CDC issues alert on invasive group A strep infections in kids

The Centers for Disease Control and Prevention (CDC) is urging US clinicians and public health authorities to be aware of an increase in pediatric invasive group A streptococcal infections (iGAS).

In a  Health Alert Network (HAN) notice issued last month, the CDC said it was notified in November about a possible increase in iGAS infections at a hospital in Colorado, and that potential increases in other states were subsequently noted by contributors to the Emerging Infections Network and the CDC’s Active Bacterial Core Surveillance System. While the overall number of cases is low, the CDC says it’s currently investigating these reports.

Group A Streptococcus bacteria causes a range of infections, including acute pharyngitis (strep throat), scarlet fever, and other, more serious and life-threatening invasive infections. The CDC says strep throat and iGAS infections tend to have a pronounced seasonal pattern in the United States, with a peak occurring from December through April, and notes that this year’s increase in pediatric iGAS cases in some jurisdictions is occurring amid increased circulation of influenza, respiratory syncytial virus, and SARS-CoV-2.

The United States isn’t the only country seeing an uptick in group A streptococcal activity. The HAN notice comes on the heels of a disease outbreak update from the World Health Organization that reported an increase in iGAS infections and scarlet fever cases in at least five European countries.

The CDC says people with concurrent or preceding infections (like flu or chicken pox), people age 65 and over, residents of long-term care facilities, American Indian and Alaska Native populations, and people with medical conditions are among those at risk for iGAS infections.

The agency is recommending that clinicians be aware of iGAS as a possible cause of severe illness in children and adults with concomitant viral respiratory infections and calling on state and territorial health departments to investigate unusually aggressive or severe iGAS infections in children under 18 and clusters of infections in any age group.