Flu season may be nearing its peak, but health officials say U.S. cases of “flesh-eating” strep throat are on the rise. A new study helmed by the Centers for Disease Control and Prevention (CDC), is bringing attention to an infectious disease called invasive group A strep—which isn't to be confused with regular strep throat.
Medical experts have observed a “substantial” increase in invasive group A strep cases, with rates more than doubling between 2013 and 2022.
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What to Know About Invasive Group A Strep
A new study published in the Journal of the American Medical Association tracked data from the Active Bacterial Core surveillance network, consisting of 35 million people across 10 U.S. states. The authors estimate that 4 in 100,000 people tested positive for invasive strep in 2013. However, by 2022, that number had doubled to 8 in 100,000 people.
Invasive group A strep is when bacteria (called group A streptococcus, the same kind that causes “regular” strep throat) attacks the lungs and bloodstream, resulting in a potential life-threatening infection. The spike in cases has health officials worried because invasive strep has the power to turn into necrotizing fasciitis, a flesh-eating soft tissue infection, or streptococcal toxic shock syndrome (STSS), which can cause organ failure.
In 2013, the network reported 1,082 invasive strep infections; confirmed cases jumped to 2,759 in 2022. Within the nine-year span, a total of 21,000 cases of invasive group A strep were recorded. The infectious disease caused 1,981 deaths.
“When you see this high number of deaths, extrapolate that across the country—we’re probably well into more than 10,000 deaths,” Victor Nizet, MD, a pediatrics medicine professor at the University of California, San Diego, told NBC News.
Specifically, the study found that a majority of cases affected men (58 percent), and people between the ages of 18 and 64 years old (64 percent). However, incidence rates among adults ages 65 and older spiked the highest during the nine-year period. Additionally, “people experiencing homelessness, people who inject drugs, and residents of long-term care facilities had substantially elevated GAS [group A strep] incidence rates,” wrote the authors.
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Look Out for These Symptoms
Mild symptoms of group A strep include sore throat, fever, increased redness, swelling, and pain at a cut/wound, and skin infection, according to NYC Health.
Because invasive group A strep can turn into necrotizing fasciitis and/or STSS, medical attention should be sought out immediately. These more invasive symptoms include:
- Fever
- Severe pain
- Swelling and redness at a cut or wound
- Dizziness
- Confusion
- Low blood pressure
- Rash
- Abdominal pain
“Within 24 to 48 hours, you could have very, very rapid deterioration,” said Nizet. Things can progress from “seeming like a routine flu-like illness to rushing the patient to the ICU, fearing for their recovery.”
Typically, strep cases are treated with penicillin and go away with rest. However, some strains of invasive strep have shown to be antibiotic-resistant.
Slowing the spread of strep throat can help prevent invasive strep, but a vaccine would be the strongest defense against the flesh-eating infection—which scientists are still working on.
"It's one of those pathogens that causes a pandemic in plain sight, and because we haven't succeeded in controlling it, we look elsewhere for easier targets, but this is one of those hard targets that I think really need to commit to dealing with," said Joshua Osowicki, PhD, a pediatric infectious diseases physician and co-author of an accompanying editorial report.
"We absolutely, desperately need a vaccine for group A strep," added Theresa Lamagni, PhD, from the United Kingdom Health Security Agency.
For now, if you or a loved one experience any of these symptoms, call your doctor ASAP.
