Strep A and pulmonary fibrosis

What is strep A?

Streptococcus is a group of bacteria. There are several different types, one of which is group A streptococcus (GAS), commonly known as strep A. GAS often lives harmlessly on our skin or in our throats, but it can cause infection and illness.

GAS infections can be categorised as non-invasive or invasive.

Non-invasive

·       Bacteria live in the throat or on the outside layer of skin.

·       Infections can include bacterial tonsilitis, pharyngitis and impetigo.

·       Infections tend to be milder but they can become more severe.

Invasive

·       Bacteria live in blood or organs, which are places where bacteria are not normally found.

·       Infections can include scarlet fever, cellulitis and necrotising fasciitis.

·       These infections can become very severe.

How strep A spreads

GAS infections are spread through droplets of mucus in the air or skin-to-skin contact. GAS bacteria can also be carried on objects or in food.

People with GAS who do not have an infection can also pass on the bacteria. This is less likely to cause an infection when passed on, however.

Symptoms of strep A

GAS causes different symptoms depending on the type of infection. This can include:

·       a sore throat (tonsilitis or pharyngitis, also known as strep throat)

·       a rash, sores or blisters (impetigo)

·       pain and swelling (cellulitis)

·       a rough, bumpy rash (scarlet fever), and

·       flu-like symptoms including a fever, muscle aches, nausea and vomiting.

Symptoms can vary from mild to severe. In rare cases, symptoms can be life-threatening, or result in post-infection complications such as rheumatic fever or glomerulonephritis. It’s not fully clear why some people respond differently to GAS bacteria but it’s thought to be genetic.

Treaing strep A

Seek advice from your GP if you have symptoms. GAS infections can sometimes be treated with antibiotics.

If you need urgent or out-of-hours medical advice contact 111, or call 999 in emergencies.

Strep A and pulmonary fibrosis

Some health conditions increase your risk of GAS infections:

·       having a reduced immune system

·       diabetes

·       cancer

·       vascular disease, and

·       open sores or wounds.

People who take steroid medication, are undergoing chemotherapy or are intravenous drug users are also at an increased risk.

There isn’t much research into how GAS infections specifically affect those with PF. GAS can cause pneumonia (a chest infection) which can make symptoms of PF worse.

You should take reasonable precautions to avoid contact with GAS infections. Since there are no specific guidelines, you might want to discuss this with the people close to you to decide what actions to take.

What you can do

There has been a recent increase in cases of GAS infections, particularly in children.

The UK government and NHS has advised the following:

·       Maintain good hand hygiene.

·       Remain at home if you are unwell.

·       Clean and cover all wounds.

·       Clean surfaces that are frequently used, e.g. door handles and children's toys.

·       Use a tissue to catch coughs and sneezes and bin immediately.

·       Avoid sharing drinks, cutlery or bedding.

There are currently no specific guidelines for people with lung conditions such as PF. People with PF may be more vulnerable to infection so be sure to follow the advice above and take precautions to avoid contact with people who could spread an infection.

If you are concerned about catching GAS, you could talk about this with people close to you so they can help to reduce the risk of spreading an infection.

For example, if you spend time with children, whether your own or within your family, make sure they know about the importance of hand washing and coughing or sneezing into tissues.

For further information:

Contact your local GP.

Read information on the NHS webpage for strep A.

Read more at the UK Health Security Agency blog on strep A.

Keep up-to-date with UK Health Security Agency news on strep A.