Strep A (Group A streptococcus)

Strep A (Group A streptococcus) is a common bacteria (germ). It is sometimes found in the throat or on the skin without causing any symptoms.

It usually causes mild illness like sore throats and skin infections.

In rare cases, these bacteria can cause a severe and life threatening illness called invasive group A streptococcal disease (iGAS).

How you get strep A

Strep A is spread by close contact. It can be passed on through coughs and sneezes, or from a wound.

You may have the bacteria in your body without feeling unwell or showing any symptoms of infections. You generally don't need treatment if you feel OK.

But you can still pass it on even if you have no symptoms. You are at a higher risk of spreading strep A if you are unwell.

Infections caused by strep A

Strep A can cause infections in your:

  • skin
  • soft tissue (muscles, tendons and ligaments)
  • respiratory system (nose, throat and lungs)

Possible infections include:

It's rare that you will get a serious infection.

Signs and symptoms of strep A

Strep A infections cause symptoms such as:

Most people with a high temperature or a sore throat have a virus and not strep A.

Urgent advice: Contact your GP urgently if your baby or child:

  • is feeding, eating or drinking much less than normal
  • has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • is under 3 months and has a temperature of 38 degrees Celsius
  • is older than 3 months and has a temperature of 39 degrees Celsius or higher
  • feels hotter than usual when you touch their back or chest, or feels sweaty
  • is very tired or irritable

Immediate action required: Call 999 or 112 or go to your local emergency department if:

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • there are pauses when your child breathes
  • your child’s skin, tongue or lips are blue
  • your child is floppy and will not wake up or stay awake

Treating strep A symptoms

You can usually treat your child's symptoms at home. Ask your pharmacist for advice on medicines. Read advice for treating symptoms of strep A such as a sore throat or a high temperature.

You can usually give your child liquid paracetamol (for example, Calpol) or ibuprofen. This should help improve their symptoms. Follow the dosage instructions on the bottle or packet.

Trust your instincts. Contact your GP, GP out-of-hours or emergency department if you are worried about your child.

Antibiotics

Antibiotics are not usually needed if you have a sore throat or high temperature. But your GP may prescribe antibiotics if they think that you have strep A.

Information:

Contact your GP if you or your child are getting worse, even if you are on antibiotics.

If you are prescribed antibiotics, keep taking them until they're finished. Do this even if you feel better.

This will reduce the chance of the infection returning.

Invasive group A strep (iGAS)

Invasive group A strep (iGAS) is the most serious infection linked to strep A.

You are at a higher risk if you:

  • are 75 or older
  • are a newborn baby under 28 days old
  • are pregnant for 37 weeks or more
  • gave birth in the last 28 days
  • have recently had chickenpox

Infections caused by iGAS

Infections caused by iGAS can:

  • cause severe muscle, fat and skin tissue infection
  • lead to sepsis
  • cause organ failure, for example in the kidneys, liver or lungs
  • cause a fast drop in blood pressure

These infections are very rare.

Signs and symptoms of iGAS

It's not always easy to tell if you have iGAS. Symptoms can appear like symptoms of other conditions.

They can include some of the below:

  • high temperature (38 degrees Celsius or higher)
  • muscle pain or severe muscle aches
  • severe pain in a wound
  • redness at the site of a wound
  • dizziness and confusion
  • a flat red rash over large areas of the body
  • diarrhoea or vomiting where there is no other obvious cause

Having these symptoms does not always mean you have iGAS. But you should get urgent medical help if you or your child feel very unwell. Trust your instincts. iGAS is a serious infection that can lead to sepsis.

Immediate action required: Call 999 or 112 or go to your GP urgently if:

  • you are worried that your child is seriously unwell

How to avoid spreading strep A

To stop getting and spreading Strep A:

  • clean your hands often - especially after going to the toilet and before eating
  • stay at home if you have symptoms - this includes not sending sick children to crèche or school until they are better
  • use your own soap, facecloth, sponge and razor
  • cover coughs or sneezes with a tissue or your sleeve - put used tissues into a bin and wash your hands

If you are in hospital:

  • limit contact with other patients and keep away from their bed space
  • avoid sharing food, newspapers or other personal items with other patients
  • tell staff if facilities in a hospital or clinic are not clean

Visitors must clean their hands thoroughly before and after they see you. They should not sit on your bed.

No vaccine for strep A

There is no vaccine against Strep A. But vaccines prevent other severe illness.

Make sure all your child’s vaccines are up to date.

Get the flu vaccine and COVID-19 vaccine if it is due.

Page last reviewed: 22 December 2022
Next review due: 22 December 2025