KEY POINT: There has been an increase in invasive group A streptococcus (iGAS) infections both internationally, in the Eastern States and recently in WA. Be alert for signs and symptoms of iGAS infections
Infectious Agent | Bacteria called Streptococcus pyogenes also known as Group A Streptococcus (GAS). Group A streptococcus is often found in throat and skin. Can cause a range of diseases and includes:
|
Mode of Transmission | Contact:
Droplet/Airborne (respiratory):
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Incubation period | Not well defined. Usually 1-3 days, however can be up to 30 days |
Infectious period | Cases are infectious from 7 days before symptom onset until symptoms have resolved or after 24 hours of effective antibiotic therapy has been initiated |
Signs and Symptoms | IGAS presentations vary depending on site and severity of infection and can include:
In children, signs and symptoms of iGAS infection can be non-specific but can include fever, rash (including scarlet fever rash), cold or mottled limbs, headache, abdominal or limb pain, poor feeding, reduced urine output, vomiting, lethargy, seizures, increased work of breathing, and persistent tachycardia. iGAS may occur concurrently with, or following, a viral infection. |
Clinical Considerations | Have a low threshold to transport to ED Early recognition of sepsis is vital - refer to Sepsis CPG NEWS2 calculator should be utilised for all cases presenting with signs and symptoms of iGAS |
Precautions required | Contact and Droplet/Airborne: PPE
Vehicle airflow Ensure vehicle airflow set per WIAMB22 Ambulance Airflow (Login required) |
Cleaning required | See Vehicle Cleaning and Spills Management - after transporting a patient requiring transmission-based precautions (contact, droplet/airborne) |
Waste management | Heavily soiled items should be disposed of as clinical waste |
Linen management | Items should not be shaken or handled in a manner that may disperse any infectious particles into the environment |
Shared transport | Patients who are symptomatic with suspected or confirmed iGAS must not share transport with other patients |
References
WA Health Alert for Clinicians. Increase in invasive group A streptococcus (iGAS) infection notifications (17th January 2023)
Interim guidelines for the public health management of invasive group A streptococcal infections in Western Australia Version 1 https://www.health.wa.gov.au/~/media/Corp/Documents/Health-for/Infectious-disease/iGAS/WA-Interim-Public-Health-Guidelines-for-iGAS.pdf
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