Group A strep in pregnancy

Group A Streptococcus (also known as GAS) is a 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 (womb) in people who have recently given birth

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

GAS can cause health 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.

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 — such as blood tests or a swab of the umbilical cord area
• prescribe antibiotics for your baby — these may be given in an intravenous (IV) drip into their blood.

Symptoms of invasive GAS in a newborn baby can include:

• fast heart rate and fast breathing
• high or low body temperature
• difficulty breathing

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

There are 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 antibiotics if you need them
• seeing a doctor if you have been in contact with someone with invasive GAS
• not 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.

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 GAS, you may have the following symptoms:

• fever, chills or sweats
• shortness of breath
• chest pain
• nausea or vomiting
• skin wounds that are very red or won't heal
• severe muscle aches

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

Invasive GAS can become life threatening in less than 24 hours. Go to the nearest emergency department immediately if you see signs of invasive GAS.

To diagnose a GAS infection, your doctor will first talk with 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 or midwife will take a swab from your vagina.

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. People with invasive GAS who are very unwell may need other medicines to help treat their condition.

If you have invasive GAS disease after giving birth, you will need to stay in hospital to be monitored and treated 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.

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

The NSW Health website has more information about the symptoms, diagnosis, treatment and prevention of invasive GAS disease and impetigo

Information for Aboriginal and/or Torres Strait Islander peoples

See the Australian Indigenous Health Info Net website for information about rheumatic fever and rheumatic heart disease.