Children’s hospitals and health agencies across the United States are monitoring a possible increase in cases of invasive group A strep infections in children, which can cause serious illness and be fatal.
It is a dangerous but rare disease that causes approximately 1,500 to 2,300 deaths each year in the United States, according to the Centers for Disaster Control and Prevention. The agency says between 14,000 and 25,000 cases typically occur each year. There has been a lull in cases during the pandemic, according to the CDC.
Now hospitals in Colorado, Texas and Arizona say they are seeing more cases of invasive group A strep (iGAS) in children than usual. Two Denver-area children died from the infection, state health officials said.
Infections occur when strep A bacteria, which usually causes mild infections like a sore throat, spreads to other parts of the body like the bloodstream or cerebrospinal fluid. This can cause “flesh-eating” skin infections, pneumonia, or toxic shock syndrome.
In the UK, more than a dozen children have died from invasive group A streptococcal infections since the start of the autumn. The World Health Organization said in a press release Thursday that France, the Netherlands, Sweden and Ireland are also reporting unusual increases in cases.
The CDC said it is reviewing reports of a possible increase in infections in the United States.
“It is possible that there will be an increase in iGAS infections this year, as seen with other infectious diseases that spread from person to person,” the CDC said in a statement.
The increase in invasive strep A infections could be linked to the continued increase in respiratory viruses, said Wassim Ballan, chief of the division of infectious diseases at Phoenix Children’s Hospital. Some people carry strep bacteria in their throat without causing infection. But if they are sick with a virus, the bacteria can invade the mucous membranes of the nose and throat.
“It can cause the type of severe disease that we describe as invasive group A strep infection,” Ballan said.
What is invasive group A streptococcus?
Normally, group A strep is not a major cause for concern. It is a bacterium that can cause illnesses in adults and children, but these illnesses are usually mild. the CDC estimates that several million cases of non-invasive group A streptococcal disease occur each year.
These cases include infections such as strep throat, which typically includes sore throat, fever, and painful swallowing, and scarlet fever, which causes a red, sandpaper-like rash. They are both treatable with antibiotics.
In rare cases, strep A can spread to areas of the body that don’t normally contain bacteria, such as the blood, cerebrospinal fluid, and joint fluid. This causes the most severe invasive group A streptococcal infections.
People with invasive group A strep can develop “flesh-eating” skin infections, bloodstream infections, toxic shock syndrome, and pneumonia. The condition is usually treated in the hospital with IV antibiotics.
Are U.S. children’s hospitals experiencing a surge?
Doctors are seeing varying trends nationwide. Some hospitals — like Boston Children’s Hospital and West Virginia University Medicine Children’s Hospital — told ABC News they are not seeing an increase in cases.
Other states are on the rise. There have been 11 cases of invasive group A strep in children in Colorado since November 1. 1, the Colorado Department of Public Health and Environment said in a statement to ABC News, two of whose children died from the infection. Typically, the state sees only one or two cases per month in children, the department said.
Texas is seeing a similar increase in cases. Texas Children’s Hospital treated more than 60 cases in October and November, Jim Versalovic, the hospital’s chief pathologist, told ABC News. That’s more than four times the number of cases seen during the same period in 2021, he said.
Phoenix Children’s is also treating more patients with invasive group A strep than usual, Ballan said.
Hospitals and health departments are not required to report cases of invasive group A strep to the CDC, so there is no nationwide picture of how the disease might be spreading.
The agency told ABC News in a statement that it is talking with hospitals across the country to better understand the trends.
What can families do to stay safe?
Doctors tell ABC News that all cases of strep throat should be seen by a doctor, whether serious or not. Parents should be on the lookout for fever, sore throat, difficulty swallowing, or children not acting like themselves. If your child is prescribed antibiotics, it is essential that they take all the medications, even if they start to feel better.
Parents should also watch for signs of toxic shock syndrome and “flesh-eating” skin infections, which can be a sign that a strep infection is invasive. Symptoms of toxic shock These include fever, chills, muscle aches, nausea, and vomiting. The first signs of a severe skin infection They include a rapidly spreading swollen area of skin, severe pain, and fever. Later, it may look like a blister, changes in skin color, or pus in the infected area.
streptococcus spread by coughing and sneezing. It can also be spread by drinking from the same glass as a sick person or by touching a surface with a strip and then touching the nose or mouth. Practicing good hygiene — such as washing hands, surfaces, and plates or glasses — can prevent it from spreading.
Because infections appear with and after viral respiratory infections, parents should also make sure children are up to date on flu and COVID-19 vaccinations, Ballan said.
“Knowing that many of these infections are preceded by a viral infection, the focus should be on preventing those that we can prevent,” he said.
Nicole McLean MD, MPH, is a member of the ABC News Medical Unit and a pediatric resident physician at Columbia University/New York-Presbyterian.
Additional reporting by ABC News’ Emma Egan and Eric Strauss.
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