Streptococcus A (strep A)
Streptococcus A (strep A)
Group A Streptococcus, often shortened to Strep A or GAS, is a type of bacteria that many people carry on their skin or in their throat without any trouble at all. Most of the time it causes no harm, but under certain circumstances these bacteria can lead to illness.
When Strep A does cause an infection, it usually shows up as a mild sore throat, commonly known as "strep throat", or as an infection of the skin and the soft tissue beneath it, such as impetigo or cellulitis.
Common Symptoms
Symptom information is not available for this condition yet.
Emergency Warning Signs
Phone 999 or go to a hospital emergency department if you suspect Streptococcus A (strep A) and:
- you or your child is having difficulty breathing (you may notice grunting noises or their tummy sucking 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
- your child is less than 3 months old and has a temperature of 38°C (101°F) or above and has not had a vaccination in the past 2 days
- your child is less than 3 months old and has a temperature of 36°C (97°F) or less and has not had a vaccination in the past 2 days
Contact your doctor if you or 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 older than 3 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 doctor is closed, call a doctor or the 16263 health line.
If you feel that you or your child is seriously unwell, trust your own judgement and seek medical help.
If you or your child needs a test for Streptococcus A, your doctor will advise you.
GAS infections
GAS bacteria can cause many different skin, soft tissue and respiratory tract infections, ranging from mild to life-threatening. These include:
- tonsillitis
- sore throat
- scarlet fever
- impetigo
- erysipelas (a type of cellulitis)
- cellulitis
- pneumonia
In rare cases, people can develop post-streptococcal complications, such as:
- rheumatic fever
- glomerulonephritis (heart and kidney diseases caused by an immune reaction to the bacteria)
iGAS infections
GAS can very rarely cause more serious conditions, known as invasive group A Streptococcus (iGAS) infections. These can include:
- bacteraemia (an infection of the bloodstream)
- septic arthritis
- meningitis
- necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin)
- Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure)
iGAS infections tend to happen in older people, the very young, or people with an underlying risk factor. Groups considered to be at risk of a serious GAS infection are:
- people with existing health conditions, like diabetes, cardiovascular disease, or a weakened immune system
- people who have recently had flu or chickenpox
- newborn babies
- women who are pregnant or have recently given birth
- people who are homeless or inject drugs
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
Phone 999 or go to A&E if:
- you or your child is having difficulty breathing (you may notice grunting noises or their tummy sucking 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
- your child is less than 3 months old and has a temperature of 38°C (101°F) or above and has not had a vaccination in the past 2 days
- your child is less than 3 months old and has a temperature of 36°C (97°F) or less and has not had a vaccination in the past 2 days
Contact your GP if you or your child:
- is getting worse
- is feeding or eating much less than normal
- is showing signs of dehydration, like sunken eyes, drowsiness
- has not passed urine for 12 hours
- is older than 3 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 the 111 service.
If you feel that you or your child is seriously unwell, trust your own judgement and seek medical assistance.
Strep A tests are not available through the NHS in Scotland for self-testing at home. Should you or your child need to be tested for Strep A, your GP or other healthcare professional will advise you.
GAS infections
GAS bacteria can cause a wide variety of skin, soft tissue and respiratory tract infections ranging in severity from mild to life-threatening. These include:
- tonsillitis
- sore throat
- scarlet fever
- impetigo
- erysipelas (a type of cellulitis)
- cellulitis
- pneumonia
In rare cases, patients may go on to develop post-streptococcal complications, such as:
- rheumatic fever
- glomerulonephritis (heart and kidney diseases caused by an immune reaction to the bacteria)
iGAS infections
GAS can very rarely cause more serious conditions, known as invasive group A Streptococcus (iGAS) infections. These can include:
- bacteraemia (an infection of the bloodstream)
- septic arthritis
- meningitis
- necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin)
- Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure)
iGAS infections tend to happen in the elderly, the very young, or people with an underlying risk factor with groups considered to be at risk of serious GAS infection being:
- people with existing health conditions such as diabetes, cardiovascular disease, or a weakened immune system
- people who have recently had flu or chickenpox
- newborn babies
- women who are pregnant or have recently given birth
- people who are homeless or inject drugs
Treatment
Most strep A (group A streptococcus, or GAS) infections are fairly mild and get better on their own, without antibiotics.
It also helps to know that symptoms which look like a strep A infection, such as a sore throat, are more often caused by viruses than by the GAS bacteria. If you or your child has a runny nose along with the sore throat, it is most likely a viral infection. A sore throat caused by a virus does not need antibiotics, unless there is a concern about complications.
You can read more about sore throat symptoms, how to look after yourself at home, and what to do if things get worse.
Your doctor or healthcare professional will consider giving antibiotics if they think:
- you or your child needs medicine to recover or to ease the symptoms
- you or your child is at risk of serious complications from a strep A infection
- you or your child has scarlet fever
If antibiotics are prescribed, they may come as a liquid or as tablets.
It is also quite common for a person to carry GAS bacteria on their skin or in their throat without being unwell at all. Such people usually do not know they have the bacteria, and they do not need antibiotics.
Prevention
Preventing GAS infection
GAS are spread by close contact between individuals, through respiratory droplets (moisture in your breath) and direct skin contact.
To help reduce the risk of picking up or spreading infections:
Do
- wash your hands properly with soap for 20 seconds
- use a disposable tissue to catch coughs and sneezes and wash your hands afterwards
- keep away from others if you feel unwell
Don’t
- do not share contaminated food, utensils, cups and glasses, baths, bed linen or towels
GAS can be a secondary infection, developing in people who are already unwell with illnesses like the flu. You can help protect your child from this risk by making sure they get their free flu vaccine this winter.
New evidence also shows that the nasal spray flu vaccine offered to children may also protect them from GAS infection.
Don’t include personal information e.g. name, location or any personal health conditions.