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March 30, 2023

Severe strep infections remain elevated, CDC says; here are the signs to look for

Most illnesses caused by the bacteria are mild. But when infections spread to portions of the body not usually affected, they can prove deadly

Children's Health Illness

Group A strep infections are considered severe – and potentially life-threatening – when the bacteria infects parts of the body it normally does not invade, like the lungs, or the blood, deep muscle and fat tissue.

The number of invasive group A strep infections in children has risen to levels not seen since before the COVID-19 pandemic began, the U.S. Centers for Disease Control and Prevention says.

The infections are caused by Group A streptococci bacteria, which is commonly found in the throat and on the skin, and also causes illnesses like strep throat and scarlet fever. Strep infections are considered invasive – and potentially life-threatening – when the bacteria infects parts of the body it normally does not invade, like the lungs, or the blood, deep muscle and fat tissue.

There are an estimated 14,000 to 25,000 cases of invasive strep A infections each year, resulting in 1,500 to 2,300 deaths, the CDC says. These infections dropped by 25% during the COVID-19 pandemic as a result of social distancing, mask wearing and remote schooling. Infections among children ages 2-17 fell to their lowest point since 1997. 

But cases have risen as the U.S. has returned to pre-pandemic life. And they remain elevated above pre-pandemic levels in some portions of the country, the CDC told ABC News

In December, children's hospitals across the country began monitoring the rise after Arizona, Texas and Colorado reported more cases than normal. A CDC analysis found invasive strep A cases were three times higher than their pre-pandemic levels in Colorado and Minnesota. At least two children in the Denver region had died. Another five children have died in Illinois this year.

A spokesperson for the Children's Hospital of Philadelphia was unable to provide any data on the situation in the Philadelphia region. The city's Department of Public Health did not respond to a media inquiry. 

What are the symptoms of Strep infections?

Commons signs of strep infections include fever, sore throat, swallowing difficulties and children acting abnormally, doctors say. 

Parents also should watch for the signs of toxic shock syndrome, a rare infection that occurs when strep bacteria spread into deep tissues and the bloodstream. that can quickly cause low blood pressure, organ failure and death. It often begins with fever, chills, muscle aches, nausea and vomiting before causing low blood pressure, a faster heart rate and rapid breathing. 

Strep bacteria also can cause necrotizing fasciitis, a deadly, flesh-eating illness that occurs when the bacteria enter the body through breaks in the skin. Early symptoms include a red, warm or swollen area of the skin, severe pain and fever. It advances to cause blisters on the skin, pus, dizziness, fatigue and diarrhea and nausea. 

Invasive strep cases generally are treated in the hospital with IV antibiotics such as amoxicillin and penicillin. Surgery may be necessary to remove infected tissue. 

Along with children, older adults and people with weakened immune systems face are at higher risk if they develop an invasive group A strep infection.

How to prevent strep infections

Strep bacteria tend to spread during the winter and early spring. 

To prevent the spread of group A strep, the CDC recommends washing your hands with soap and water, covering your mouth when coughing or sneezing, and thoroughly washing glasses, utensils and plates. 

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