Streptococcus pyogenes, or beta streptococcus group A (GAS) is a very common pathogenic bacterium in humans causing a wide range of disease ranging from the mild to severe and life threatening.

Strep throat is caused by group A Streptococcus bacteria./CDC
Strep throat is caused by group A Streptococcus bacteria./CDC

Infections caused by the bacterium are responsible for outbreaks in schools in Galicia, Spain and Madison County, OH during the past week.

In Spain, dozens of students at Virxe do Carme school in the province of Lugo, Galicia were diagnosed with streptococcal pharyngitis, according to a La Region report (computer translated).

The Regional Health Department reported that the health center diagnosed the 1st cases on 27 Sep 2015; however, the next Monday, 67 students went to the pediatrics department and 65 of them tested positive for the streptococcus infection.

An additional 16 new cases were confirmed on Wednesday. Among the total cases was at least two cases of scarlet fever.

The report notes the school will continue to take extreme hygiene measures, as it did from the moment it became aware of the problem, to reduce the chance of infection. Among other measures, drinking glasses were given to all the children in order to avoid sharing bottles, drinking from faucets, or any other risky behavior.

The territorial delegate in Lugo, Raquel Arias, explained that it appears “the outbreak of tonsillitis in the Virxe do Carme school is past its peak,” and noted that “the gradual return of the students to their classrooms is expected.”

In Madison County, OH, located about 25 miles southwest of the Ohio capital of Columbus, the Madison-Plains Local Schools closed their doors on Friday due to an outbreak of impetigo. reports Superintendent Tim Dettwiller said four kids have been sent home with confirmed impetigo. There are 60 other kids with rashes of unknown cause in grades K-9.

The school was cleaned and sanitized on Friday and Saturday.


Impetigo can be caused by GAS or Staphylococcus aureus, the exact etiology was not mentioned in the local media report.

The most common disease caused by GAS is pharyngitis, or strep throat. Strep throat is very common in school-aged children, particularly in the winter and spring months. Untreated strep throat can lead to more serious complications like rheumatic fever; however, this is relatively uncommon.

It is also a cause of several skin infections such as impetigo and cellulitis. Impetigo is a characterized by a crusty lesion frequently found on the mouth area. Cellulitis typically occurs after a wound or burn where the bacteria enters and spread though the skin and lower tissues.

More serious, potentially life-threatening infections caused by Streptococcus pyogenes include necrotizing fasciitis (commonly called flesh-eating bacteria) and toxic shock syndrome. In addition, Streptococcus pyogenes can cause scarlet fever, septicemia and pneumonia. The death of Muppet’s creator Jim Henson was a result of an infection with Streptococcus pyogenes.

Worldwide each year, there are 616 million cases of pharyngitis caused by GAS. An estimated 663,000 cases of severe infection and 470,000 cases of acute rheumatic fever result in 517,000 deaths annually. In the U.S., there are 1,850 deaths each year from invasive Group A streptococcal disease. Necrotizing fasciitis kills close to 30% of patients and streptococcal toxic shock syndrome has a mortality rate of 30-70%.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today and the Executive Editor of The Global Dispatch

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