Invasive Strep A in Kids: What to Know After the Deaths in Colorado

Since September, complications from strep A infections have led to the deaths of 21 children in the UK. Now, public health officials in the US are concerned after two strep A-related deaths were reported in Colorado, both of which affected young children. 

Strep A infections are caused by a bacteria called group A Streptococcus, and they’re actually really common: Strep A causes millions of non-invasive infections each year, like strep throat, scarlet fever, and a skin infection called impetigo, per the Centers for Disease Control and Prevention (CDC). What’s not so common, however, is invasive group A strep (iGAS), which can lead to life-threatening complications.

The CDC says it is investigating an increase in these rare iGAS cases; the agency has not confirmed how many cases have been reported in the US this year. “It’s too soon to say whether iGAS case numbers are just returning to pre-pandemic levels or if they are rising beyond what we would normally expect based on what we know about GAS seasonal patterns,” a CDC spokesperson told CNN. The numbers from these recent outbreaks are somewhat puzzling and jarring; per the UK Health Security Agency, the 2017-2018 winter was the last “comparably high” season for group A strep infections in the UK. Notably, Colorado hasn’t reported any strep A deaths since 2018, per reporting from NBC News.

Officials don’t fully understand why this uptick in deadly strep A complications is happening, Cory Fisher, DO, a family medicine physician at the Cleveland Clinic, tells SELF. However, there’s one predominant theory floating around the medical community, according to the experts SELF spoke with: “Some have postulated that high circulating viral infections like RSV [respiratory syncytial virus], influenza, or COVID may create enough baseline inflammation to make patients more vulnerable to complications,” Dr. Fisher says. Basically, if a young child is already sick, they’re pretty vulnerable if another infection hits, potentially increasing the risk of these rare but severe complications.

Below, experts explain what parents, in particular, should know about strep A, including iGAS, and how to stay as safe as possible through the rest of cold and flu season.

What should parents know about strep A—and should you be worried?

First, it’s important to remember that strep A complications aren’t common, and the CDC is still investigating the reported deaths in Colorado. A spokesperson for UKHSA said in a December 22 statement that non-invasive infections, like strep throat, are often “easily treated with antibiotics and it is very rare that a child will go on to become more seriously ill.” 

Sara Siddiqui, MD, a pediatrician at NYU Langone, echoes this; she tells SELF that as long as a child is seen by a doctor once they start feeling unwell, the infection (if confirmed) can usually be treated successfully. It’s untreated cases that can become serious, she notes.

Though strep throat is most common in children five to 15 years old (and rare for children under three), it can affect people of any age, per the CDC. Children who have chickenpox or the flu are at higher risk of developing iGAS, per the World Health Organization (WHO). Like children, older adults may be more vulnerable to serious infection as well, Dr. Fisher says.