Group A Strep: The symptoms to look out for


Group A streptococcus (GAS) is a common bacteria. Lots of us carry it in our throats and on our skin and it doesn’t always result in illness. However, GAS does cause a number of infections, some mild and some more serious.

The most serious infections linked to GAS come from invasive group A strep, known as iGAS.

These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. In rare cases an iGAS infection can be fatal.

The UK Health Security Agency (UKHSA) has confirmed an increase in cases of Group A Strep, especially in children under the age of 10 years old.

Professor Dominic Mellon, Regional Deputy Director for UKHSA South West, spoke to BBC Points West about the symptoms to look out for and what parents should do:


Symptoms to look out for in your child include:

  • Sore throat
  • Headache
  • Fever
  • A fine, pinkish or red body rash with a sandpapery feel. On darker skin the rash can be more difficult to detect visually but will have a sandpapery feel.


As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.

UKHSA are advising parents to keep their children away from school, other education and childcare settings to minimise the spread of infection as much as possible. If your child is unwell and has a fever, they should stay home from school or nursery until they feel better and the fever has resolved.

If you need healthcare advice, you should contact your GP or NHS 111 if:

  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or show other signs of dehydration
  • your baby is under 3 months and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • your child is very tired or irritable

Call 999 or go to A&E if:

  • Your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • They pause while they are breathing
  • Their skin, tongue or lips are blue
  • You child is floppy, is not waking up or staying awake.
UKHSA letter to parents and carers of children (6 December 2022)

The latest information about Group A Strep can be found on the UKHSA website.

Learn more about keeping under 5s well this winter on UKHSA’s blog.

Flu and GAS infections

Numerous posts have appeared on social media suggesting that nasal flu vaccine for children is causing Group A Strep infections. Stakeholders continue to report this issue is being raised in clinical settings and some parents are cancelling flu vaccination appointments for their children.

Dr Gayatri Amirthalingam, Deputy Director of Public Health Programmes at UKHSA, said:

“Getting flu and other viral infections can increase the risk of invasive Group A Strep infection in the following weeks. Invasive Group A Strep infections increased during the 2009-10 flu pandemic. The flu vaccine reduces the risk of having flu and group A Strep infections at the same time therefore it reduces the chance of developing invasive Group A Strep.

“We strongly recommend children who are eligible get a flu vaccine – it’s the best way to protect them from serious illness. The flu vaccine for children has an excellent safety record, this includes the nasal spray given to school aged children and pre-schoolers, which has been given to millions of children in the UK and worldwide.”


  • There is no current evidence to suggest that the nasal spray flu vaccine given to children causes iGAS
  • We know that children can become infected with invasive group A Streptococcal (iGAS) disease and influenza at the same time, causing a very severe illness. Flu and other viruses may increase the risk of iGAS, therefore we reinforce the recommendation that children who are eligible for influenza vaccination take up the offer.
  • iGAS infections increased in England during the 2009-10 influenza pandemic.
  • The influenza vaccines given to children have excellent safety records. This includes the nasal spray flu vaccine given to school-aged children and pre-schoolers, which has been given to millions of children in the UK and worldwide. The flu vaccination programme in England first used nasal spray vaccines in children aged 2 and 3 years and in primary schools in pilot areas in 2013 before being rolled out incrementally to older age groups over the past nine years.
  • Nasal flu vaccines prevent flu in children who are vaccinated and those around them too.
  • The nasal flu vaccine will help prevent influenza which can cause very severe infection.
  • The nasal influenza vaccine also therefore reduces the risk of coinfection of influenza and Group A Streptococcal infections, and in turn the potential development of iGAS infections