Rapid communication Open Access
Like 0


Increases in invasive group A streptococcal (iGAS) infection and associated deaths, particularly in children, above seasonally expected levels are being seen this season (772 notifications reported in weeks 37 to 48 in 2022) across England. Diagnoses of iGAS infection from lower respiratory tract specimens in children under 15 years increased to 28% in November 2022. Medical practitioners have been alerted to the exceptional increase in incidence, including unusual numbers of children presenting with pulmonary empyema.


Article metrics loading...

Loading full text...

Full text loading...



  1. UK Health Security Agency (UKHSA). GP in-hours consultations bulletin: 8 December 2022 week 48. London: UKHSA; 2022. Available from: https://www.gov.uk/government/publications/gp-in-hours-weekly-bulletins-for-2022
  2. UK Health Security Agency (UKHSA). Group A streptococcal infections: update on seasonal activity in England, 2021 to 2022. London: UKHSA; 2022. Available from: https://www.gov.uk/government/publications/group-a-streptococcal-infections-activity-during-the-2021-to-2022-season/group-a-streptococcal-infections-update-on-seasonal-activity-in-england-2021-to-2022
  3. Department of Health and Social Care (DHSC). Health protection legislation (England) guidance 2010. London: DHSC; 2010. Available from: https://webarchive.nationalarchives.gov.uk/ukgwa/20130105053557/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_114589.pdf
  4. UK Health Security Agency (UKHSA). UK guidelines for the management of contacts of invasive group A streptococcus (iGAS) infection in community settings. London: UKHSA; 2022. Available from: https://www.gov.uk/government/publications/invasive-group-a-streptococcal-disease-managing-community-contacts
  5. UK Health Security Agency (UKHSA). Group A streptococcal infections: first update on seasonal activity in England, 2022 to 2023. London: UKHSA; 2022. Available from: https://www.gov.uk/government/publications/group-a-streptococcal-infections-activity-during-the-2022-to-2023-season/group-a-streptococcal-infections-first-update-on-seasonal-activity-in-england-2022-to-2023
  6. UK Health Security Agency (UKHSA). National flu and COVID-19 surveillance report: 8 December 2022 (week 49). London: UKHSA; 2022. Available from: https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2022-to-2023-season
  7. Lynskey NN, Jauneikaite E, Li HK, Zhi X, Turner CE, Mosavie M, et al. Emergence of dominant toxigenic M1T1 Streptococcus pyogenes clone during increased scarlet fever activity in England: a population-based molecular epidemiological study. Lancet Infect Dis. 2019;19(11):1209-18.  https://doi.org/10.1016/S1473-3099(19)30446-3  PMID: 31519541 
  8. Li H, Zhi X, Viera A, Whitewell HJ, Schricker A, Jauneikaite E, et al. Characterisation of emergent toxigenic M1UK Streptococcus pyogenes and associated sublineages. bioRxiv. 2022. http://biorxiv.org/content/early/2022/12/28/2022.12.27.522030
  9. Boeddha NP, Atkins L, de Groot R, Driessen G, Hazelzet J, Zenz W, et al. Group A streptococcal disease in paediatric inpatients: a European perspective. Eur J Pediatr. 2022;1-10.  https://doi.org/10.1007/s00431-022-04718-y  PMID: 36449079 
  10. de Gier B, de Beer-Schuurman I, de Melker H, van Sorge N. Increase in invasive Streptococcus pyogenes disease among young children and adults, the Netherlands, March-July 2022. European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE); 23-25 November 2022, Stockholm, Sweden. Poster presentation; Abstract ID: 511. Available from: https://www.escaide.eu/sites/default/files/documents/ESCAIDE2022_AbstractBook.pdf
  11. Santé Publique France. Infection invasive à streptocoque du Groupe A (IISGA): point de situation au 6 décembre 2022. [Invasive group A streptococcal disease (IISGA): status update on 6 December 2022]. Saint-Maurice cedex: Santé Publique France; 2022. French. Available from: https://www.santepubliquefrance.fr/les-actualites/2022/infection-invasive-a-streptocoque-du-groupe-a-iisga-point-de-situation-au-6-decembre-2022
  12. Health Protection Surveillance Centre (HPSC). Update on group A streptococcus. Dublin: HPSC; 2022. Available from: https://www.hpsc.ie/news/title-22663-en.html
  13. European Centre for Disease Prevention and Control (ECDC). Communicable disease threats report, 4 – 10 December 2022, week 49. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/communicable-disease-threats-report-4-10-december-2022-week-49
  14. Centers for Disease Control and Prevention (CDC). Increase in invasive group A strep infections, 2022. Atlanta: CDC; 2022. Available from: https://www.cdc.gov/groupastrep/igas-infections-investigation.html#:~:text=CDC%20is%20looking%20into%20a,and%20streptococcal%20toxic%20shock%20syndrome
  15. Chudasama DY, Tessier E, Flannagan J, Leeman D, Webster H, Demirjian A, et al. Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021. Euro Surveill. 2021;26(48):2101019.  https://doi.org/10.2807/1560-7917.ES.2021.26.48.2101019  PMID: 34857070 
  16. UK Health Security Agency (UKHSA). Group A streptococcal infections: fourth update on seasonal activity in England, 2022 to 2023. London: UKHSA; 2022. Available from: https://www.gov.uk/government/publications/group-a-streptococcal-infections-activity-during-the-2022-to-2023-season/group-a-streptococcal-infections-fourth-update-on-seasonal-activity-in-england-2022-to-2023
  17. Watts V, Balasegaram S, Brown CS, Mathew S, Mearkle R, Ready D, et al. Increased risk for invasive group A streptococcus disease for household contacts of scarlet fever cases, England, 2011-2016. Emerg Infect Dis. 2019;25(3):529-37.  https://doi.org/10.3201/eid2503.181518  PMID: 30602121 

Data & Media loading...

Supplementary data

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error