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What is Strep A?

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 5 minutes read
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Group A streptococcus (or group A strep) is a type of bacterium (germ) that commonly lives on our skin or in our nose and throat. Many of us carry this bacteria but never become ill. Strep A infections vary in severity from very mild - such as throat infections - to severe such as pneumonia, but fortunately most can be treated with antibiotics.

How do I catch Strep A?

Many people carry group A Strep without realizing it - it causes no problems and they remain well and don’t develop any illness. It can be passed from person to person by close contact with someone who has Strep A such as by kissing or from skin to skin contact. Strep A can also sometimes be spread through food if someone infected with group A strep prepares or serves food which is then shared.

Who’s most at risk from Strep A?

Although most people exposed to Strep A have either no symptoms or mild ones, you’re more likely to be at risk from it if you:

  • have close contact with someone with Strep A
  • are older than 65
  • are diabetic
  • have heart disease or cancer
  • have recently had chickenpox
  • have HIV
  • have a weakened immune system or take long-term steroids

What are the symptoms of Strep A infection?

Fortunately for most people, being in contact with Strep A either doesn’t cause any symptoms or only a mild illness. The usual mild illnesses include:

  • strep throat - this is a mild throat infection causing a sore throat, swollen glands and discomfort in swallowing.
  • earache - due to a middle ear infection, often with a high temperature.
  • impetigo - a blistering type of skin infection usually affecting the nose, mouth or trunk.
  • sinusitis - infected spaces behind the forehead and cheekbones (normally filled with air) that cause facial pain and a runny or blocked nose.
  • scarlet fever - an infection causing a widespread, fine, pinkish-red rash over the body.

More severe illnesses linked to Strep A are called invasive group A Strep (IGAS), where deeper tissues or organs are infected. These include:

  • pneumonia - a lung infection causing breathing difficulties, cough and a high temperature.

  • meningitis - a potentially fatal infection of the fluid that surrounds the brain, causing headache, neck pain and stiffness, fever and confusion.

  • necrotizing fasciitis - a severe skin and muscle infection where there is a high temperature and skin pain, and potentially destruction of skin and tissue.

  • Streptococcal Toxic Shock Syndrome (STSS) a blood infection that can cause fever, confusion, abdominal pain, and a rash. It can cause failure of the kidneys, liver and lungs.

How is Strep A diagnosed?

It’s usually diagnosed by taking a swab of affected tissue or saliva and checking it for the presence of Strep A. You can also have a blood test to see if your immune system has produced certain antibodies in response to a strep A infection. If a more serious invasive Strep A infection is a possibility, you can also have blood tests to see if you have the bacteria in your blood.

How is Strep A treated?

Fortunately, most minor strep A infections usually get better on their own after a few days without needing any medical treatment. To help relieve any symptoms while this is happening you can take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and also acetaminophen to help reduce a high temperature and discomfort. Please note that aspirin should not be given to children aged under 16 because of the risk of Reyes’ syndrome. If you have a skin infection this may require treatment with antibiotic tablets or creams and if you have a ‘strep throat’ stay home from work or school until after you have taken antibiotics for 24 hours as this reduces the chance of you giving the infection to someone else. Always take any prescribed antibiotics as directed.

Am I fit for work?

If you have strep throat you’re not fit for work.

Healthwords pharmacist's top tips

Your doctor may prescribe antibiotics for a strep throat, but your pharmacist may also suggest some other things to help improve your symptoms while you're getting back to normal. These could include:

  • painkillers such as those containing acetaminophen, or anti-inflammatories containing either aspirin or ibuprofen.
  • anesthetic lozenges or sprays to numb the pain of a sore throat.
  • a localized anti-inflammatory throat spray or rinse.
  • suggesting you gargle with salt water.

When should I see my doctor?

Contact your doctor urgently or go to your nearest emergency center if your child:

  • is causing you to have increasing concern about their health
  • is feeding or drinking less than usual
  • has not peed for 12 hours or more
  • is very tired, floppy or irritable
  • has a temperature greater than 101.3 degrees

How can I reduce my risk of catching Strep A?

Because strep A is spread by close contact - such as from skin-to-skin contact or from inhaling infected respiratory droplets from someone else - there are ways of helping to reduce this risk:

  • wash your hands properly with soap for 20 seconds
  • use a disposable tissue to catch coughs and sneezes
  • keep away from others if you feel unwell
  • don’t share food, utensils, cups and glasses, baths, bed linen or towels

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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