are on the Rise

Kids get sick – a lot. It’s how their immune system grows and develops. While natural, parents and guardians are often left to decipher whether their child’s sickness warrants a visit to the doctor or if some rest and watchful waiting should do the trick.

If you suspect your child has strep – as in he or she is experiencing a sore throat, fever and painful swallowing – bring your child in to see a doctor.

“Severe or not, all cases of strep should be seen by a doctor,” advises Liborio LaRussa, MD, Chief, Pediatric Hospital Medicine, Lehigh Valley Reilly Children’s Hospital. “Recently, we have been seeing a rise in cases of the invasive form of group A strep in children, which can be life-threatening if it’s not caught early and treated right away.”

As it turns out, Lehigh Valley Reilly Children’s Hospital isn’t alone in its findings. The Centers for Disease Control and Prevention (CDC) is looking into reports of a possible increase in invasive group A strep (iGAS) infections across the United States.

iGAS is a dangerous but rare disease that causes severe illnesses and can be deadly. Dr. LaRussa explains what you need to know about iGAS and how to protect your family.

Normally, group A strep (GAS) isn’t a major cause for concern, most often causing strep throat and scarlet fever. However, when GAS spreads to areas of the body that normally don’t have any bacteria (e.g. the blood, spinal fluid or joint fluid), it results in the more severe infection known as invasive group A strep (iGAS).

“Some people carry strep A bacteria in their throat without it causing an infection,” explains Dr. LaRussa. “But if they’re sick from a virus or catch strep from someone, the bacteria can invade their body through the mucous membranes in the nose and throat. This can cause the type of severe disease we describe as invasive group A strep infection, which can be deadly especially for children.”

iGAS can cause severe illnesses, such as "flesh-eating" skin infections, pneumonia and toxic shock syndrome. It also can be deadly, with the CDC reporting that iGAS leads to 1,500 to 2,300 deaths in the United States annually.

Early symptoms of iGAS include a fever, restlessness or uneasiness that’s accompanied by a sore throat, a skin infection or follow a minor injury. Severe symptoms can develop rapidly and include a purple-colored rash that looks like bruising, lethargy or an altered mental state, and signs of shock.

“Toxic shock syndrome and “flesh-eating” skin infections can be a sign that a strep infection is invasive,” Dr. LaRussa says. “So, parents and guardians should keep an eye out for signs of these conditions.”

Symptoms of toxic shock include fever, chills, muscle aches, nausea and vomiting. Early signs of a serious skin infection include a fast-spreading swollen area of skin, severe pain and fever. Later on it might look like blisters, changes in skin color, or pus at the infected area.

While Dr. LaRussa advises that all cases of strep should be seen by a doctor, you should bring your child for medical evaluation if: a minor injury is associated with high fever or lethargy, signs of skin infection or a purple-colored rash is associated with fever and illness, or if your child appears ill out of proportion to what you expect from a sore throat.

Most GAS cases are mild and can be treated with oral antibiotics as an outpatient. However, for children with signs or symptoms of more severe illness, a period of observation in a hospital such as Lehigh Valley Reilly Children’s Hospital may be warranted. If diagnosed with iGAS, treatment includes IV (intravenous) antibiotics and other supportive measures to maintain vital organ function.

Strep spreads through coughs and sneezes, as well as by drinking from the same glass as someone who is sick or by touching a surface with strep and then touching the nose or mouth. Practicing good hygiene – like washing hands, surfaces and plates or glasses – can keep it from spreading.

“The focus should be on trying to prevent contagious diseases in general including strep by staying home when sick, avoiding sharing germs and getting vaccines,” Dr. LaRussa explains.