What is Group A Strep?
Group A Strep (iGAS). Let’s talk about the basics: what is it, why you should know about it, and what you can do and a little bit more on knowing the signs of sepsis.
Group A streptococcus is a common bacteria or germ that most of us carry it in our throats and/or on our skin and it doesn’t always cause problems. However, Group A streptococcus can cause a number of infections tonsillitis, pharyngitis (throat), impetigo and cellulitis (Skin). Some mild, some more serious.
It can also cause scarlet fever in children. The first signs of scarlet fever can be flu-like symptoms: fever, a sore throat and swollen neck glands. The rash appears 12 to 48 hours later. It looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash feels rough, like sandpaper. It can be hard to see sometimes on darker skin but still feels like sandpaper.
The most serious infection caused when it becomes “invasive”. This means the bacteria gets into parts of the body like the lungs or bloodstream and can cause serious infection. We are talking about it because we have seen a higher amount of iGAS than we would expect. Experts are exactly sure why yet. There have been 25 deaths since October 2022, 12 in children under 18. Other countries are also seeing higher than normal levels of iGAS – not just Ireland. Anyone can get iGAS, not just children. Other high risk groups include newborns, those who are 75 or older, women who are pregnant for 37 weeks or more or those who gave birth in the last 28 days, and people of any age who have recently had chickenpox.
What’s the best advice?
Practice good hand washing and respiratory hygiene. Teach your child how to wash their hands properly with soap and warm water for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others (and out of childcare or school) when they are feeling unwell, they will be able to reduce the risk of picking up, or spreading, infections. Do not share personal items like facecloths, razors, nail clippers. Clean wounds (soap and water is fine) and keep them covered with a clean plaster.
Keeping your child up to date with their vaccines will also help them to keep well. (Because there are other – preventable! – things, like measles, that are also circulating at high levels right now, too!) There is no vaccine against GAS, but there are vaccines that can help such as chickenpox vaccine. Data from the UK over a 4 year period suggests that the nasal flu vaccine (available in October every year) may reduce Strep A infections in children. If you are vaccine hesistant, that’s okay. But don’t just hesitate. Make an appointment to discuss your concerns with your child’s GP.
When to get help: how would I know if my child has Group A Strep?
It’s actually this simple: If you are worried, seek help. Always seek qualified medical help if you are worried about your child. It can be very hard to know, but your child relies on you to be their voice for accessing medical care. Trust your gut – not Dr. Google, not the comments section on social media – when you know your child isn’t right.
So, while we are here, it’s worth talking a moment about sepsis: Even if it’s not iGAS, there are other infections that can cause serious illness, especially in children.
“Sepsis” is a serious complication of an infection. There are a lot of awareness campaigns for sepsis because it can be hard to tell. There are lots of possible symptoms. Symptoms can be like symptoms of other conditions, including flu or a chest infection.
Anyone can get sepsis, but young infants and those with underlying medical conditions are more at risk.
What are some signs in older children or adults?
Acting confused, not making sense or not their usual self
has difficulty breathing or breathing very fast
blue or slightly blue/grey lips
pounding in their chest
hands and feet that feel cold, clammy and look pale (this is tricky because babies often have cold hands normally!)
feels dizzy, faint or passes out)
is not peeing for 10 -12 hours
has a rash that does not fade when you roll a glass over it, in the same way you check for meningitis
has severe muscle pain
is complaining of severe leg pain or difficulty standing
has an infection, is still unwell after 24 hours or is getting worse
When to contact GP , OOH GP, or ED?
Abnormal temperature (below 36 or above 38 Celsius)
chills and shivering
a fast heartbeat
problems with or changes to breathing
Behaving differently from normal
Vomiting repeated
a severe or unusual headache
If you are worried
It can be hard to tell in young children. When to contact your GP (or Out of Hours GP or ED) for a child?
a temperature of 38 degrees Celsius or higher in babies under 3 months or a temperature of 39 degrees Celsius or higher in babies aged 3 to 6 months
a temperature below 36 degrees Celsius – re-check after 5 minutes to confirm
difficulty breathing
no interest in feeding (in babies) or not drinking anything for more than 8 hours when awake
dry nappies for 12 hours
been vomiting repeatedly or bloody/black vomit
sunken eyes
a bulging soft spot on their head
less responsive, irritable or difficult to console
a stiff neck, especially when trying to look up and down
been behaving differently than usual to the point that you are worried
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