Cases of Group A strep—which can cause strep throat—have skyrocketed in the U.S. this year, according to a new report.
The report, which was conducted by Epic Research, a company that analyzes electronic health records, found that cases of strep throat hit a five-year high in February and March. They were also nearly 30% higher than during the previous peak of cases of strep throat in 2017.
Data show that the vast majority of cases were in 4- to 9-year-olds, although all age groups—including adults—saw a noticeable jump in cases.
A spokesperson from the Centers for Disease Control and Prevention (CDC) told Prevention that unpublished data from the National Syndromic Surveillance Program show the number of non-invasive group A strep cases from emergency department visit data nationally in February and March 2023 were at the highest level for this period in the past five years.
The CDC also reports that many states are continuing to see higher than usual numbers of invasive group A strep cases, especially in children ages 17 years and younger and adults ages 65 years and older.
This isn’t the first time strep has been flagged as an issue over the past few months. In late December, the Centers for Disease Control and Prevention issued a health alert warning about an increase in cases of invasive group A strep infections in kids.
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But what’s behind this increase in strep A and when are cases likely to go down? Here’s the deal.
Why are strep cases so high right now?
There hasn’t been a study conducted yet to try to determine what’s behind this surge, but doctors have some theories.
A big theory is that the COVID-19 pandemic played a role. “It’s similar to what we’ve seen with other infectious agents,” says Thomas Russo, M.D., an infectious disease expert at the University of Buffalo. “The lack of contact and mask usage decreased the spread during the height of the pandemic, and people are interacting again.”
“There isn’t any doubt that strep infections went way down during the COVID era,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “Now that we’ve taken off our masks, strep infections and illnesses like influenza are coming back.”
In some areas of the country, cases of strep have gone back to baseline levels, Dr. Schaffner says, “But in other areas and in some places in Europe, they’ve gone above what we would normally anticipate.”
Dr. Schaffner says there’s “no good single answer for this” except that people are mingling again after being apart for so long. “Now, we’re spreading this bug amongst ourselves,” he says.
What is group A strep?
Group A strep, aka group A Streptococcus, is a bacteria that can cause a range of infections, according to the CDC. Those include strep throat, impetigo, and cellulitis.
In more severe cases, invasive group A strep can cause bloodstream infections, scarlet fever, rheumatic fever, and toxic shock syndrome.
Strep A symptoms
Symptoms of strep A can vary and largely depend on where someone is infected, according to the Cleveland Clinic. Mild infections may cause symptoms like:
- Trouble swallowing or pain when swallowing
- Small red spots on the roof of your mouth
- Sore throat
- Stomach pain
- Swollen tonsils or lymph nodes
A skin infection from group A streptococcal infection may cause symptoms like:
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- Rash on your neck, armpits, or groin
- Small, red to purple sores on the nose, mouth, arms, and legs
- Itchy skin
- Sores that leak a clear to yellow fluid or pus
- Crusty yellow scabs form over the sores
If a group A streptococcal infection is severe, it can include these symptoms:
- Large wounds, blisters, or black spots on the skin
- Nausea or vomiting
- Pain that spreads beyond the wound
- Skin that changes color
- Skin that’s swollen or warm to the touch
How do you get strep A?
In the case of strep throat, the bacteria is usually spread through person to person contact. That includes through respiratory droplets or contact with secretions like saliva or mucus, the CDC says.
Because of this, it’s a good idea to try to steer clear of people who are obviously sick, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. “It’s not something that is really avoidable other than to avoid individual who are sick with it until they are no longer contagious,” he says.
Dr. Schaffner agrees. “Other than avoid people who are sick, there’s not much you can do,” he says.
How is strep A treated?
If you or your child has a fever and sore throat without a runny nose or cough, Dr. Russo recommends getting it checked out. (If they have a runny nose or cough with their sore throat, Dr. Russo says it’s more likely to be due to a respiratory infection).
When will strep A cases go down?
Experts say that cases should start to decrease soon. “Strep is pretty seasonal and cases are usually higher in the winter,” Dr. Schaffner says. “This ought to wane now that we’re getting into warmer weather.”