What Is Strep A? Causes, Symptoms, and When to Worry

Strep A is making headlines, but pediatricians stress it’s not typically life-threatening. Still, knowledge and vigilance are key; here’s what to look out for.

Throat exam on a little girl

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Sick season has been especially hard this year. RSV, colds, the flu, and COVID-19 have parents saying this season is more pronounced than others, and trouble finding Tylenol isn't helping.

But there's another illness making headlines: Strep A. New reports out of the United Kingdom show that 15 children under 15 have died of the bacterial infection since September. Officials from the Centers for Disease Control and Prevention (CDC) told reporters earlier this week that they haven't noted an uptick in cases in the U.S. A pediatric infectious disease expert concurs.

"Currently, we are not seeing the same increases in the U.S., and it is unknown if we will," says Dr. Anthony Flores, M.D., a chief of pediatric infectious diseases with UTHealth Houston and Memorial Hermann Hospital in Houston, TX.

Still, doctors are urging parents to be vigilant—but not scared. "It's definitely overwhelming for all parents of young children right now, but it's really important to be able to recognize the symptoms of Strep A so that parents can seek medical care if their children develop symptoms of it," says Dr. Jessica Madden, M.D., a board-certified pediatrician and medical director of Aeroflow Breastpumps. "Strep A is easy to diagnose (requires a throat culture) and is treated with antibiotics."

Here, Dr. Madden and other experts weigh in on causes, spread, symptoms, and treatment for strep A.

What Causes Strep A?

"Strep A, also known as Group A Streptococcus, is a bacterial [illness] that commonly causes infections in the throat," says Dr. Matthew Harris, M.D., a pediatric emergency department physician at Cohen Children's Medical Center.

Though it's making headlines, it's actually not new—you've likely heard it referred to as "strep throat" and may have had it as a child. "Group A strep [or] the strep throat bug is a common infection in children," says Dr. Flores. That's good news because it means pediatricians are well-versed in treating it; strep throat isn't new like COVID-19 was three years ago.

Dr. Madden says strep A is contagious. "Strep A lives in people's noses and throats," says Dr. Madden. Its spread via respiratory droplets from activities like sneezing and coughing. She adds that children often pick it up at school or in daycare. There's no vaccine to protect against strep A.

Possible Complications of Strep A

Though it's relatively harmless, health care providers say prompt treatment is essential when dealing with Strep A. "If there is a delay in treatment—seven to 10 days—undetected strep A can affect the heart and kidneys," says Dr. Sara Siddiqui, M.D., a pediatrician at Hassenfeld Children's Hospital at NYU Langone and NYU Langone Huntington Medical Group.

One possible severe complication of untreated strep A is rheumatic fever, which causes inflammation in the body, including the heart and brain, according to the CDC.

But Dr. Siddiqui stresses serious complications are very rare because of modern medicine. Prompt diagnosis and treatment are also essential in reducing the spread, since the illness spreads easily among kids.

Symptoms of Strep A

Dr. Siddiqui says the most common Strep A symptom is a sore throat. Other symptoms may include:

  • Fever (but not always)
  • Difficulties swallowing because of pain
  • Lethargy
  • Skin rashes

Diagnosing Strep A Infection

Dr. Harris advises parents who suspect group A strep to take their child to their pediatrician or urgent care. The provider can run a swab of the tonsils in the office. If it's negative, they will likely send a more sensitive and accurate culture test to a lab. Families can expect results within 24 to 48 hours.

"The diagnosis is made by using a rapid antigen test from a swab of the throat," says Dr. Harris. "When these tests are positive, they are reliable and should prompt treatment. When tests are negative, a confirmatory bacterial culture is sent out, and results are typically available within 24 hours."

Still, Dr. Siddiqui says that, though it's rare to need the ER for strep A, some children may require more prompt care. "Trust your instincts about how your child is acting and behaving," says Dr. Siddiqui. "Look for vomiting, extreme lethargy, and dehydration. If your child is not drinking, wetting diapers, or urinating enough, those are things you want to get treated right away."

In these cases, Dr. Siddiqui suggests heading to the ER if your child's pediatrician or local urgent care cannot see you right away. Still, it's unlikely—though not impossible—you'll need to take this course.

How Do You Treat Strep A?

Strep A is typically treatable with antibiotics. A liquid form of amoxicillin is the usual first-line treatment, says Dr. Harris. But he says there's currently a shortage of liquid amoxicillin.

Other options are available, though. Penicillin is one, says Dr. Siddiqui. And Dr. Madden notes that children who are allergic to penicillin can receive Cephalexin and clindamycin.

"No matter which antibiotic your child is prescribed, it's really important that every dose is taken to prevent complications," says Dr. Madden.

But again, Dr. Madden and the CDC note these complications are rare, and the prognosis is good when treated correctly.

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