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The Signs & Symptoms Of Strep A

by Melissa Bell
5 minutes read

Towards the end of 2022, there were several reports of increased cases of invasive Strep A (iGAS) in several countries around the world.

The World Health Organisation released an official statement regarding the increased incidence of scarlet fever and invasive Group A Streptococcus infection across multiple countries, including the UK, France, Sweden, Ireland and the Netherlands.

The WHO reported that children younger than 10 were the most affected age range. In early 2023, the Centers for Disease Control and Prevention reported an increasing number of Strep A cases across several states in the USA.

Although Invasive Group A Streptococcus remains rare, the number of cases is higher than in previous years.


What Is Strep A?

Group A Streptococcus (GAS), often referred to as Strep A is a common bacterium usually found in the throat and on the skin. Although it is more prevalent in children, Strep A is easily transmittable and is therefore common in both adults and children.

Some people will not have any signs or symptoms of illness and will therefore not be aware that the bacteria is present in their body.

Strep A can cause a wide range of illnesses, ranging from mild to life-threatening (especially in children younger than 10). These illnesses include a variety of skin, soft tissue and respiratory tract infections such as;

  • tonsillitis
  • sore throat
  • scarlet fever
  • impetigo
  • erysipelas (a type of cellulitis)
  • cellulitis
  • pneumonia.

In rare cases, Group A Streptococcus can become invasive Group A Streptococcus (iGAS) and cause more serious conditions.

This occurs when the bacterium gets into parts of the body where it is not usually found, such as the bloodstream or lungs.

This can cause life-threatening conditions, including meningitis, necrotising fasciitis and streptococcal toxic shock syndrome. iGAS is more common in children under 10, elderly people and those with a weakened immune system.

What Are The Signs & Symptoms Of Strep A?

The signs and symptoms of Strep A vary widely due to the high number of illnesses and conditions associated with the bacterium. According to the NHS UK, the most prevalent symptoms include:

  • flu-like symptoms such as high temperature, an aching body, swollen glands and fatigue
  • Red swollen tonsils, white/yellow patches on the tonsils, swollen lymph nodes in the neck and pain when swallowing (Tonsilitis)
  • Small red bumps on the skin that feel rough like sandpaper (scarlet fever)
  • Recurring scabs and sores (often yellow in colour) that can be itchy and painful (Impetigo)
  • Nausea and vomiting
  • Pain and swelling (cellulitis).

Strep A spreads very easily. Anyone who has symptoms of Strep A should avoid being around people for at least 24 hours. This means staying away from work, school or nursery. They should wash their hands frequently and should cover their mouth and nose when sneezing or coughing. Any tissues used should be disposed of immediately.

How Is Strep A Diagnosed?

A GP can usually diagnose Group A Streptococcus based on the symptoms present. A range of rapid Strep A Tests are also available, which can accurately and speedily determine whether or not the bacterium is present in the body.

How Is Strep A Treated?

Treatment for Group A Streptococcus varies depending on the illness. Most mild symptoms, such as high temperature, aching body and swollen glands can be treated at home with over-the-counter paracetamol, fluids and rest.

However, some of the conditions, including impetigo, scarlet fever and tonsilitis will require a course of antibiotics to fight the bacteria. Similarly, if mild symptoms do not improve with store-bought medication, antibiotics may be needed.

If invasive Group A Streptococcus is diagnosed, this is usually treated with antibiotics during a hospital stay.

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