The bacteria that causes the infection – group A streptococcus – is actually incredibly common, and often is present in humans without causing any illness.
So how does it turn deadly, and should Australians be concerned about the recent cases and deaths? Here’s everything you need to know about strep A.
How many people have died in Australia from strep A?
We know at least two children, both in Victoria, died in 2022 after contracting strep A, but keeping track of the exact number of fatalities is difficult, as it was only recently added to the National Notifiable Diseases Surveillance System (NNDSS).
“Invasive Group A Streptococcus (iGAS) was made nationally notifiable in 2021. However, some jurisdictions were unable to begin providing iGAS notification data to the NNDSS until September of this year,” a Department of Health spokesperson told 9News.com.au.
“As such, notification and deaths data from the NNDSS for iGAS does not provide a full picture of iGAS in Australia at this time. In particular, states and territories do not routinely publicly report deaths associated with iGAS as they are difficult to confirm.
“The number of deaths is reliant on the follow-up of cases to determine the outcome of their infection. iGAS deaths reported to the NNDSS thus do not represent the true mortality associated with this disease and we do not have permission to share them.”
What we do know is that cases are on the rise.
The majority of them were recorded late in the year. After 166 cases in January-March, 214 from April-June, and 305 cases from July-September, there were 132, 134 and 212 in October, November and December respectively.
Queensland recorded the most infections, with 392, followed by Western Australia (226), Victoria (198), NSW (154), the Northern Territory (106), South Australia (82) and Tasmania (5). The ACT had no recorded cases.
As of January 13, there have been 52 infections recorded in 2023.
What is strep A and how do you get it?
Strep A is a bacterium found in the throat and on the skin.
It is carried without symptoms by many people, but often causes high fever or throat infections – known as strep throat.
When it can get deadly is in cases where it develops a more severe invasion: invasive group A streptococcal disease (iGAS), which occurs when the bacteria invade the body, overcoming its natural defences to enter areas such as the blood.
It can also cause other serious illnesses like scarlet fever and cellulitis, and lead to infected skin sores.
According to the Australian Department of Health, the two most severe forms of iGAS are necrotising fasciitis (which, in layman’s terms, is often referred to as flesh-eating bacteria) and streptococcal toxic shock syndrome.
Infection can spread when people cough or sneeze droplets which contain the bacteria and via skin-to-skin contact.
The best way to avoid infection, according to the Department of Health, is to maintain good hygiene.
Who is at highest risk from strep A?
While anyone can develop an infection, there are some groups who are at much higher risk of disease than others.
According to the Australian Department of Health, they are:
- children under five years of age, especially infants
- older people over 65 years of age
- people with poor access to hygiene facilities
- people who live or spend time in crowded conditions
- people with weak immune systems or chronic illnesses
NSW Health and researchers also say Aboriginal and Torres Strait Islander peoples are at high risk from strep A.
What are the symptoms of strep A?
Symptoms of infection include pain when swallowing, fever, skin rashes and swollen tonsils and glands, the US Centres for Disease Control and Prevention (CDC) says.
Parents of young children should be on the lookout for the following signs and symptoms, according to the UKHSA:
- the child is getting worse
- the child is feeding or eating much less than normal
- the child has had a dry nappy for 12 hours or more or shows other signs of dehydration
- the child is under three months and has a temperature of 38 degrees, or is older than three months and has a temperature of 39 degrees or higher
- the child feels hotter than usual on their back or chest, or feels sweaty
- the child is very tired or irritable
How many people have died from strep A in the UK?
As of January 12, 190 people had died with group A streptococcus A this season in England, including 30 children.
The last period of high infections in the UK was between 2017 to 2018, when four people under 10 were among the 27 children and 355 total people who died.
“Invasive group A strep infections remain rare but are currently higher than we see in a typical year,” the UK Health Security Agency (UKHSA) said in an update.
“So far this season there have been 1539 iGAS cases across all age groups, compared to 2967 across the whole of the last comparably high season in 2017 to 2018.
“So far this season, there have been 177 iGAS cases in children aged one to four compared to 194 cases in that age group across the whole of the 2017 to 2018 season.”
The UKHSA in December said it doesn’t believe a new strain is circulating, with the increase in infections likely a result of “circulating bacteria and social mixing”.
Is there a vaccine for strep A?
While there are efforts underway to develop a vaccine for strep A, there isn’t one available at the moment.
If there’s no vaccine, how is it treated?
There are a range of antibiotics which can effectively treat strep A – doctors will decide on which is best depending on the location of the infection and its severity.
When the infection is serious, hospitalisation will often be required for treatment.
How long does strep A last?
The duration of a strep A illness depends on the nature of the infection.
In the case of strep throat, for example, symptoms will typically last around one to five days, however untreated patients can remain infectious for up to three weeks.
People will generally no longer be contagious 24 hours after starting antibiotic treatment.
In the case of iGAS, the illness can become severe within 12-24 hours, making it critical that medical care is sought urgently.