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Information sheet on Strep A

Published Dec 05, 2022

Following the recent news items on the increase of infectious diseases, particularly Scarlet Fever that can develop from Strep A as well as invasive Strep A, we felt it was important to direct you towards relevant and useful information made available by the Government through agencies such as the UK Health Security Agency (UKHSA), formerly Public Health England.

What is Strep A?

Group A Streptococcus (GAS; Streptococcus pyogenes) is a bacterium which can colonise the throat, skin and anogenital tract. It causes a diverse range of skin, soft tissue and respiratory tract infections including:

  • Tonsilitis
  • Pharyngitis
  • Scarlet fever
  • Impetigo
  • Erysipelas
  • Cellulitis
  • Pneumonia

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

  • Rheumatic fever
  • Glomerulonephritis

What is invasive Strep A?

GAS can occasionally cause infections that are extremely severe. Invasive GAS (iGAS) disease occurs when the bacterium gets into parts of the body where it is not usually found, such as blood, muscle tissue or lung tissue. This may occur when the bacterium get past the body’s natural defences, when sores or other breaks in the skin allow bacterium to enter the bloodstream or deep tissue, or when a person’s ability to fight off infection is decreased due to a weakened immune system. Any GAS manifestation can be associated with the development of streptococcal toxic shock syndrome, although patients with necrotising fasciitis are at highest risk.

How does Strep A spread?

GAS is spread by close contact between individuals through:

  • Respiratory droplets
  • Direct skin contact

It can also be transmitted environmentally through:

  • Contact with contaminated objects such as towels or bedding
  • Ingestion of food inoculated by a carrier

What can be done to prevent and control infection?

A proactive and preventative approach is advised when attempting to prevent and control any type of infection, and effective measures aim to interrupt the chain of transmission. In general, germs are spread during the infectious period and for some diseases this can be before the person affected shows any symptoms.

Many of the measures introduced during the Covid-19 pandemic will provide the backbone to an effective management scheme, with a renewed focus on:

  • Hand hygiene
  • Respiratory and cough hygiene
  • Cleaning
  • Toileting and sanitation
  • Safe management of the environment, linen and soft furnishings
  • Safe management of blood and bodily fluids
  • Effective provision of PPE

Establishments should also review localised emergency management and business continuity plans for the required actions in response to infectious diseases, liaise with their local authority and healthcare trust and frequently review guidance and updates by the UKHSA for changes or provision of specific guidance and the potential for reporting a disease to the UKHSA or similar agency. Reporting to the HSE under RIDDOR is typically not a requirement for a child being diagnosed with a disease as it is often not attributable to a work activity. Further guidance should always be sought on an individual case-by-case basis.

What sources of information are available?

There are a range of information sources available to healthcare and education settings. We have collated a group for you to access below:

Source: Dave Wright