Strep A

5 mins read

This advice applies across the UK.

Strep A (formally called Group A Streptococcus or GAS) is a common type of bacteria often found on the skin or in the throat. The bacteria can cause many different infections. Some are mild, like “Strep throat”, and some are rarer but more serious, like invasive GAS infection (iGAS). On this page, we explain the signs and symptoms of Strep A, how to protect your child from Strep A, and when to get help when your child is unwell.

What is Strep A?

Strep A (formally called Group A Streptococcus or GAS) is a common type of bacteria often found on the skin or in the throat.

The bacteria can cause many different infections. Some are mild, like ‘Strep throat’, and some are rarer but more serious, like invasive GAS infection (iGAS).

Strep A spreads by close contact between people through droplets in your breath and direct skin contact. It is more common in children, but adults can get it too.

Is my disabled child more at risk from Strep A?

Not necessarily. NHS advice to all families is the same unless your child’s consultant gives you specific advice.  

If a child has low muscle tone, it may be harder for them to clear their airways if they catch get a winter infection like flu or respiratory syncytial virus (RSV). This in turn can make them more susceptible to Strep A infections.

Children with weak immune systems may also be more susceptible to viral and bacterial infections, including Strep A. Their consultant may prescribe preventative antibiotics to reduce this risk.

Signs and symptoms

Strep A infection can cause a variety of skin, soft tissue and respiratory tract infections.

Common symptoms of these can include:

• Flu-like symptoms, such as a high temperature, swollen glands or aching body.
• Sore throat (“Strep throat” or tonsillitis).
• A rash that feels rough, like sandpaper (scarlet fever).
• Scabs and sores (impetigo).
• Pain and swelling (cellulitis).
• Severe muscle aches.
• Nausea and vomiting.
• Pneumonia.

These are usually mild, but can sometimes be life-threatening.

What about more serious Strep A infections?

Much more rarely, Strep A can cause more serious infections, called invasive Group A Streptococcus (iGAS).

iGAS can result in:

• Bacteraemia (an infection of the bloodstream).
• Septic arthritis.
• Meningitis.
• Necrotising fasciitis (a severe infection involving death of soft tissue below the skin).
• Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure).

Seeking medical attention

When should I call the GP or 111?

If you feel that you or your child is seriously unwell, trust your own judgement and seek medical assistance.

Contact your GP if your child:

• Is getting worse.
• Is feeding or eating much less than normal.
• Is showing signs of dehydration, like sunken eyes or drowsiness.
• Has not passed urine for 12 hours.
• Is under three months and has a temperature of 38°C or higher.
• Is older than three months and has a temperature of 39°C or higher.
• Feels hotter than usual when you touch their back or chest, or feels sweaty.
• Is very tired or irritable.

If your GP is closed, phone NHS 111.

When should I call 999 or take my child to A&E?

Phone 999 or go to A&E if:

• You or your child is having difficulty breathing (you may notice grunting noises or their tummy pulling in under their ribs).
• There are pauses when you or your child breathes.
• You or your child’s skin, tongue or lips are blue.
• You or your child is floppy and will not wake up or stay awake.

Treatment

Strep A infections can be easily treated with antibiotics, usually penicillin or amoxicillin. If your child is allergic to penicillin, they will be offered another type of antibiotic like azithromycin. 

Your GP will prescribe antibiotics if they think your child has a Strep A infection.

Treatment involves:

• Antibiotics to kill the bacteria causing it.
• Rest to help your child get better faster.
• Over-the-counter medicines and home remedies to ease symptoms.

Serious Strep A infections (iGAS) must be treated in hospital with intravenous antibiotics. .

There can be localised antibiotic shortages in some areas at times, most commonly shortages of antibiotics in liquid forms.

Pharmacists have permission to dispense suitable alternatives where they cannot obtain specific antibiotics. 

If your child has a normal swallow when well, it is useful to teach them to take tablets. These are more readily available, don’t need refrigerating and are cheaper. For advice on helping your child swallow tablets, see this Kidzmed leaflet [PDF].

Prevention

How can I reduce the risk of my disabled child catching Strep A?

Make sure you child has had their flu vaccine.

The UK Health Security agency reports that that giving children the nasal flu vaccine may protect them against strep A. This is possibly because children who catch flu are at greater risk of further viral and bacterial infections, including Strep A.

Follow basic hygiene steps, such as:

• Washing your hands properly with soap for 20 seconds.
• Using disposable tissues to catch coughs and sneezes and washing your hands afterwards.
• Keeping away from others if you or your child feel unwell.

Read more about the flu vaccine and disabled children

Can I test for Strep A at home?

Home testing kits are available to buy online.

Home tests are not sold in England or Scotland through the NHS because experts say their accuracy is variable.

You can buy tests over the counter at pharmacies in Wales.

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