As the holidays wrap up, and travel booms, infectious diseases like RSV, Strep A, the flu and COVID are spreading. Strep A in particular is worrying medical experts as children are susceptible; the CDC just issued a warning days before Christmas. “CDC is looking into an increase in invasive group A strep (iGAS) infections among children in the United States. iGAS infections include necrotizing fasciitis and streptococcal toxic shock syndrome,” said the agency just days before Christmas. “Bacteria called group A Streptococcus (group A strep) can cause many different infections.” Read on to see what else the CDC said and how to stay safe—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

While the strep you may think of includes a sore throat, the more devious Invasive group A strep disease can include, says the CDC:

• Cellulitis with blood infection. Cellulitis is a serious bacterial infection that affects the deeper layers of the skin and the underlying tissue. It can occur anywhere on the body, but is most common on the legs, face, and arms. Cellulitis is characterized by red, swollen, and tender skin that is warm to the touch. It may also cause fever, chills, and fatigue.
• Necrotizing fasciitis. Necrotizing fasciitis is a rare but serious bacterial infection that affects the deeper layers of the skin and the underlying tissue. It is also known as flesh-eating disease or flesh-eating bacteria syndrome.
• Necrotizing fasciitis is caused by a variety of bacteria, including streptococcus and staphylococcus. It can occur when bacteria enter the skin through a cut, scrape, or insect bite, or when bacteria enter the skin through a wound or surgical incision. The bacteria release toxins that damage the surrounding tissue, leading to the death of the tissue, or necrosis.
• Pneumonia. Pneumonia is an infection that affects the lungs. It is caused by a variety of bacteria, viruses, and other microorganisms, and it can range in severity from mild to life-threatening. Symptoms of pneumonia may include fever, cough, chest pain, shortness of breath, rapid breathing, sweating, fatigue, and muscle aches. In severe cases, pneumonia can cause confusion, difficulty breathing, and low blood pressure.
• Streptococcal toxic shock syndrome (STSS). Streptococcal toxic shock syndrome (STSS) is a rare and potentially life-threatening condition caused by a type of bacteria called group A streptococcus. This type of bacteria is the same type that causes strep throat, impetigo, and other infections. STSS can occur when group A streptococcus bacteria release toxins into the body, leading to a toxic shock-like reaction. Symptoms of STSS may include fever, chills, low blood pressure, dizziness, rapid heart rate, rash, redness of the skin, nausea, vomiting, and diarrhea. In severe cases, STSS can cause organ failure and death.

At least two children have died from Strep A in Colorado. “The Colorado Department of Public Health and Environment is monitoring an increase in pediatric hospitalizations caused by group A strep. Group A strep is a bacteria that can cause many different infections. As the Department has been following recent increases in other illnesses , CDPHE is working with hospital partners in a coordinating role to ensure resources are available for those who need them,” said the agency. “There have been 11 reported cases of invasive group A strep in children since Nov. 1, 2022, in the Denver metro area where invasive group A strep is a reportable condition through Centers for Disease Control and Prevention’s Emerging Infections Program. Recent cases range in age from 10 months to 6 years, but anyone of any age can get group A strep. CDPHE is aware of two deaths among these cases. Both were young children who were not yet school aged. The official cause of death has not been finalized by a coroner or medical examiner. The last reported death in a pediatric patient with group A strep in Colorado was in 2018.”

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At least 21 children have died in the UK due to Strep A. “It is very rare that a child will go on to become more seriously ill, but parents know better than anyone else what your child is usually like, so you’ll know when they are not responding as they would normally. Make sure you speak to a healthcare professional if your child is getting worse after a bout of scarlet fever, a sore throat or respiratory infection – look out for signs such as a fever that won’t go down, dehydration, extreme tiredness, intense muscle pains, difficulty breathing or breathing very fast,” says the UK government.

“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,” CDC spokesperson Kate Grusich wrote. “The recent increases in respiratory viruses, particularly influenza, may also be contributing to a possible increase in iGAS infections. Concurrent or preceding viral infections such as influenza and skin conditions such as chickenpox may increase risk for iGAS infections.” 

“While they remain rare, CDPHE is seeing invasive group A strep infections in Colorado that cause severe illness,” said Dr. Rachel Herlihy, state epidemiologist, CDPHE, in the Colorado alert. “There is no vaccine for group A strep, but keeping up to date on vaccines for COVID-19, flu, and chickenpox can help protect your child from developing complications from a group A strep infection. Stay home when you are sick and practice good hand hygiene — regularly wash your hands with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer with at least 60% alcohol and avoid touching your face. Call your child’s doctor if they are experiencing new or worsening symptoms of an illness.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

Alek Korab