With a dangerous and potentially deadly type of strep throat infection on the rise in Illinois, sparking warnings across the state as levels rise to their highest in years, what should parents watch for?
So far, at least five pediatric deaths have been reported in the state involving the invasive group A strep throat, with Illinois' health department expressing concern.
"We’re worried about children as we're seeing group A strep outbreaks, just strep throat outbreaks rampant in a lot of communities and in schools," said Dr. Arti Barnes, chief medical officer for the Illinois Department of Public Health.
The Centers for Disease Control and Prevention also said it is "looking into an increase in invasive group A strep infections among children in the United States," adding that such infections include things like necrotizing fasciitis and streptococcal toxic shock syndrome.
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On March 10, IDPH Director Dr. Sameer Vohra said more cases of the group A strep throat leading to severe complications have been reported in 2023 "than in any of the past five years."
“As COVID-19 cases and community levels remain stable, I want to share my concern about the growing number of strep throat cases in Illinois that are leading to severe complications,” Vohra said in a statement. “These cases, known as invasive Group A strep, are the result of disease spreading from the throat to blood, muscle and lungs. I urge parents to contact their health providers when their children start showing early symptoms."
According to Vohra, those symptoms could include "sudden onset of sore throat, pain when swallowing and fever," but there are many other conditions associated with group A strep that could present differently.
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Experts says early detection of the infection is "critical."
Here's what to know:
Symptoms to Know
The symptoms can start quickly with invasive group A strep throat, according to medical experts.
"Sore throat - that can start very quickly," said Dr. Deanna Behrens with the American Academy of Pediatrics. "It can lead to pain with swallowing, and that fever."
Dr. Michael Cappello with Advocate Children's Hospital also advises parents check their child's skin.
"If they're having red, warm, swollen, painful skin, especially in an area where may have been disrupted by a cut or a scrape or oozing something, you want to seek care for that," Cappello said.
Some who are infected with group A strep can be contagious even if they don't have symptoms.
"Some infected people do not have symptoms or seem sick. Infected people who are sick with strep throat are more contagious than those who do not have symptoms," the CDC states.
Strep Throat Symptoms
- Fever
- Pain when swallowing
- Sore throat that can start very quickly and may look red
- Red and swollen tonsils
- White patches or streaks of pus on the tonsils
- Tiny, red spots on the roof of the mouth, called petechiae (pronounced pi-TEE-kee-eye)
- Swollen lymph nodes in the front of the neck
- Headache
- Stomach pain
- Nausea or vomiting
- Rash (scarlet fever)
Scarlet Fever
- Very red, sore throat
- Fever (101°F or higher) or chills
- Whitish coating on the tongue early in the illness
- “Strawberry” (red and bumpy) tongue
- Red skin rash that has a sandpaper feel
- Bright red skin in the creases of the underarm, elbow, and groin
- Swollen glands in the neck
- Headache or body aches
- Nausea, vomiting, or abdominal pain
Streptococcal Toxic Shock Syndrome
Seek medical attention right away if you or your child have these
Initial symptoms:
- Fever and chills
- Muscle aches
- Nausea and vomiting
Later symptoms:
After the first symptoms start, it usually only takes about 24 to 48 hours for low blood pressure to develop. Once this happens, STSS quickly grows more serious, the CDC states:
- Hypotension (low blood pressure)
- Tachycardia (faster than normal heart rate)
- Tachypnea (rapid breathing)
- Organ failure (other signs that organs are not working)
- Examples: Someone with kidney failure may not make urine. Someone with liver failure may bleed or bruise a lot or their skin and eyes may turn yellow.
Necrotizing Fasciitis
Seek medical attention right away if you or your child have these
Early symptoms:
- A red, warm, or swollen area of skin that spreads quickly
- Severe pain, including pain beyond the area of the skin that is red, warm, or swollen
- Fever
Later symptoms:
- Ulcers, blisters, or black spots on the skin
- Changes in the color of the skin
- Pus or oozing from the infected area
- Dizziness
- Fatigue (tiredness)
- Diarrhea or nausea
For more possible conditions associated with invasive group A strep and their symptoms, click here.
What is Invasive Group A Strep Throat?
According to the CDC, what makes the group A strep throat invasive is that it invades parts of the body "that are normally free from germs."
"When this happens, disease is usually very severe, requiring care in a hospital and even causing death in some cases," the CDC states. "Necrotizing fasciitis and streptococcal toxic shock syndrome are examples of iGAS infections. In addition to causing uncommon but severe and invasive infections, group A strep bacteria cause common and generally mild illnesses like strep throat and scarlet fever.
"Just having strep throat doesn't automatically lead you to having it invade your body," Barnes told NBC 5. "That happens in a very small proportion of cases."
What Makes Group A Strep So Dangerous?
How can strep turn fatal?
Doctors said group A strep produces a toxin that, once it enters the blood stream, can overpower the immune system.”
"Once that toxin enters, it can really cause damage to of course your heart your kidneys, your liver, your joints, your bones," Barnes said.
The reason behind the spike in pediatric cases, however, remains unclear.
"We don't know if there's something specific about the strain of strep that we're seeing right now that's making it so that kids are getting sicker or if it's just we're seeing more strep throat," said Behrens.
In the last three months, Advocate Children's Hospital said it has treated eight children for invasive group A Strep.
"Some of them pretty sick, requiring, you know, even intensive care hospitalization," said Dr. Michael Cappello.
This comes as the CDC warns of a national shortage of amoxicillin, which is "most often prescribed to children to treat group A strep infections."
"The shortage is anticipated to last several months," the CDC states.
What Can I Do to Protect My Child?
Doctors say vaccinations are key, particularly for chickenpox.
"Those breaks in the skin that may occur can also allow for an entryway for the group A strep to get into the bloodstream," Cappello said.
Antibiotics are also important.
“You've got to treat it early, the antibiotics work," Barnes said.
Doctors also suggest maintaining good hygiene.
To prevent group A strep infections, the CDC recommends you:
- Cover your mouth and nose with a tissue when you cough or sneeze.
- Put your used tissue in the waste basket.
- Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
- Wash your hands often with soap and water for at least 20 seconds.
- Use an alcohol-based hand rub if soap and water are not available.
