The killer bug doctors warn is on the rise in Australia

A rise in potentially deadly strep A cases among Aussies kids has health authorities on high alert. So, what are the symptoms?

Australian health authorities are warning of a marked increase in a dangerous and potentially deadly bacterial infection – group A streptococcal disease – known colloquially as strep A.

The killer bacteria has already claimed the lives of dozens of children in the UK, with cases spiking in more than half of Australian states and territories in the past three months.

Associate Professor Manisha Pandey from the Institute for Glycomics at Queensland’s Griffith University says strep A mainly presents as a mild illness; however, a surge in the rarer, life-threatening version of the disease, known as invasive strep A (or iGAS), is causing concern.

In Western Australia cases have doubled among adults and children, in the state’s first major surge of the infection in two decades, while in Queensland, New South Wales and Victoria, authorities have reported recent rises in case numbers.

Strep A is the same infection that led to the death of Perth girl Aishwarya Aswath in 2021 and claimed the lives of at least two other children in Victoria last year.

What is strep A?

Strep A disease is caused by bacteria known as group A streptococcus.

“It’s a common infection that is carried without symptoms by many people, but it can cause sore throats, scarlet fever or skin conditions such as cellulitis and impetigo, otherwise known as school sores,” Prof Pandey says.

“While these conditions are relatively mild, they can develop into the more invasive strep A disease, where the bacteria overcomes the body’s natural defences and enters the bloodstream and then spreads to other areas of the body.

“Things then tend to escalate very, very quickly and parents need to trust their instincts and seek medical attention immediately if symptoms emerge so that the infection can treated with antibiotics.”

How Strep A can lead to rheumatic fever

University of Sydney infectious diseases expert paediatrician Prof Robert Booy says when the bacteria becomes an invasive disease it can lead to serious complications that can harm the heart, a condition known as rheumatic fever, causing permanent damage.

“A child can go from having scarlet fever to having rheumatic fever and damage to the heart if infections aren’t properly treated,” Prof Booy says.

The Australian Department of Health says the two most severe forms of iGAS are necrotising fasciitis, often referred to as flesh-eating bacteria and streptococcal toxic shock syndrome.

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What are the symptoms of invasive Strep A?

Warning signs of invasive streptococcal disease can include fevers and chills, cold hands and feet, dizziness, shortness of breath, a stiff neck, nausea and vomiting, a red skin infection, which may have pus, or ulceration and abdominal pain.

Symptoms to look out for in young children include fever, a sunburn-like rash, irritability, difficulty waking, vomiting, high-pitched crying, cold or mottled limbs, refusal to eat or feed, not wanting to walk and difficulty breathing.

“If the bacteria gets into the bloodstream, things can deteriorate in a matter of hours,” Professor Pandey says.

“Don’t wait until tomorrow, rapid intervention can be lifesaving.”

Why have severe cases of invasive strep A increased?

Prof Booy says the surge in influenza and other respiratory illnesses that occurred when Australia opened its borders after the pandemic may have contributed to the rise.

“The lessening of social restrictions has seen cases of both bacteria and viruses go up at times they wouldn’t normally do so,” he says.

“Strep A outbreaks commonly happen on the back of an uptick in other infections – those viruses cause damage to the lining of the throat and can set up fertile ground for the invasion of the bacteria into the bloodstream.”

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Who is most at risk of strep A infection and how does it spread?

People most at risk are those under five or over 65, pregnant and post-partum women, Aboriginal and Torres Strait Islanders, intravenous drug users and people who are immunosuppressed or have a chronic disease such as diabetes.

“Strep A bacteria are usually spread from one person to another by sneezing, coughing or kissing and via skin-to-skin contact,” Prof Pandey says.

“Damaged skin, such as cuts, sores and wounds, can increase the risk of severe strep A.”

The best way to avoid infection, according to the Department of Health, is to maintain good hygiene.

Wash your hands regularly, avoid close contact with people who are sick and treat skin infections promptly to stop them from spreading.

Is there a vaccine for strep A?

While there isn’t a vaccine for strep A available at the moment, teams of researchers across the world are working on vaccine trials, which could be up and running in the next few years.

Written by Liz McGrath.