Group A streptococci are bacteria commonly found in the throat and on the skin. The vast majority of GAS infections are relatively mild illnesses, such as strep throat and impetigo. Occasionally, however, these bacteria can cause much more severe and even life threatening diseases such as necrotizing fasciitis (occasionally described as “the flesh-eating bacteria”) and streptococcal toxic shock syndrome (STSS), or invasive GAS infections.


This patient revealed a scarlet fever rash on the volar surface of the forearm due to group A Streptococcus bacteria Image/CDC
This patient revealed a scarlet fever rash on the volar surface of the forearm due to group A Streptococcus bacteria

Health officials in England are reporting  a more than double number of cases of scarlet fever during the past several months.

According to the latest Health Protection Report published Friday, 11,982 cases of scarlet fever have been reported since mid-September 2017, compared to an average of 4,480 for the same period over the last 5 years.

Nick Phin, Deputy Director at Public Health England, said:

It’s not uncommon to see a rise in cases of scarlet fever at this time of year. Scarlet fever is not usually a serious illness and can be treated with antibiotics to reduce the risk of complications and spread to others. We are monitoring the situation closely and remind parents to be aware of the symptoms of scarlet fever and to contact their GP for assessment if they think their child might have it.

Whilst there has been a notable increase in scarlet fever cases when compared to last season, greater awareness and improved reporting practices may have contributed to this increase.

Scarlet fever usually starts with a sore throat, headache and fever and may be followed by a fine red, erythematous rash, which gives the skin a sand-paper-like texture.The rash may occur at any part of the body such as the upper trunk, armpit and neck, but spare the face, palms of the hands and sole of the feet. The tongue of the infected person may appear swollen, red and bumpy, and have a “strawberry”-like appearance with a whitish coating.

It usually runs a mild course, but complications may develop occasionally. Potential complications include otitis media, throat abscess, pneumonia, meningitis, acute rheumatic fever, acute glomerulonephritis, sepsis and toxic shock syndrome. SF can be effectively treated with antibiotics. Prompt treatment helps alleviate symptoms faster, prevents rare but serious complications, and minimizes the risk of transmission.

Region of Peel

Group-A Streptococcus (GAS)/CDC
Group-A Streptococcus (GAS)/CDC

The Regional Municipality of Peel in Southern Ontario, Canada continues to report cases of invasive GAS infections, a continuation from 2017.

According to Peel Public Health, there were 47 cases from Jan. 1, 2017 to Dec. 31, 2017 and five associated deaths.

So far in 2018, there have been 13 cases of the infection and one associated death confirmed in Peel hospitals.

In most cases, infections involving strep A don’t advance beyond strep throat, but more invasive strains can turn life threatening.

Invasive GAS disease is a severe and sometimes life-threatening infection in which the bacteria have invaded parts of the body, such as the blood, deep muscle and fat tissue or the lungs. Two of the most severe, but least common, forms of invasive GAS disease are called necrotizing fasciitis (infection of muscle and fat tissue) and streptococcal toxic shock syndrome (a rapidly progressing infection causing low blood pressure/shock and injury to organs such as the kidneys, liver and lungs).

Approximately 20 percent of patients with necrotizing fasciitis and 60 percent with STSS die. About 10-15 percent of patients with other forms of invasive group A streptococcal disease die.