What is Strep A? And how is it related to toxic shock syndrome?

TSS is not just a “tampon-related condition,” says a GP.
Strep A Signs Symptoms  How It's Linked To Toxic Shock Syndrome
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The UK Health Security Agency (UKHSA) has confirmed an increase in infections of Strep A this year, particularly among those under the age of 10. 

In recent weeks, diseases caused by Strep A bacteria have claimed the lives of nine children in the UK.

Whilst Strep A can lead to life-threatening conditions, its bacteria is commonly found in our bodies and can be easily treated with antibiotics. 

Scarlet fever is amongst the illnesses caused by a Strep A bacterial infection. 

The UKHSA recently reported statistics showing 23,000 cases of scarlet fever documented in 2022 thus far, whilst in 2021 there were just 2,323 in the same period. 

Common symptoms to look out for include; a sore throat, chills, a fever and muscle aches. 

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GLAMOUR asked GP and Medical Director at Flo Health, Dr. Claudia Pastides, on what Strep A really is, how serious it can become, how to prevent it from spreading and how it's related to toxic shock syndrome.

What is Strep A?

Strep A (also known as Group A Streptococcus), are bacteria commonly found in the throat or on the skin. Under some circumstances, these bacteria can cause diseases such as tonsillitis, a sore throat and scarlet fever. These conditions are treatable with antibiotics and are usually mild.

How serious is the illness/ how serious can it get?

On very rare occasions, Strep A can cause invasive Group A strep (iGAS) infections. iGAS infections include conditions such as necrotising fasciitis (a severe infection of the skin), infection of the bloodstream and streptococcal toxic shock syndrome (a rare life-threatening condition caused by the bacteria’s toxins). In rare cases, iGAS can lead to death.

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How can it be spread/ how contagious is Strep A?

GAS are spread by close contact with others. It is spread through respiratory droplets when people talk or are close together and also by direct skin contact.

GAS can also be transmitted through contact with contaminated food and objects. The current increase is most likely related to high amounts of circulating bacteria and social mixing. And currently, there is no evidence that a new strain is circulating.

To reduce the spread of this infection and your chances of catching it, the advice is much the same as it is with COVID (although it is good to note, GAS is a bacteria and not a virus like COVID, so the pathogen involved in this infection is not the same):

  • Washing hands well, with soap, for 20 seconds regularly is important.
  • Using tissues to cough/sneeze into and binning the tissues straight after.
  • And keeping away from other people if you’re feeling unwell
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Is Strep A related to toxic shock syndrome?

People often think of TSS as being a tampon-related condition, but actually, TSS is an iGAS, where group A strep bacteria releases a harmful toxin, which can make someone very ill very quickly.

Causing symptoms like a fever, a sunburn-like rash, lowering their blood pressure and leading to end-organ damage. TSS can be due to non-menstrual reasons and can affect men, children and non-menstruating women, too.

The important takeaway information here is to practice good hand and respiratory hygiene and make sure you’re monitoring how you feel if unwell. 

It is, of course, winter, and there are many other infections, such as cold and flu viruses going around, not forgetting COVID too. So if you or your child has a sore throat/cough and are getting worse – make sure to speak to NHS 111 or your doctor. If you suspect you or your child has scarlet fever, contact NHS 111 or call your doctor because early treatment with antibiotics is important.