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CDC Warns Of Increase In Strep Throat Infections Among Kids Amid Rise In COVID, Flu, RSV Cases

The Centers for Disease Control and Prevention (CDC) has issued an advisory warning of an increase in cases of strep throat infections among children amid the so-called "tripledemic" of COVID-19, flu and respiratory syncytial virus (RSV) cases.

A look at signs and symptoms of strep throat.

A look at signs and symptoms of strep throat.

Photo Credit: CDC

The CDC said it has notified clinicians and public health authorities of a recent increase in pediatric invasive group A streptococcal (iGAS) infections. 

In November 2022, the CDC said it was notified of a possible increase in iGAS infections among children at a hospital in Colorado.

Potential increases in pediatric iGAS cases in other states were subsequently noted by contributors to the Infectious Diseases Society of America’s provider-based Emerging Infections Network and by certain jurisdictions participating in CDC’s Active Bacterial Core Surveillance System (ABCs). 

"This increased number of pediatric iGAS cases in some jurisdictions has occurred in the setting of increased circulation of respiratory syncytial virus (RSV), influenza viruses, SARS-CoV-2 (COVID-19), and other respiratory viruses," the CDC said. "While the overall number of cases has remained relatively low and iGAS infections remain rare in children, CDC is investigating these reports."

Group A Streptococcus (GAS) bacteria can cause a range of illnesses, from pharyngitis (i.e., strep throat) and skin and soft tissue infections to uncommon but severe diseases such as sepsis, streptococcal toxic shock syndrome, and necrotizing fasciitis. 

Strep throat is most common among school-aged children (i.e., 5 to 15 years of age), and exposure to someone with strep throat is a risk factor for iGAS infection. 

"In addition, increased rates of iGAS infection have been noted during times of increased influenza activity," the CDC said.

Seasonal influenza activity is currently high in the US and above the levels seen in recent years.

For a look at signs and symptoms of strep throat, see the image above.

People with concurrent or preceding viral infections, such as influenza and varicella (chickenpox), are at increased risk for iGAS infection. 

Other groups at higher risk for iGAS include:

  • People aged 65 years or older
  • American Indian and Alaska Native populations
  • Residents of long-term care facilities
  • People with medical conditions such as diabetes, malignancy, immunosuppression, chronic kidney, cardiac, or respiratory disease
  • People with wounds or skin disease
  • People who inject drugs or who are experiencing homelessness

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