Official State of Iowa Website Here is how you know
Iowa Department of Health and Human Services

Group A Streptococcus


Group A Streptococcus (GAS) or “strep” is a bacteria often found in the throat and on the skin. Strep can be in your body and not cause any illness. GAS usually causes mild illnesses that include a sore throat (strep throat) or skin infections (impetigo). Occasionally, a deadly type of GAS can invade the blood, muscle and fat tissue, or lungs and cause a serious and often life-threatening infection called invasive group A strep. Two of the most severe but least common forms of invasive GAS disease are necrotizing fasciitis and streptococcal toxic shock syndrome. Necrotizing fasciitis, sometimes described by the media as "the flesh-eating bacteria," is a destructive infection of muscle and fat tissue. Streptococcal toxic shock syndrome is a rapidly advancing infection that causes shock and injury to internal organs such as the kidneys, liver, and lungs.


Signs and symptoms depend on the type of illness caused by group A strep. Strep throat causes:

  • Fever
  • Sore throat
  • Swollen lymph glands

Strep skin infections causes:

  • Red, weeping sores

Early signs and symptoms of necrotizing fasciitis are:

  • Fever and severe pain
  • Swelling
  • Heat
  • Redness at a wound site

Early signs and symptoms of streptococcal toxic shock syndrome often include:

  • Fever
  • Dizziness
  • Confusion

Streptococcal toxic shock syndrome has no sign or symptom that distinguishes it from other illnesses, making it difficult to diagnose.


Strep is spread by direct contact with drainage from the nose or throat of infected persons or by contact with infected wounds or sores on the skin.

Risk Factors

Few people who come in contact with strep will get serious illness. Some will have a throat or skin infection. Most will have no symptoms at all. Although healthy people can get serious strep illness, those with cancer, diabetes, and kidney disease needing dialysis, and those who take certain medicine are at higher risk. Breaks in the skin, like cuts, wounds, or chickenpox lesions may provide a way for the bacteria to get into the body.


The spread of strep is less likely when you wash hands after coughing and sneezing, before fixing foods and before eating. Persons with a sore throat should be seen by a health care provider. A lab test can say if it is strep throat. If it is, the person should stay home from work, school, or child care until 24 hours after starting antibiotics. All sores should be kept clean. If a sore gets red or puffy, drains pus or hurts, see a health care provider.


Strep infections can be treated with many different antibiotics. It is always important to complete the full course of antibiotics as ordered by your health care provider.

Additional Resources


Public Health


Business and Childcare

Health Care Providers