What is Strep A?

With the arrival of the winter months, it was observed that there was a significant increase in epidemics, especially in children going to school. The outbreak, which can result in loss of life, has led to concerns in families. Yeditepe University Hospitals Infectious Diseases and Clinical Microbiology Specialist Prof. Dr. Meral Sönmezoğlu answered questions about the symptoms and treatment of Strep A disease.

“Some European countries (France, Ireland, the Netherlands, Sweden), except the UK, reported an increase in the number of cases of invasive Group A streptococcal disease (iGAS-Strep A) among children under the age of 10 in 2022, especially since September. During the same period, deaths associated with strep A disease were also reported in children under the age of 10 from other European countries, including France, Ireland, and the Netherlands. In France and the UK, the number of strep A cases observed in children was several times higher than before the pandemic in the same months.
The UK Health Safety Agency (UKHSA) announced that the report of streptococcal scarlet fever, which was 4,672 in the same period between 2017 and 2018, increased to 33,836 in 2022-2023. On the other hand, in the United States, after November 2022, the CDC warned health authorities about the increase in reports of Strep A-related pharyngitis and scarlet fever in children's age groups.”

What Are the Symptoms of Strep A?

Explaining the symptoms of the disease, Sönmezoğlu stated: “Group A streptococci are a common cause of infection and most often cause sore throat, middle ear inflammation, scarlet fever, and tonsillitis. In certain cases, especially in the elderly and people with weakened immune systems, infection can spread and cause serious conditions such as blood poisoning, meningitis, and toxic shock syndrome.
 Strep A bacteria are the most common cause of bacterial pharyngitis in school-age children. Strep A infections often cause mild illnesses such as sore throat, headache, fever, and a thin, red rash (scarlet fever). The incidence of GAS pharyngitis usually peaks in winter and early spring in Europe. Outbreaks are frequently reported in kindergartens and schools. GAS pharyngitis is diagnosed by rapid antigen testing and/or throat culture and treated with antibiotics and supportive care.”

Not Easy to Notice

Stating that it is not easy to distinguish the symptoms of the disease from other respiratory infections, Sönmezoğlu: "However, children with a severe sore throat, difficulty swallowing, resistant high fever, headache, and joint pains and whose general condition tends to worsen should be alerted and contacted to a health institution."

Who is at Risk For Strep A Virus?

Explaining the people at risk in the epidemic, Sönmezoğlu: "In rare cases, GAS bacteria can also cause a serious, life-threatening infection known as strep A disease, which can occur in the form of bacteremia, pneumonia or skin and bone infection (cellulitis, osteomyelitis, necrotizing fasciitis). Children with viral infections, such as chickenpox or the flu, are at higher risk for contracting strep A disease.”

Measures to be Taken Against an Outbreak

Referring to the measures to be taken regarding the protection from the epidemic, Sönmezoğlu: “All European countries should be alert to the similar increase in cases among children, especially given the increase in respiratory virus circulation that is currently occurring in Europe. Infections can initially occur with very nonspecific symptoms (fever, general fatigue, loss of appetite), but can quickly progress to serious illness, especially in children. For this reason, parents and school officials should be aware of the alarming symptoms and refer them to further evaluation if they worsen. Seasonal influenza and vaccination against COVID-19 should also be encouraged, as the prevention of viral diseases can be important in reducing the risk of strep A disease.

Adequate hand and respiratory hygiene, as well as good indoor ventilation, should continue to be emphasized as important protective measures during this winter season. Schools and other educational institutions where Strep A infections are reported should follow cleaning and disinfection instructions for toys and frequently touched surfaces.”

Press Coverage: posta