Infection Prevention and Control
What is Group A Streptococcus (GAS)?
Group A streptococcus (GAS) – also known as Streptococcus pyogenes – are bacteria that can be found in the throat and on the skin. People may carry GAS and have no symptoms of illness or may develop infection.
How are GAS spread?
Streptococcus bacteria survive in throats and on skin for long enough to allow easy spread between people through sneezing and skin contact. People who are currently carrying GAS in the throat or on the skin with no symptoms of illness are described as colonised Both individuals who are colonised with GAS, or who are unwell with a GAS infection, can pass these bacteria on to others.
What kind of illnesses are caused by GAS?
Most GAS illnesses are relatively mild such as ‘strep throat’, scarlet fever or a skin infection such as impetigo. However, on rare occasions, these bacteria can cause other severe and even life-threatening diseases.
What is invasive Group A Strepococcal disease (iGAS)?
Although rare, life-threatening GAS disease may occur when bacteria get into parts of the body where bacteria usually are not found, such as the blood or muscle. These infections are called invasive Group A Streptococcal (iGAS) disease. Two of the most severe, but rare, forms of iGAS disease are necrotising fasciitis and streptococcal toxic shock syndrome. Necrotising fasciitis destroys muscles, fat and skin tissue. Streptococcal toxic shock syndrome causes blood pressure to drop rapidly and organs (for example kidney, liver, lungs) to fail.
Why does iGAS disease occur?
iGAS infections occur when the bacteria get past the defences of the person who is infected. This may occur when a person has sores or other breaks in the skin that allow the bacteria to get into the tissue, or when the person’s ability to fight off the infection is decreased because of chronic illness or an illness that affects the immune system. Although healthy people can get iGAS disease, people with chronic illnesses (such as cancer, diabetes, heart disease), and individuals who are pregnant or have recently given birth, have a higher risk.
How Common is iGAS?
iGAS disease is rare. There are 2 to 4 cases per 100,000 population annually.
How do we prevent the spread of GAS?
In hospital if you are told that you have a GAS infection in a wound for example or a blood sample, you will be placed in a single room to help reduce the risk of spread to other patients in the ward.
Your doctor will review you and commence antibiotic treatment if necessary. You will need to stay in the single room until you have received 48 hours of the suitable antibiotic treatment. Any staff entering the room will put gloves and an apron on before entering the room, prior to leaving, the gloves and apron will be removed and their hands will be washed. Your visitors do not need to wear gloves and apron unless they are going to be involved in any direct care, for example assisting with your hygiene needs.
Information for household contacts of patients:
Am I at risk of getting iGAS disease from close contact with a relative or household contact?
Most people who come into contact with GAS remain well and symptom-free or may develop mild throat or skin infections. Healthy people can get invasive GAS disease from a relative or a member of their household who has been ill or is colonised with GAS, but it is very rare.
Do contacts of a case require treatment?
Contacts of an iGAS case do not usually require any treatment, and it is rare for contacts to develop symptoms. However, some household contacts may be offered antibiotics if they are pregnant (≥37 weeks), elderly (75 years or older), have chickenpox, or are a newborn baby (under one month). If someone else in the household experiences any symptoms of a GAS infection such as sore throat, skin infection or fever within 30 days of the first case, they should also contact their doctor promptly and may require antibiotics.
What do I need to be aware of?
The most important thing to be aware of are the early signs and symptoms of invasive disease, which are shown below:
Early signs and symptoms of invasive Group A Streptococcal
- High fever
- Severe muscle aches
- Localised muscle tenderness
- Pain in one area of the body
- Increasing pain, swelling and redness at the site of a wound
- Unexplained diarrhoea or vomiting
What should I do if I develop any of these symptoms?
If you develop any of these symptoms contact your G.P. or seek medical advice immediately. Tell the doctor that you have been in contact with someone recently diagnosed with invasive Group A Streptococcal (iGAS) disease and that you have developed some symptoms that you are worried about. It is very likely that the doctor will ask you to come into the surgery so he or she can examine you. If you are too unwell to visit the surgery or it is closed do not delay in seeking alternative medical advice. It may help to take this leaflet with you.
Good infection control measures such as effective hand hygiene, good general cleaning and careful handling of soiled household linens, such as bedding and towels, reduce the risk of cross infection.
Remember
Most people who come into contact with GAS remain well and symptom-free, or develop mild throat or skin infections. Contracting invasive GAS disease from a relative or household member is very rare. UKHSA may get in touch with you depending upon your results.
You can get more information from the UKHSA website or check your symptoms on 111 online at https://111.nhs.uk/ (for children aged 5 and over)
Contact us
If you have any further questions, please ask your nurse or contact the Infection Control Team, either via the ward nurse or directly on the following number:
Telephone: 01642 854800 – 8am until 5pm, Monday to Friday (excluding bank holidays)
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the patient experience department of any special requirements, for example; braille or large print by emailing:
[email protected]