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What is Group A Streptococcus, why has it been heard about so frequently lately, and what can it cause in humans?

Bacteria, such as streptococcus, are among the earliest forms of life on Earth, are found everywhere, and form part of the microbiome of the human body. During the COVID-19 pandemic, severe invasive Group A Streptococcus (iGAS) infections decreased, particularly among children, due to the measures that had been imposed. However, more recent data from the Centers for Disease Control and Prevention (CDC) indicate an increase in iGAS infections among children and adults over the age of 65, associated with the widespread epidemiological circulation of the bacterium in the community and with respiratory infections.

During a viral infection, the immune system focuses on fighting the virus, leaving the body’s defenses against bacterial infections “temporarily weakened.” Group A Streptococcus is highly contagious, but as a rule it is not life-threatening. Approximately 5% of people carry this bacterium in the pharynx without showing any symptoms (healthy carriers).

It usually causes mild symptoms, such as fever, sore throat, swelling of the tonsils and cervical lymph nodes, headache and rash, and most people recover without complications. However, when the bacterium affects parts of the body where it is not normally present, it can cause severe disease which, if left untreated, may be fatal.

How is it transmitted and how is a streptococcal throat infection diagnosed?

Transmission occurs through droplets, with most cases identified in communal living settings, as well as among immunocompromised patients. Because the symptoms of streptococcal infection resemble those of other respiratory infections, a definitive diagnosis is made by the pediatrician or otorhinolaryngologist based on the clinical examination and laboratory findings. For rapid detection of streptococcus (<15 minutes), a Strep test is used; when positive, it confirms the diagnosis and allows treatment to begin immediately.

However, a negative result does not rule out the presence of the bacterium. In cases of strong clinical suspicion, confirmation by culture is required. The most reliable method is a throat swab culture, although 2-3 days are required for the result.

How is it treated and how can we limit the transmission of the bacterium, particularly among children?

Treatment of the infection requires the appropriate antibiotic. It is equally important to observe personal protection measures, such as proper hand hygiene. Ventilation of indoor spaces and thorough cleaning of surfaces and toys also help, as the bacterium can survive on various objects. In addition, it is important to keep children’s vaccinations up to date.

Through play, we can teach children the correct handwashing technique using soap and water, the use of a tissue or the elbow when coughing and sneezing, as well as the avoidance of close contact when they feel unwell. As was seen during the pandemic, children were more compliant than many adults!

Ultimately, should parents be so concerned? What advice should they follow if their child becomes ill?

Streptococcal infection usually causes an uncomfortable sore throat and leads to a few days away from school. In fact, 24 hours after starting antibiotic treatment, symptoms gradually begin to subside, while the child’s clinical condition improves and the risk of transmitting the infection decreases.

It is vital to follow the doctor’s instructions carefully regarding completion of the treatment, as stopping the antibiotic prematurely may lead to recurrence of the infection and the development of antibiotic resistance. With calmness, consistency in treatment and trust in the doctor, we can successfully overcome this challenge as well!