Tuesday, May 26, 2015

Group A strep

Maine CDC is investigating an increase in the number and severity of invasive group A Streptococcal (GAS) infections in the first half of 2015 compared to a similar time frame in previous years.  Maine CDC received reports of 15 cases of invasive GAS in April and the first week of May alone, almost half of the 33 cases reported to date this year.  Of those 15 cases, six resulted in streptococcal toxic shock syndrome (STSS), a more serious presentation in which the disease affects multiple organs.  At this time in 2014, Maine had reports of 23 cases of invasive GAS and nine cases of STSS. 
Most GAS infections are relatively mild such as “strep throat,” scarlet fever or impetigo.  Invasive GAS disease is more severe and includes pneumonia, cellulitis and the least common forms but most severe forms -- necrotizing fasciitis and STSS. 
Invasive GAS infections are seasonal, peaking December through April. The spread of GAS can be prevented by good hand washing, especially after coughing and sneezing.  People with sore throats diagnosed as strep throat should stay home from work, school or day care until 24 hours after taking antibiotics.
Recommendations: 
Health care providers should consider invasive GAS in any patient who presents with early signs of STSS and should collect culture specimens and consider prompt antibiotic treatment. Because invasive GAS infections can progress rapidly, providers are encouraged to be familiar with early signs of STSS:
  • Fever
  • Abrupt onset of generalized or localized severe pain, often in an arm or leg
  • Dizziness
  • Influenza-like syndrome
  • Confusion
  • A flat red rash over large areas of the body (occurs in 10% of cases)
Reporting requirements:
All cases of suspected invasive GAS and STSS should be reported by phone to the Maine CDC at 1-800-821-5821, or by fax to 1-800-293-7534.
For more information:
 US CDC’s Group A Strep webpage:  http://www.cdc.gov/groupastrep/

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