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Group A Streptococcal Disease (GAS)

What is GAS?

Group A streptococcus, a bacterium, may be carried in the throat or on the skin of people.
Carriers may or may not have symptoms of being sick. GAS is the same organism that
causes “strep throat”, and skin infections like impetigo (non-invasive diseases). Most
often infections cause mild illnesses. Although rare, these bacteria can cause severe, lifethreatening
diseases referred to as “invasive GAS disease.” Two of the most severe forms
of invasive GAS disease are necrotizing fasciitis, commonly referred to as “flesh-eating
bacteria”, and Streptococcal toxic shock syndrome (STSS). Necrotizing fasciitis destroys
muscle, fat and skin tissue. STSS causes a rapid drop in blood pressure and organ failure
of the kidneys, liver and lungs. Both invasive GAS and STSS are reportable diseases in

How is GAS bacteria spread?

Bacteria from the secretions of the nose, throat, wounds or sores on the skin may be
spread by direct contact from an ill person to another person. Carriers of the bacteria are
not as contagious. It is unlikely that indirect contact with plates, cups and mouthed toys
will spread the bacteria. Generally, after being on antibiotics for 24 hours, a person’s
ability to spread the bacteria is eliminated. However, the entire course of antibiotics
should be completed as prescribed.

Who is at risk for GAS Disease?

People with suppressed immune systems and those with chronic diseases, like cancer,
diabetes and kidney diseases, have a higher risk of becoming infected with invasive
disease. If a person has breaks in the skin, such as chicken pox, the bacteria may get into
the tissue and cause invasive disease. Some strains are more likely to cause severe
disease than others. However, most people develop throat or skin infections, or have no

What are the symptoms of necrotizing fasciitis and STSS?

Necrotizing fasciitis (early symptoms):
• Fever
• Severe pain and swelling
• Redness at the wound site
STSS (early symptoms):
• Fever
• Dizziness
• Confusion
• Rash (flat, red over large areas of the body)

How is Group A Streptococcal Disease diagnosed and treated?


Persons with sore throats should be seen by a doctor and have a “strep screen” or culture
performed to determine whether the illness is strep throat.
Invasive Group A Streptococcus is diagnosed when Streptococcus pyogenes is cultured
from the blood, spinal fluid, joint, lung, or heart fluids. Many different antibiotics can be
used to treat GAS. Supportive care in the intensive care unit may be required for people
with severe illness. Surgery is often needed for people with damaged tissue due to
necrotizing fasciitis. Early treatment with antibiotics may reduce the risk of death from
invasive disease. However, in some instances even the best medical care cannot prevent
death in every case.

How can Group A Streptococcal Disease be prevented? 

• Good hand washing can reduce the spread of GAS bacteria. Hands should be
washed after coughing, sneezing, and before preparing foods or eating.
• Persons, whose test results show strep throat, should stay home from work,
school, or day care until 24 hours after starting an antibiotic.
• Skin wounds should be kept clean and monitored for signs of infection, redness,
swelling, drainage and pain at the wound site. If fever occurs, persons with
infected wounds should see a doctor.
• Most often it is not necessary for anyone who is exposed to someone with
invasive GAS to receive antibiotics to prevent infection. A doctor should be asked
if antibiotic treatment is appropriate for contacts of an infected person.


Last Updated 7/31/2007