What are the symptoms of strep A infections?

profile picture of Rishi Patel
Clinical Innovation Lead, Bupa
14 December 2022
Next review due December 2025

Sadly, there have recently been a few cases of severe strep A infections in children. While strep A infections are not usually serious, it’s important to know the signs and symptoms of severe strep A. Here, I’ll explain what to look out for and when to seek help.

person spraying hand sanitiser on a child's hand

What is strep A?

Strep A is short for group A streptococcus bacteria. This type of bacteria is pretty common. It can live in your throat, or your skin, without causing you any harm. But sometimes, strep A can cause infections.

Most of the time, when strep A causes an infection, it’s mild. Occasionally, strep A bacteria can also cause a more serious type of disease, called severe strep A infection. You might also hear these serious strep A infections referred to as invasive group A strep (iGAS). These infections are caused by the bacteria getting into parts of the body where it’s not usually found, such as the lungs or bloodstream.

Strep A symptoms

Symptoms of strep A vary depending on which illness the bacteria have caused. Mild strep A symptoms tend to include a sore throat, swollen tonsils, small red dots on the roof of your mouth and headaches.

Severe or invasive strep A symptoms can include:

  • high fever
  • severe muscle aches
  • pain in one area of the body
  • redness at the site of a wound
  • vomiting or diarrhoea

What type of infections can strep A cause?

Strep A bacteria can cause a range of infections in the skin, soft tissue, and respiratory tract. These include:

  • tonsilitis
  • pharyngitis
  • scarlet fever
  • impetigo
  • cellulitis

These types of infections tend to be mild and can usually be managed by taking antibiotics. At the moment doctors are seeing lots of scarlet fever cases.

Invasive strep A infections can include necrotising fasciitis, necrotising pneumonia, and streptococcal toxic shock syndrome.

How do you catch strep A?

Strep A bacteria can be passed on when you are in close contact with someone who is infected. Usually, the bacteria are spread through coughs and sneezes. But it can also be passed on through close contact or if a wound is infected with strep a bacteria.

People who have strep A bacteria but are not ill can also sometimes pass it on to others. But it’s much more likely when somebody is already unwell.

Who is at risk of strep A?

Unfortunately, young children appear to be at a higher risk of catching strep A. Strep A infections usually affect children under 10 years old. But strep A can also affect older adults aged 65 or over. People who have weak immune systems due to chemotherapy, steroid use, or other serious illnesses may also be at higher risk of catching strep A.

Can you prevent strep A?

Good hand and respiratory hygiene are important for stopping the spread of many bugs, including strep A. So, washing your hands, and covering your mouth when coughing or sneezing can help. Keeping away from others who are feeling unwell also helps to reduce the risk of picking up or spreading infections. In some cases, people who have been exposed to invasive strep A, at school for example, will be offered antibiotics as a preventative.

What is causing an increase in strep A cases?

Some scientists think that the recent increase in strep A cases may stem from reduced immunity in the population after the COVID 19 pandemic. During this time, lots of younger children were not exposed to as many different bacteria and viruses as they usually would have been. This may have made children more susceptible to diseases such as scarlet fever, chicken pox, and strep A. But this has not yet been confirmed, and more studies are needed.

Aside from this, there is usually also an increase in infectious diseases during the winter months, as people gather together indoors more.

How is strep A treated?

Strep A infections such as scarlet fever are usually treated by a course of antibiotics. Rest, hydration, and painkillers such as paracetamol may also help to reduce symptoms. After 24 hours of taking antibiotics you are no longer deemed to be contagious.

For severe or invasive strep A, antibiotics will also be used. However, these more serious infections may also require additional hospital support, and occasionally, intensive care is required to provide extra treatment.

When to seek help for strep A

It’s good to use your own instinct as a parent to decide when your child is very unwell. You should contact your GP if you have any concerns.

You should consider contacting NHS 111 or your GP if your child is getting worse, or:

  • is feeding or eating much less than normal
  • is showing signs of dehydration (including having a dry nappy for 12 hours or more)
  • your baby is under three months and has a temperature of 38C, or is three to six months and has a temperature of 39C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • is very sleepy or irritable

Call 999 or go to A and E quickly if:

  • your child is having trouble breathing. Sometimes this looks like their tummy is being sucked in underneath their ribs
  • there are pauses when your child breathes
  • your child’s skin, tongue or lips are blue in colour
  • your child is floppy and cannot wake up or stay awake

Here at Bupa we understand how important your family is. So with our family health insurance you can rest assured knowing that eligible treatment and support is available to you and your loved ones when you need it.

profile picture of Rishi Patel
Dr Rishi Patel (he/him)
Clinical Innovation Lead, Bupa

    • Group A Strep – what you need to know. UK health security agency., published 5 December 2022.
    • Why are strep A cases rising and how worried are scientists? Nature., published 9 December 2022. doi:

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