Invasive Group A Streptococcus Infection FAQ

Group A streptococci are bacteria often found in the throat and on the skin of people who have no symptoms of illness. These bacteria commonly cause "strep throat," or impetigo (bacterial infection of the skin).

Rarely, Group A streptococcal bacteria cause severe and even life-threatening illness when they get into parts of the body such as the blood, muscle, or the lungs. These infections are called "invasive” Group A streptococcus infection. Examples are necrotizing fasciitis (also known as “flesh eating disease” – see BC HealthFile #60 Necrotizing Fasciitis), or streptococcal toxic shock syndrome.

Group A streptococci are bacteria often found in the throat and on the skin of people who have no symptoms of illness. These bacteria commonly cause "strep throat," or impetigo (bacterial infection of the skin).

Rarely, Group A streptococcal bacteria cause severe and even life-threatening illness when they get into parts of the body such as the blood, muscle, or the lungs. These infections are called "invasive” Group A streptococcus infection. Examples are necrotizing fasciitis (also known as “flesh eating disease” – see BC HealthFile #60 Necrotizing Fasciitis), or streptococcal toxic shock syndrome.

Early signs and symptoms of “invasive” Group A streptococcus can include fever, and:

• Increasing, severe pain, swelling or redness at a wound or injury site; OR

• A change from the usual level of mental alertness.

These bacteria are normally passed from person to person through close personal contact with an infected person, such as through kissing, sharing drinking cups, forks, spoons, cigarettes or joints. It spreads most easily between “close contacts” of an infected person, such as:

• persons living or sleeping in the same house; or

• people having direct contact with an infected person’s mouth or nose secretions.

In general, the chances of getting “invasive” Group A streptococcus infection in B.C. are low. Normally in B.C., about 4 or 5 persons out of 100,000 are infected every year.

Risk factors for getting “invasive” Group A streptococcus infection include:

• injecting drugs that are not prescribed by a doctor;

• skin wounds (burn, trauma, surgery);

• a weakened immune system due to disease (e.g., people with HIV infection or AIDS; people who have been getting treatment for cancer (i.e., radiation therapy or chemotherapy) and people who have had an organ or bone marrow transplant and are taking anti-rejection drugs); other chronic disease (e.g. chronic heart, lung or liver disease, alcoholism);

• recent close contact with a person who had an “invasive” Group A streptoc

• having had chickenpox. A recent chickenpox infection can increase a child's risk of getting
necrotizing fasciitis by 10 times. So even thouchickenpox does not account for very many cases, streptococcus skin infections are a noted complication of chickenpox. Public health officials in B.C. suggest that people get their children immunized against chickenpox. (sHealthFile #44b Chickenpox Vaccine for information about the chickenpox vaccine).

There is no vaccine to prevent Group A
streptococcal infections. Antibiotics are
recommended for “close contacts” (see apeople with certain types of “invasive” Grstreptococcus infection. To reduce the spread of Group A streptococcus bacteria:

• wash hands, especially after coughing or sneezing;

• always take good care of minor cuts to redthe chance of infection getting into the tissues
under the skin. If you have a small cut or wound, wash it well in warm, soapy water, keep it cleanand dry with a bandage, and watch for signs of infection (redness, swelling, drainage, fever, and pain);

• if you have a severe sore throat, see your doctor. If you have strep throat, you should stay
home from work, school or daycare until 24hours after starting an antibiotic;

• if you have severe pain at the site of a wound, see your doctor.

If you have further questions, call 811 to speak to a registered nurse, available 24 hours a day:

• 604.215.4700 (In Greater Vancouver)

• 1.866.215.4700 (toll-free in BC)

• 1.866.889.4700 (deaf and hearing impaired)

A pharmacist is available from 5:00 pm - 9:00 am every day.