Streptococcus A infections, what should you know?

Last December, an unusual increase in infections by Streptococcus Pyogenes In children. From the approximate 186 cases that had been reported in previous years, there were 851 cases, with a predominance of common upper airway infections; among them, the tonsillitis and the scarlet fever. In parallel, there was also an increase in invasive group A streptococcal (iGAS) infections in children under 10 years of age.

Meanwhile, in Spain, called for calm and the Spanish Society of Pediatric Infectious Diseases (SEIP) assured that “in our country, iGAS cases are being analyzed in recent weeks and tables, but the death of some children is already known and a number of serious cases to be determined that could lead us to think that we are also suffering an increase in cases ”. In fact, in some children it could be a superinfection of a viral respiratory infection, such as the famous RSV or the flu, which are very common at this time. For its part, the Ministry of Health has assured that it is under “active surveillance” in the face of possible new cases of invasive disease caused by streptococcus A. A surveillance that is still being maintained and that, with the return of all the children to the classroom, not to be missed.

However, to stay calm, recognize its symptoms and find out what are the most common diseases it causes, we wanted to talk to the Marta Espartosa, pediatric nurse and child health promoter on Instagram (@marta_enfermera_pediatrica), who explains it to us in detail. In addition, she tells us that the health alert “should not cause alarm in parents or in the general populationsince they are helpful so that pediatricians can be informed and focus on diagnosing these types of conditions prematurely, avoiding complications ”.

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What is strep A and what diseases does it cause?

streptococcus A or Streptococcus Pyogenes is a bacteria, not a virus. And, although we may think that a bacterium is much more dangerous than a virus or vice versa, “the reality is that both are different and can cause mild symptoms in a patient or more serious symptoms”, the nurse explains. Where they do differ is in treatment: “infections caused by bacteria, for example, require antibiotic treatment in order to be overcome”. In fact, a bacterium is a pathogen that frequently produces a wide variety of infectious processes – from pharyngitis or tonsillitis to the aforementioned scarlet fever.

Now, the most common cause of sore throats is usually viruses, but in the case of the strep A bacterium, this is also a symptom of the diseases that it causes, so it can be somewhat confusing. To differentiate them, according to the Center for Disease Control (CDC)there are three key symptoms: cough, runny nose and hoarseness. If we have any of these three symptoms, it is most likely that we have to fight against a virus and not a bacterium.

Symptoms and most common diseases of streptococcus A

The most common symptoms of a condition caused by this bacterium are the following:

  • Sore throat that worsens when swallowing.
  • Fever.
  • Redness of the tonsils.
  • Inflammation of said tonsils and also of the lymph nodes found in the neck.
  • Small white spots, which are usually with pus, and the appearance of red dots on the palate.

Among the most frequent conditions that it suffers are both tonsillitis and scarlet fever. The first of these is at the skin level, which undoubtedly shares prominence with impetigo. To differentiate them, the nurse explains, “we must know that the first always manifests itself with tonsillitis, they go together.”

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Scarlet fever

Scarlet fever, as we have said, manifests with tonsillitis (what we usually call angina) and with a skin rash. It can be accompanied by fever, which usually lasts three to five days, sore throat, and swollen glands in the neck. Generally, it is on the second day that this rash usually appears. “Consists in a rash of very small pimples that give a rough appearance to the skin”, explains the nurse. “The rash extends from top to bottom (from face and neck to the rest of the body), although on the face it is usually just a bit of white around the lips.” usually affects for children between the ages of two and eight.


Impetigo usually occurs “Because the child has a wound and, having lost the protection that the skin offers, a superinfection of this bacterium can occur”. It usually occurs in wounds that are already very exposed (especially on the face and extremities) and “generally appears in times that are somewhat hotter than today.” To identify it, the lesions are initially much redder and, gradually, they acquire a honey color. “It’s not dangerous at all, but the infection could spread to other areas of the skin.” usually affect children between the ages of two and five.

When should I see a doctor?

This is always one of the questions that parents often ask themselves when the child has a fever or feels unwell. Everyone doubts when it is time to go with their child to the ER or to the doctor. For this reason, Marta Espartosa tells us that “If our little one has a fever and a sore throat, which does not subside in two or three days and, in addition, we observe the appearance of that rash that we have talked about, we should go to our pediatrician to assess it”. Once we have the diagnosis and antibiotic treatment is prescribed, we will see how the child improves in a few days.

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In any case, he warns us, “in the face of this and other infections, you should go to your pediatrician or an Emergency Department, whenever a child presents tendency to be sleepy, if the fever is very high and lasts 72 hours and if we observe that it is difficult for you to breathe”. These are three warning signs that should make us decide to see a medical professional. And it is that, although, in general, “the infections produced by this bacterium are mild and easy to treat with antibiotics, we can also find more serious forms, such as pneumonia, sepsis or septic shock.”

Are there preventative measures for strep A?

Currently, there is no vaccine for this bacterium, “although there are several studies linking the intranasal flu vaccine, which began this fall for children ages two and older, with increased protection against strep A infections”. It is a piece of information that the nurse finds interesting, since it seems that the most serious cases that have set off alarm bells this winter, “have been related (as we have commented) to superinfections by streptococcus A and VRS or influenza”.

Now, as always, both the experts and the nurse offer us some hygiene recommendations that can help prevent the spread and contagion: regular hand washing, the use of disposable tissues, the importance of ventilation in spaces not only relatives or the use of a mask if we notice any symptoms.

HELLO! The total or partial reproduction of this report and its photographs is prohibited, even citing their origin.



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