Group A strep in pregnancy

What is group A streptococcus?

Group A Streptococcus (also known as GAS) is bacteria that usually causes mild illnesses like sore throats (strep throat) or skin infections (impetigo). When GAS causes severe disease this is referred to as invasive GAS.

Invasive GAS can cause:

• infection of the blood (sepsis)
• meningitis
• pneumonia
• toxic shock syndrome
• necrotising fasciitis (known as ‘flesh eating disease’)
• infection of the uterus in women who have recently given birth

GAS can also colonise (live in) certain areas of the body without causing disease. For example, GAS commonly colonises the throat without causing a throat infection. If GAS is colonising your throat, you can still spread GAS to other people even though you feel well yourself.

GAS can also cause complications later in life, like rheumatic fever and problems with the kidney. Rheumatic fever can cause a high body temperature (fever), joint pain, rash as well as heart and neurological problems. To prevent these complications, it is important to diagnose and treat GAS early, and not to ignore your symptoms.

What could GAS mean for my baby?

If you have invasive GAS infection of your uterus during or after birth, your baby is at high risk of developing GAS sepsis (infection of the blood). Your health team will monitor your baby closely, take some tests (for example, blood tests or a swab of the umbilical cord area) and prescribe antibiotics for your baby. Your baby may need intravenous (IV) antibiotics directly into their blood.

You and your baby will need to stay in hospital for longer than usual, until you are both well enough to go home.

Can GAS infection be prevented?

There are several things that you can do to help prevent GAS infection. Prevention strategies include:

• carefully washing your hands with soap and water
• keeping wounds clean and covered until they heal
• seeing a doctor if you have a sore throat or skin sores, so they can prescribe you with antibiotics if you need them
• seeing a doctor if you have been in contact with someone with invasive GAS so you can take antibiotics
• avoiding going to work or school if you have GAS until you have been treated with antibiotics for at least 24 hours to avoid spreading it to others

There is currently no available vaccine for GAS.

What are the symptoms of GAS?

Symptoms of GAS depend on what part of the body is affected. If you have strep throat, symptoms include sore throat, fever and tender, swollen neck glands. If you have impetigo (skin sores) symptoms include skin sores that are either crusted or blistering.

If you have invasive group A disease, you may have the following symptoms:

• fever
• chills/sweats
• dizziness
• shortness of breath and/or chest pain
• headache and /or neck stiffness
• nausea and vomiting
• rapidly spreading skin infection

If you have invasive GAS after having a baby, symptoms may include:

• lower abdominal (tummy) pain
• bleeding from your vagina
• bad smelling discharge from your vagina

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

How is GAS diagnosed?

To diagnose a GAS infection, your doctor will first talk to you and examine you. Your doctor may also take some tests. For example, if your doctor suspects a GAS infection in your throat, they will take a throat swab. If you have a suspected GAS skin infection, your doctor may take a swab from the skin sores. If invasive GAS infection is suspected, your doctor will take blood tests and possibly other tests, depending on what part of the body is affected. If you have just had a baby and have suspected invasive GAS infection, your doctor will take a swab from your vagina.

How is GAS treated?

GAS is treated with antibiotics. It is important that you isolate (stay away from other people) for the first 24 hours after starting antibiotics to avoid spreading GAS to others. Patients with invasive GAS who are very unwell may need other medicines to help treat their condition.

What happens after the birth?

If you have invasive GAS disease after giving birth, you will need to stay in hospital for careful monitoring and treatment with antibiotics. You may also need to take other medicines. Your health team will check your baby and treat them with antibiotics as well.

You will not need to be separated from your baby.

Once you are feeling well enough, you should discuss your breastfeeding options with your doctor.

Resources and support

For more information about the symptoms, diagnosis, treatment and prevention of strep throat infections see the SA Health website.

For more information about the symptoms, diagnosis, treatment and prevention of impetigo see the NSW Health website.

For more information about symptoms, diagnosis, treatment and prevention of invasive GAS disease see the NSW Health website.

Looking for information for Aboriginal and Torres Strait Islander people? See the Australian Indigenous Health Info Net website for information about rheumatic fever and rheumatic heart disease.