Group A Streptococcal Disease, Invasive

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What is Invasive Group A Streptococcal Disease?

Streptococci are bacteria that are usually harmless residents of human throats and skin, generally causing at most sore throat, commonly called “strep throat”.
The most common forms of Invasive Group A Streptococcal Disease are:

  • toxic shock-like syndrome, the syndrome is characterized by sudden onset of shock and rapid involvement of the vital organs
  • skin or soft tissue, commonly called flesh-eating disease.

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What are the signs and symptoms of Invasive Group A Streptococcal Disease?

The streptococci usually enter the body through a break in the skin. Over the course of several hours, the injured tissue becomes hot, red and very painful. A flu-like illness may also develop with fever, pain and muscle aches. Once the infection becomes established, tissue destruction moves at a fast pace, as the streptococci release toxins that destroy body tissue. Without prompt treatment, death can occur within 24 hours.

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How is Invasive Group A Streptococcal Disease transmitted?

Streptococci usually live harmlessly in throats and on the skin of many healthy people. It is usually passed from person to person through close personal contact with an infected person, through kissing or sharing cutlery, drinking bottles etc. In the severe form of the disease, experts believe that the streptococci usually gain entry through a break in the skin. There are reports of secondary cases of invasive Group A streptococcal disease resulting from exposure to infected family members, patients in hospitals or nursing home residents.

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How is Invasive Group A Streptococcal Disease diagnosed?

The diseases usually diagnosed by the signs and symptoms and laboratory confirmation of the invasive strain of Group A Streptococcus from blood, tissue or sterile body fluids.
The presence of redness, swelling or heat near a small cut, and severe pain in the affected area are signs that will assist the physician in making a diagnosis.

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Is there effective treatment for Invasive Group A Streptococcal Disease?

There are a number of antibiotics which are very effective in the treatment of streptococcal infections. Surgery may be required in some instances in addition to the use of antibiotics.

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Who gets Invasive Group A Streptococcal Disease?

Any person can develop invasive group A streptococcal disease. However, the elderly, children with chickenpox infections and those with chronic medical conditions are more susceptible to severe disease.

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Is the illness always severe?

The 2 most severe forms of the disease are the toxic shock-like syndrome and the skin or soft tissue infection commonly called flesh-eating disease. The death rate for cases of toxic shock-like syndrome is 70% compared to 15% with necrotizing fasciitis. Group A streptococcus also causes mild infections such as throat infections, scarlet fever or impetigo as well as serious illnesses such as rheumatic fever, kidney infections and cellulitis.

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How common is it?

Severe invasive group A streptococcal disease, toxic shock-like syndrome and necrotizing fasciitis (commonly called flesh-eating disease) are rare affecting 1 or 2 people per 100,000 per year.

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Is there a vaccine available for the disease?

There is no vaccine available to prevent this infection.

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What do I do if am exposed to an infected person?

There are very limited data on the occurrence of secondary disease following exposure to a case of invasive group A streptococcal disease. A close contact is defined as any persons who have had direct mucous membrane contact with the oral or nasal secretions of a case within 7 days prior to the case illness. A 10-day course of an appropriate antibiotic(s) is recommended for close contacts.

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