By: Elizabeth Williams, MD, FAAP
If your child has ever had a throat or skin infection, it may have been caused by group A streptococcal (Group A Strep) bacteria. Group A strep bacteria are extremely contagious, and they can cause a variety of infections, from mild to severe.
What infections does group A strep cause?
The most common group A strep infection is
strep throat, which usually has symptoms of a fever and sore throat. Strep throat is especially common among school-aged children and teenagers.
Group A strep organisms can be responsible for certain types of skin infections too, such as
impetigo (itchy, red, oozing sores) and cellulitis (red, swollen, painful skin).
Group A strep bacteria can cause an infection called scarlet fever, too. This infection is basically strep throat with a rash, which is caused by a toxin the bacteria releases into the body.
It's rare, but there is a serious infection called necrotizing fasciitis that's often caused by group A strep bacteria. It's a severe streptococcal infection that kills tissue very quickly. It is sometimes called "the flesh-eating disease." Infants and anyone with chronic health conditions like diabetes and kidney disease are more at risk.
Streptococcal toxic shock syndrome (STSS)
STSS is another rare infection caused by group A strep bacteria. This serious illness happens when a toxin made by the bacteria gets into the body. STSS causes symptoms like a dangerous drop in blood pressure, increased heart rate, and breathing fast.
What are symptoms of group A strep infection?
When Group A Strep infects a child younger than 3 years of age, the signs and symptoms tend to be milder than in older children.
Infants with a streptococcal infection may have a low fever and thick discharge from their nose.
Toddlers may have a fever, irritability, a decreased appetite, and in some cases, swollen glands in the neck. The risk of acute rheumatic fever is very low in young children, so it's usually not necessary to test for group A strep in mild cases of sore throat.
Kids older than 3 years may have more serious streptococcal-related symptoms, For example, they may have a red and very painful sore throat, a high fever (greater than 102°F or 38.9°C), white patches of pus on the tonsils (but not always) and swollen glands in the neck.
When to call your pediatricianIf your child has a sore throat, and especially if they have pus on the tonsils or swollen glands, give your pediatrician a call.
How long is the incubation period for group A strep?
An infected child will usually start feeling sick become ill 2 to 5 days after being exposed to streptococcal bacteria.
How is group A strep diagnosed in children?
Your health care provider will swab your child's throat and tonsils to test whether they have a Group A Strep infection. Some pediatricians' offices have quick-result strep tests that can help diagnose streptococcal infection in several minutes. A throat culture may be used if the quick-result test is not available, or if your provider thinks the quick-result test was inaccurate. Results from the culture test may take a few days.
How is a group A strep infection treated?
The primary treatment for sore throats caused by Group A Strep is penicillin, an antibiotic that's taken orally. Other antibiotics like ampicillin, amoxicillin, or oral cephalosporins are sometimes used instead. If your child is allergic to penicillin, oral azithromycin is an option.
A skin infection caused by group A strep may be treated with a topical antibiotic ointment.
How long should my child stay home with a group A strep infection?
If your child has a throat or skin infection caused by group A strep bacteria, they shouldn't go back to school or childcare until they've been on antibiotic treatment for at least 12 hours.
How can I help my child feel better?
Home remedies such as gargling with warm salt water may relieve some of your child's throat pain. Ibuprofen or acetaminophen can lower your child's temperature and lessen the pain.
How long does it take to recover from group A strep infection?
When antibiotics are given to treat a group A strep infection, your child should recover fully. However, if strep throat or scarlet fever goes untreated, the infection may spread to other parts of the body.
While it's rare, some children get sick after a group A strep infection because of the way their bodies reacted to it. This can result in serious effects to the kidney (a disease called glomerulonephritis) or the heart (a condition called rheumatic fever). Most kids who end up with glomerulonephritis get better within a few weeks, and rheumatic fever is treatable with antibiotics.
How to prevent group A strep
Group A streptococcal infections are very common, and very contagious. Your child can pick up a skin or throat infection by coming into close contact with someone who’s infected. Group A Strep bacteria are spread through respiratory droplets, either in the air or on surfaces.
The best prevention is to make sure your child regularly washes their hands, especially after coughing or sneezing. Keep surfaces in your home clean, especially if anyone in your family is sick. Have your child cover their mouth and nose with a tissue when sneezing or coughing.
If your child does get sick, don’t send them back to school or childcare too early—this increases the risk of spreading the infection to others. Have your child take their antibiotic exactly as prescribed, too.
About Dr. Williams
S. Elizabeth Williams, MD, MPH, FAAP, is a board-certified general pediatrician. She is an Assistant Professor in the Department of Pediatrics at Vanderbilt University Medical Center in Nashville, TN, and has a research background in vaccine safety and vaccine education. Within the American Academy of Pediatrics (AAP), Dr. Williams is a member of the Section on Infectious Diseases.