Group A Streptococcal (GAS) Disease
(strep throat, necrotizing fasciitis, impetigo)

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2. Take the Strep Throat Infection Quiz!
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• What is group A streptococcus(GAS)?
• How are group A streptococci spread?
• What kind of illnesses are caused by group A streptococcal infection?
• How common is invasive group A streptococcal disease?
• Why does invasive group A streptococcal disease occur?
• Who is most at risk for getting invasive group A streptococcal disease?
• What are the early signs and symptoms of necrotizing fasciitis and streptococcal toxic shock syndrome?
• How is invasive group A streptococcal disease treated?
• What can be done to help prevent group A streptococcal infections?

What is group A streptococcus (GAS)?

Group A streptococcus is a bacterium often found in the throat and on the skin. People may carry group A streptococci in the throat or on the skin and have no symptoms of illness. Most GAS infections are relatively mild illnesses such as "strep throat," or impetigo. On rare occasions, these bacteria can cause other severe and even life-threatening diseases

How are group A streptococci spread?

These bacteria are spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin. Ill persons, such as those who have strep throat or skin infections, are most likely to spread the infection. Persons who carry the bacteria but have no symptoms are much less contagious. Treating an infected person with an antibiotic for 24 hours or longer generally eliminates their ability to spread the bacteria. However, it is important to complete the entire course of antibiotics as prescribed. It is not likely that household items like plates, cups, or toys spread these bacteria.

What kind of illnesses are caused by group A streptococcal infection?

Infection with GAS can result in a range of symptoms:

• No illness
• Mild illness (strep throat or a skin infection such as impetigo)
• Severe illness (necrotizing faciitis, streptococcal toxic shock syndrome)

Severe, sometimes life-threatening, GAS disease may occur when bacteria get into parts of the body where bacteria usually are not found, such as the blood, muscle, or the lungs. These infections are termed "invasive GAS disease." Two of the most severe, but least common, forms of invasive GAS disease are necrotizing fasciitis and Streptococcal Toxic Shock Syndrome. Necrotizing fasciitis (occasionally described by the media as "the flesh-eating bacteria") destroys muscles, fat, and skin tissue. Streptococcal toxic shock syndrome (STSS), causes blood pressure to drop rapidly and organs (e.g., kidney, liver, lungs) to fail. STSS is not the same as the "toxic shock syndrome" frequently associated with tampon usage. About 20% of patients with necrotizing fasciitis and more than half with STSS die. About 10%-15% of patients with other forms of invasive group A streptococcal disease die.

Picture of necrotizing fasciitis (flesh-eating disease)