Group A Strep is increasing throughout Canada. Alberta has also been seeing a rise in cases. This was first reported back in January and remains of concern.
Group A Strep (GAS) causes several diseases: strep throat, cellulitis, scarlet fever, toxic shock syndrome, impetigo, rheumatic fever, necrotizing fasciitis and post-strep glomerulonephritis. It is classified as invasion GAS (iGAS) when it spreads along tissue and becomes life-threatening. It’s transmitted by large droplets and direct contact. The incubation period is unclear but seems to be 1-3 days. Communicability is 10-21 days.
People at increased risk are children aged 5-11, those with chronic lung, liver and heart disease, diabetes, varicella infection, lowered immunity, open skin wounds and those living in crowded, unsanitary conditions Most cases will present with fever, pharyngitis and/or skin infections (especially impetigo). It’s important to identify and treat early. Antibiotic treatment is required. Many people are carriers of GAS, so identifying potential carriers is useful when reoccurring cases are happening in a family or other group in close contact. Scarlet fever is a disease that isn’t seen often. A telltale symptom is the “strawberry tongue” along with a sore throat, high fever and often a skin rash.
What can you do as a primary care nurse?
First, protect yourself. For contact & droplet, precautions include good hand hygiene, eye protection, procedure mask, gloves and gown. Click here for a reminder about donning & doffing. Monitor patients coming into your care for these symptoms and refer them to the appropriate care provider for testing and treatment.
References:
Alberta public health disease management guidelines : streptococcal disease group A, invasive (April 2023)
BC Centre for Disease Control: Streptococcal Disease, Invasive, Group A
Centers for Disease Control and Prevention: Diseases Caused by Group A Strep
Canadian Pediatric Society: Group A streptococcal (GAS) pharyngitis: A practical guide to diagnosis and treatment