Group A Strep

Please click the frequently asked questions below for further information and IPC precautions required:

• What is Group A Streptococcus (GAS)?

  GAS 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.

  

• How does it spread?

  Streptococci survive in throats and on hands for long enough to allow easy spread between people through:

  • Respiratory droplets including as sneezing and coughing
  • Kissing
  • Direct skin contact.

  It can also be transmitted environmentally, through:

  • contact with contaminated objects, such as towels or bedding
  • ingestion of food inoculated by a carrier
• What kind of illnesses are caused by GAS?

  It causes a diverse range of skin, soft tissue and respiratory tract infections, including:

  • Strep Throat
  • Tonsillitis
  • Pharyngitis
  • Scarlet fever
  • Impetigo
  • Erysipelas
  • Cellulitis
  • Pneumonia

   

  On rare occasions, GAS can cause other severe diseases including Invasive GAS.

• What is invasive GAS disease or iGAS?

  Invasive GAS disease occurs when the bacterium gets into parts of the body where it is not usually found, such as the blood, muscle, or lungs or the birth canal after childbirth. These infections are called invasive GAS. Two of the most severe, but rare, forms of invasive GAS disease are necrotising fasciitis and Streptococcal Toxic Shock Syndrome.

  Most people who come into contact with GAS remain well and symptom-free, or develop mild throat or skin infections. These infections can be easily treated by your GP. Healthy people can get invasive GAS disease from a relative or a member of their household but it is very rare. Certain groups of people might be more at risk of contracting a more serious infection, for example, people who have recently given birth, or had surgery.

• What are the symptoms of GAS?
  • High Fever
  • Severe muscle aches
  • Redness at the site of a wound
  • Vomiting or diarrhoea
  • Sore Throat

  GAS which causes Scarlet Fever may also be accompanied by a characteristic fine red rash which may feel like sandpaper. It may also be accompanied by a white coating on the tongue, swollen glands and a flushed red face.

• Why is this important?

  If NIAS staff are aware that the patient has a suspected or confirmed case this should be communicated to the Control Room (Emergency or Non-emergency as appropriate) and the staff in the receiving unit when transferring the patient to ensure effective patient care and management.

• What cleaning is required?

  All equipment and the ambulance should have an in-between patient clean, paying particular attention to touch points.

• IPC Precautions
  • Droplet precautions should be used. Precautions can be reviewed/ removed on the patients has received more 24hrs of appropriate antibiotic therapy.
  • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
  • Eye protection should be risk assessed for any concern regarding a splash risk.
  • A Fluid Resistant Surgical Mask should be worn.
  • Gloves and Aprons should be worn.
  • The patient should be transported via ambulance with no other patients present.
  • Laundry should be treated as contaminated, placed into an alginate bag and placed into a red laundry bag.
• Do staff need prophylaxis or follow up?

  If you develop any of the symptoms of GAS contact your GP or seek medical advice. Routine prophylaxis antibiotics are not usually required.

  If you have been in contact with an invasive GAS you should tell your GP if you have been in contact with someone recently diagnosed with invasive GAS disease and that you have developed some symptoms that you are worried about. It is very likely that your GP will ask you to come into the surgery so you can be examined. If you are too unwell to visit the surgery or it is closed, you should not delay in seeking medical advice.

  **If you have been diagnosed as having invasive GAS you must notify Occupational Health**

  Immediate Actions: Inform Station Officer / Line Manager and contact the IPC team during working hours for further advice.

• Links to Guidance

  Guidelines for prevention and control of group A streptococcal infection in acute healthcare and maternity settings in the UK (his.org.uk)