Strep A: What you need to know

Group A Streptococcus (GAS)  – also known as Streptococcus pyogenes – are bacteria which can colonise the throat, skin and anogenital tract.

number of laboratory reports of Group A Streptococcus (GAS), 2017 to 6 December 2022, Scotland

In Scotland, GAS infection is monitored routinely using laboratory-confirmed positive specimen results. Laboratory confirmed infections from upper respiratory tract samples – for example, throat and nose samples – are considered a proxy estimate for cases of scarlet fever (which is not notifiable in Scotland).

GAS infection commonly presents as a mild illness with a sore throat. GAS can also cause a range of skin, soft tissue and respiratory tract infections.  

In rare cases, people may go on to develop post-streptococcal complications, such as:

  • rheumatic fever
  • glomerulonephritis

GAS also can occasionally cause severe infections. Invasive GAS (iGAS) is an infection where the bacteria are isolated from a normally sterile body site, such as the blood.

Under the Public Health (Scotland) Act 2008, cases of iGAS are notifiable. iGAS cases are also reported to PHS through an enhanced questionnaire, which provides further information or risk factors and outcomes. In addition, invasive GAS samples are sent to the reference laboratory for further analysis and typing.

GAS is spread by close contact between people, through respiratory droplets and direct skin contact. It can also be transmitted environmentally, through contact with contaminated objects, such as towels or bedding or ingestion of food inoculated by a carrier.

Currently, there is an increase in GAS in Scotland earlier in the season compared to recent seasons.

 In the most recent time period (November 2022) there have been around 800 upper respiratory tract GAS (scarlet fever proxy) reports.

 In the most recent time period (November 2022) there have been around 25 iGAS cases across all age groups. This compares with between 30 and 55 cases during peaks in previous years. Incidence is usually highest in those under the age of 10 years.

The next update from PHS: 14 December 2022

Click on this link for more information: NHS Inform Streptococcus A (strep A)

And this: UK Health Security Agency Group A Strep – What you need to know

2 replies »

  1. Thanks to Orkney News for pointing out the different transmission routes. Many other media outlets appear to neglect this, perhaps due to an assumed (and to an extent probably real) fatigue in society to hear and read about diseases and being repeatedly reminded to continue with sensible precautions.
    The thing is: some information we have, others we don’t (yet) have. Finding causes and/or correlations takes time. And it even takes more time to investigate and present evidence. Evidence which may – or may not – be conclusive at the point it is being presented.
    But we have common sense (hopefully). And common sense should tell us that it is probable that communicable diseases spread much more easily after restrictions (for another disease) were lifted. To some extent immune systems were less trained to deal with pathogens, simply because there were (necessary!) contact restrictions. A certain flare up of diseases was expected. However, only because there are several reasonable explanations for the range of factors which can influence disease dynamics, we should not be complacent. This would be a disservice to the ones affected.
    The current numbers are unseasonably high, the case fatality rate of the severe infections clearly exceeds the one experienced with Covid-19 (https://www.gov.uk/government/publications/group-a-streptococcal-infections-activity-during-the-2022-to-2023-season/group-a-streptococcal-infections-first-update-on-seasonal-activity-in-england-2022-to-2023 and https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1123671/NOIDS-weekly-report-week49-2022.pdf), and Strep A can cause some significant issues (https://www.cdc.gov/groupastrep/diseases-hcp/index.html).
    Virulence of strains can vary quite significantly (https://promedmail.org/promed-post/?id=8707237) and investigations are ongoing.

    The presence of the bacteria in many people who do not become ill (often as long as their health isn’t compromised by other issues), makes it easy to shrug your soulders and ignore risks.
    But we must not forget that this unseasonable increase of a potentially dangerous “bug” occurs at a time where several external factors and crises coincide:

    A cost of living crisis which puts many people under financial and mental stress which does not facilitate health and wellbeing (or strengthen immune systems).
    Sitting in the cold with reduced availability of nutritious warm food will make people far more susceptible to experience health issues.
    The risk of co-infections (for example flu, Covid-19 etc.) is high.
    The NHS as well as ambulance services and some GPs are under extreme pressure.
    Whilst the government insists that there are no shortages of antibiotics, some news reports and comments from pharmacists may suggest otherwise and even if those were mainly distribution-associated issues, they are certainly not ideal when quick access is vital.
    And since we have for many years considered antibiotics to be the silver bullet for whatever disease and have been quite liberal in their (sometimes misplaced) use, prevention (of diseases which may depend on antibiotics to treat) should always be the first line of defence.

    Whether it is a nasty virus (such as for example Covid or the flu) or a bacterium, a fungus or other nasties, vaccination where available, hygiene (respiratory and otherwise) and some reasonable precautions and applied common sense are simply a requirement of this era of diseases, conflicts and crises if we want to continue having the same standard of health (and healthcare) we used to have in recent years and decades.

    We shouldn’t dismantle all previously made progress on purpose.