Strep A Linked To 2 U.S. Pediatric Deaths: What CA Parents Should Know

ACROSS CALIFORNIA — Public health officials are monitoring a rare, invasive form of the usually mild and common bacteria known as group A strep that has been linked to at least two U.S. pediatric deaths. The development comes as the antibiotic to treat the infection is in short supply.

The Centers for Disease Control and Prevention is investigating a possible increase in invasive group strep A infections, which killed between 1,500 and 2,300 people a year in the last five years, the agency said.

Group A streptococcus bacteria, or iGAS, is highly contagious and commonly carried by people in the nose, throat and skin. It usually causes a sore throat and can be treated with the liquid antibiotic amoxicillin suspension; however, a shortage of this drug is expected to last for several months. Alternative therapies are available.

In its invasive form, strep A can enter the bloodstream, lungs, spinal cord and other places inside the body where the bacteria typically would not live, leading to diseases such as pneumonia, endocarditis (an infection of the heart’s inner lining), meningitis, urinary tract infections, sepsis, the serious skin and tissue infection necrotizing fasciitis, and streptococcal toxic shock syndrome, which causes low blood pressure and injury to organs such as the kidneys, liver and lungs.

In California, invasive group A streptococcal infections are not reportable as individual cases, the California Department of Public Health told Patch. However, the California Emerging Infections Program conducts active population-based surveillance for iGAS infections in three Bay Area counties — Alameda, Contra Costa, and San Francisco — to monitor trends and assess disease burden. Based on CEIP data, no pediatric deaths from iGAS have been reported to date in California in 2022.

Still, the California Department of Public Health said parents should make sure their children are up to date on their varicella (chickenpox) and influenza (flu) vaccinations, as occasionally, group A strep infections occur following viral infections such as chickenpox and influenza.

"The CDC is also advising parents and caregivers to learn about the symptoms of the severe infections associated with iGAS, such as severe skin infections (aka “flesh-eating” infection) and toxic shock syndrome," California public health officials said. "Parents should seek medical care quickly if they, their children, or other family members think that they may have one of these infections."

Parents whose children show invasive group A strep symptoms should contact their physicians. Those symptoms include:

• A fever of 100.4 degrees Fahrenheit or higher;
• Severe muscle aches;
• Localized muscle tenderness; and
• Redness at the site of a wound.

In Colorado, there have been 11 reported cases of invasive group strep A in children since Nov. 1. in the Denver metro area in children 10 months to 6 years old. The Colorado Department of Public Health and Environment said it was aware of two deaths among these cases. Both were young children who were not yet school-aged. The state had not seen a pediatric death due to group A strep since 2018.

Minnesota health officials also issued an invasive group A strep advisory, saying the number of cases reported so far in November (46)was more than double the number in other months this year.

Infections are increasing in Europe, too, with health officials in Great Britain saying Thursday that strep A infections are linked to the deaths of 74 people, including 16 children.

The World Health Organization said Thursday that increases in invasive group A strep diseases have also been reported in France, Ireland, the Netherlands and Sweden, mostly among children under 10.

Health officials aren’t sure what is causing the increase in invasive A strep infections. CDC spokesperson Kate Grusich said in an email to CNN that the agency hasn’t determined if group A strep infections are returning to normal pre-pandemic levels or if something else is at work.

“The recent increases in respiratory viruses, particularly influenza, may also be contributing to a possible increase in iGAS infections,” Grusich said. “Concurrent or preceding viral infections such as influenza and skin conditions such as chickenpox may increase risk for iGAS infections.”