Group A strep is a common bacteria best known for causing strep throat. Most infections are mild and easy to treat. But in late 2022, the Centers for Disease Control and Prevention (CDC) alerted doctors to a rise in serious, invasive group A strep infections in children, reminding parents why it’s worth knowing the warning signs.
What is group A strep?
Group A Streptococcus bacteria commonly live in the throat and on the skin. Many people carry them without getting sick. The bacteria spread through respiratory droplets from coughing and sneezing, and through contact with infected sores. Infections are more common in winter and early spring, and they’re especially common in school-age children.
The CDC’s 2022 health advisory followed a rise in invasive cases first noticed at a children’s hospital in Colorado. The agency noted that the seasonal increase in risk applies to people of all ages, and that the rise came alongside high levels of flu, RSV and COVID-19.
Common, milder infections
- Strep throat: sudden sore throat, pain when swallowing, fever, red and swollen tonsils sometimes with white patches, tiny red spots on the roof of the mouth, and swollen neck glands. Coughs and runny noses are less typical and point more toward a viral illness.
- Scarlet fever: a strep throat infection with a red, sandpaper-like rash, often with a flushed face and a red, bumpy “strawberry” tongue.
- Impetigo: itchy red sores, often around the nose and mouth, that break open and form honey-colored crusts.
These are usually treated with antibiotics, which help children feel better faster, reduce spread and prevent complications.
Serious invasive infections
Rarely, group A strep invades deeper tissues or the bloodstream. These infections need urgent hospital care:
- Cellulitis: red, swollen, warm and painful skin, sometimes with fever.
- Necrotizing fasciitis: a rapidly spreading infection with severe pain out of proportion to how the skin looks, swelling and fever.
- Streptococcal toxic shock syndrome: fever, aches and vomiting followed by a sudden drop in blood pressure and organ failure.
- Pneumonia and bloodstream infections.
Complications after infection
Untreated strep can occasionally trigger immune reactions weeks later, including rheumatic fever, which can damage the heart and joints, and post-streptococcal glomerulonephritis, a kidney problem that can cause dark urine and swelling. Completing the full course of antibiotics helps prevent these.
When to see a doctor
Contact your child’s doctor if they have a sore throat with fever and no cough, a sandpaper-like rash, or skin sores that are spreading. A quick throat swab can confirm strep.
Seek urgent care if your child has trouble breathing, is unusually drowsy or hard to wake, has severe pain, a rapidly spreading red area of skin, a high fever that won’t come down, signs of dehydration, or seems to be getting worse after a recent illness such as flu or chickenpox.
Prevention tips
- Wash hands often with soap and water.
- Cover coughs and sneezes.
- Don’t share cups, utensils or towels.
- Keep wounds clean and covered.
- Stay home when sick. Children with strep can usually return to school after at least 12 hours of antibiotics and no fever.
- Stay up to date with flu and chickenpox vaccines, since these infections can raise the risk of invasive strep.
The bottom line
Most group A strep infections are mild and respond well to antibiotics. Knowing the signs of serious infection, and acting quickly when a child seems very unwell, can make all the difference.
This article is for general information and isn’t medical advice. Talk with your healthcare provider about your individual needs.
