CDC warns of a rise in severe strep A infections among children

Antonio Planas and Aria Bendix

The Centers for Disease Control and Prevention on Thursday alerted the medical community to an increase in pediatric cases of invasive group A strep infections.

Group A streptococci are the same bacteria that cause strep throat and scarlet fever, but invasive infections refer to more serious cases in which the bacteria spread to areas of the body that such pathogens normally don't reach, like the bloodstream.

The CDC warned in its health advisory that although rare, "these severe and invasive diseases are associated with high mortality rates and require immediate treatment, including appropriate antibiotic therapy."

The spike in invasive strep A was first detected in the U.S. in November, among children at a hospital in Colorado, the CDC said. After that, potential increases in cases “in other states were subsequently noted,” according to the advisory.

Two young children in the Denver metro area have died since Nov. 1, according to Colorado’s public health department.

NBC News reported last week that several children’s hospitals across the U.S. had detected increases in invasive group A strep infections. At the time, the CDC said it was “hearing anecdotes from some U.S. doctors of a possible increase in infections among children” and was still “talking with surveillance sites and hospitals in multiple states to learn more.”

In its Thursday advisory, the agency noted that the increase in strep A infections is occurring amid a rise in respiratory viruses, including RSV, influenza and Covid. Nationally, 74% of pediatric inpatient beds were full as of Wednesday, according to data from the Department of Health and Human Services.

In some cases, kids who develop severe strep A infections start out with a viral respiratory infection.

However, the overall number of invasive group A strep infections among children remains low and the condition is rare, according to the CDC.

Like other illnesses, the risk of contracting strep A increases seasonally among all age groups, the CDC said. Generally, people over 65 and those with chronic illnesses are most susceptible to invasive strep infections.

The CDC therefore emphasized the “importance of early recognition, diagnosis, and appropriate treatment of these diseases in children and adults.”

Invasive group A strep infections can trigger the following:

  • Lower airway infections like pneumonia or empyema, which is characterized by pockets of pus in the fluid-filled space surrounding the lungs. Early signs include fever, chills, difficulty breathing or chest pain.

  • Skin infections like cellulitis or necrotizing fasciitis, also known as flesh-eating disease. Both involve red, warm, swollen or painful rashes, though necrotizing fasciitis spreads quickly and can turn into ulcers, blisters or black spots.

  • Streptococcal toxic shock syndrome, an immune reaction that can lead to organ failure. The condition often begins with fever, chills, muscle aches, nausea or vomiting and then causes rapid heart rate or breathing.

In England, at least 21 children have died from invasive group A strep since mid-September. The U.K. Health Security Agency said in an advisory on Thursday that 94 deaths have been recorded in England across all age groups.

The World Health Organization said last week that cases were also increasing in France, Ireland, the Netherlands and Sweden.

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