Invasive Group A Streptococcal Disease Fact Sheet

August 2010

What Is Group a Streptococcal Disease (GAS)?

GAS is a germ (bacterium) that is often found in the nose, throat and/or on the skin of healthy people.

How Does GAS Spread?

These bacteria are spread through direct contact with secretions from the nose or throat of people who are infected (e.g. open mouth kissing, mouth to mouth resuscitation) or through contact with infected wounds or sores on the skin. Those who are ill with GAS are the most likely to spread it to others. People who carry the bacteria but have no symptoms are much less contagious. Treating an infected person with an antibiotic for 24 hours or longer generally eliminates their ability to spread the bacteria.

Am I at Risk of Developing Invasive GAS?

Close contacts of people with invasive GAS may be at increased risk of infection, however, the risk of infection is low.

Close contacts include:

• People living in the same household as the sick person
• People sharing sleeping arrangements with the sick person
• People who have had direct contact with the sick person through mouth to mouth resuscitation, open mouth kissing, and open skin sores
• Injection drug users who shared needles with the sick person.

School classmates (kindergarten and older), work colleagues, as well as social or sports contacts of
the sick person are not usually considered to be close contacts.

What Kind of Illnesses Are Caused by GAS?

Most people who get GAS will experience common infections such as sore (strep) throat, tonsillitis, and skin infections (e.g. impetigo, pyoderma). GAS is sometimes found in unusual places such as blood, fluid surrounding the brain and spinal cord, or in the lining of muscles and joints. GAS found in these unusual places is called “invasive disease” and can result in severe invasive GAS disease.

What Are the Signs and Symptoms of Severe Invasive GAS?

Symptoms that may indicate severe invasive GAS include:

• Necrotizing fasciitis and myositis: fever, severe pain, swelling and/or redness of part of the body
• Meningitis: fever, severe pain on movement of the neck, nausea, and or vomiting
• Streptococcal toxic shock syndrome: fever, a general feeling of unwellness, dizziness, confusion and/or a flat, red rash on the body

What Precautions Can Be Taken to Prevent the Spread of Infections, Including Invasive GAS Disease?

• Use good personal hygiene, especially frequent and thorough hand washing
• Cover your cough or sneeze with a tissue or into your upper sleeve
• Wounds and cuts should be well cleansed and bandaged.

What Is the Role of Toronto Public Health?

Toronto Public Health investigates reports of communicable diseases including Invasive GAS disease. Our role is to notify close contacts of an infected person and assess the need for preventive antibiotics. Close contacts are advised to self-monitor for signs and symptoms of GAS infection, including fever, for 30 days.

More Information

Call Toronto Public Health at 416-338-7600 (TTY at 416-392-0658) or speak to your healthcare provider.