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10 February, 2010

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Streptococcal infection - group A

Streptococcal infection – group A is also known as streptococcal disease. It is caused by bacteria known as Group A (beta-haemolytic) Streptococcus.

Streptococcal infection – group A is a common infection that can cause sore throats (pharyngitis), scarlet fever or impetigo (school sores).

In rare cases it can cause a toxic shock syndrome similar to that caused by the bacteria Staphylococcus aureus, also known as ‘golden staph’. Streptococcal infection – group A can also cause the extremely rare illness of necrotising fasciitis (flesh-eating bacteria).

Occasionally streptococcal infection – group A can lead to serious complications such as rheumatic fever, which can affect the heart, and kidney disease (glomerulonephritis).

Symptoms of streptococcal infection – group A

Streptococcal sore throat (pharyngitis)
Typical symptoms include of streptococcal sore throat include:

A sore, red throat with thick pus-like fluid around the tonsils.
Fever and chills.
Enlarged and tender lymph nodes in and around the neck.
Vomiting and abdominal complaints, particularly in children.

Scarlet fever
The symptoms of scarlet fever include:

Inflammation of the throat.
A pink-red rash spreading across the abdomen, side of the chest and in the skin folds. The rash may feel like sandpaper when touched.
A bright red tongue (known as ‘strawberry tongue’).
Paleness around the mouth.

Impetigo
Streptococcal bacteria can cause impetigo, or ‘school sores’. However impetigo can also be caused by the Staphylococcus aureus (‘golden staph’) bacteria.

Symptoms of impetigo include:

Blisters, typically around the nose and mouth and the legs.
Fever and swollen lymph nodes in severe cases.

Diagnosis of streptococcal infection – group A
For cases of pharyngitis and scarlet fever, the routine method of diagnosis is identification of the organism from a throat swab. Blood tests may also be ordered.

Impetigo is diagnosed by taking a swab of the blisters or crust of sores and checking for the presence of bacteria.

Toxic shock syndrome is diagnosed by examining symptoms and in some cases, by taking blood tests.

Person to person contact spreads streptococcal bacteria
You can contract streptococcal infection – group A after contact with infected persons. The bacteria are present in saliva and nasal discharge so sneezing, coughing and shaking hands can spread the bacteria.

In rare cases it can also be contracted from contaminated foods including:

Milk and milk products
Eggs.

Impetigo is highly contagious. People with skin lesions or blisters should not handle food until the infection has cleared.

Antibiotics are the standard treatment
A ten-day course of antibiotics is the standard treatment for streptococcal infection – group A. Antibiotics which may be prescribed include:

Penicillin
Erythromycin if you are allergic to penicillin
A cephalosporin if you cannot take penicillin or erythromycin
Antibiotic ointments for impetigo.

Keep sick children away from other children
If your child develops streptococcal infection – group A, including scarlet fever or impetigo, you should:

Keep them away from children’s settings such childcare centres or school until your child has received at least 24 hours of antibiotic treatment and the child feels well.
Make sure your child completes the entire course of antibiotics.
If your child has impetigo, the child can return to school after commencing antibiotic treatment. Make sure all exposed sores are covered with a watertight dressing.

You could remain infectious for months
If your streptococcal infection is not treated, you could remain infectious for between 10 and 21 days. An untreated infection with a pus-filled discharge can remain infectious for months.

With adequate antibiotic treatment the streptococcal infection will not spread after the first 24 to 48 hours. It is important to complete any course of antibiotics you are prescribed.

Where to get help

Your doctor
The emergency department of your nearest hospital
Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
Public Health, Department of Health Victoria Tel. (03) 9096 0000

Things to remember

Streptococcal infection – group A commonly causes a sore throat and fever.
Infected children should be kept away from school, pre-school or childcare until they have received at least 24 hours of antibiotic treatment and feel well.
Streptococcal bacteria can be spread by sneezing, coughing and hand contact, and in rare cases food.

You might also be interested in:
Impetigo - school sores.

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