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Here's The Unusual Strep Symptom Parents Should Look Out For

While some Chicago-area doctors say strep cases have been increased in recent weeks, the symptoms might not be ones you typically think of.

Dr. Neha Bhagi, a pediatrician at John H. Stroger Jr. Hospital of Cook County, said she's among those seeing a rise in infections.

"The cases have been rising a lot, actually," she told NBC Chicago in an interview Tuesday.

Bhagi said that while the typical season for strep might be in winter months, when children experience strep throat, there are other presentations the infection can take, particularly in warmer weather.

"Usually around winter time you can see a lot of sore throat, you can see a lot of ear infections with strep. More to summertime you start seeing more skin infections with strep because, you know, you're exposed, outside, you're wearing less layers of clothes, you can get a staph infection of the skin, per se, for strep," Bhagi said.

The recent cases come months after health officials issued a warning about a dangerous and potentially deadly type of strep throat infection on the rise in Illinois, which caused a number of pediatric deaths in the state.

"We're worried about children as we're seeing group A strep outbreaks, just strep throat outbreaks rampant in a lot of communities and in schools," Dr. Arti Barnes, chief medical officer for the Illinois Department of Public Health, said in March.

The Centers for Disease Control and Prevention also said at the time it was "looking into an increase in invasive group A strep infections among children in the United States," adding that such infections include things like necrotizing fasciitis and streptococcal toxic shock syndrome.

In mid-March, IDPH Director Dr. Sameer Vohra said more cases of the group A strep throat leading to severe complications had been reported in 2023 "than in any of the past five years" and urged people to monitor for early symptoms.

According to Vohra, those symptoms could include "sudden onset of sore throat, pain when swallowing and fever."

Beyond that, there are the typical symptoms many watch for with strep, and then there are the not-so-typical symptoms.

"[Strep is] very notorious," Bhagi said. "So it can cause multiple signs and symptoms in your body. You can have strep-related ear infection; you can have strep-related sore throat; you can have strep-related brain infection - actually it can lead to meningitis, which we call brain infection going down; strep can also infect your skin, which is more in summer months rather than winter months obviously because of the exposure. Strep can also lead to very deep or very severe blood infection, which we call toxic shock syndrome that you can get with strep. Ultimately strep can infect your kidneys and your heart if left untreated."

Bhagi recommends anyone showing symptoms gets tested.

Here's what to know:

Common Symptoms

Some of the more common symptoms, according to Bhagi and the CDC, include:

  • Fever
  • Pain when swallowing
  • Throat may look red
  • Red and swollen tonsils
  • White patches or streaks of pus on the tonsils
  • Tiny, red spots on the roof of the mouth, called petechiae
  • Swollen lymph nodes in the front of the neck
  • "If you have the classic symptoms of strep, which is fever - whether it's low grade, like, you know, 100.1 or even 101 or 102, which is high grade - you do not have much of cough symptoms but you're having a lot of throat pain, you feel itchiness, you feel you're having difficulty swallowing, you feel every time you drink or eat something it causes pain in your throat ... You must always get tested. So that is classic strep."

    But strep can also infect the skin.

    "Group A strep bacteria are very contagious. When group A strep bacteria infect the skin, they cause sores," the CDC states. "The bacteria can spread to others if someone touches those sores or comes into contact with fluid from the sores."

    It can take up to 10 days for a sore to appear following exposure, experts say.

    Symptoms for this type of infection could include "red, itchy sores that break open and leak a clear fluid or pus for a few days" and "a crusty yellow or 'honey-colored' scab forms over the sore."

    "If you're feeling that you are developing infection of your skin, you're seeing more yellowish color, pussy discharge or crusting around your skin, especially on your face ... Or you have an open wound, you just had a fracture or you just fell somewhere and you have an open wound where you're seeing a puss kind of discharge coming out, it's always good to swab it and send it to see if it's growing strep infection."

    Less Common Symptoms

    Some of the lesser-known symptoms might include:

    Symptoms Not Associated With Strep

    Symptoms you likely won't see with strep infections include things like:

  • Cough
  • Runny nose
  • Hoarseness (changes in your voice that make it sound breathy, raspy, or strained)
  • Pink eye (conjunctivitis)
  • But that doesn't mean you won't see these in someone with strep.

    "Usually you don't have much of a cough, usually don't have much of runny nose and congestion, but there's always atypical findings, you know, as in any infection, there can always be atypical presentation."

    The 1 Symptom You Could See With All Strep Infections

    According to Bhagi, one symptom is common across all types of strep infections.

    "I think one thing with strep is mostly, mostly everybody gets a little bit of fever, whether it's low-grade fever or high-grade fever," she said.

    What Can I Do to Protect My Child?

    To prevent group A strep infections, the CDC recommends you:

  • Cover your mouth and nose with a tissue when you cough or sneeze.
  • Put your used tissue in the waste basket.
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Use an alcohol-based hand rub if soap and water are not available.
  • To prevent skin infections:

  • Clean and care for wounds
  • Wash your hands and laundry often
  • Take antibiotics, if prescribed

  • 'Very, Very Unusual': MUSC Doctors See Spike In Invasive Strep Cases

    © Provided by Charleston WCSC-TV Health experts at MUSC are warning about a rise in a certain type of strep infections among children.

    CHARLESTON, S.C. (WCSC) - Doctors at the Medical University of South Carolina in Charleston say cases of a certain type of strep have risen in children in high enough numbers to cause concern.

    Cases of Invasive Group A Strep have climbed to more than a dozen, according to Allison Eckard, the division chief of Pediatrics infectious Diseases at MUSC. The increase is something doctors are calling "very, very unusual."

    "You're the one who knows your child the best, and if things don't quite seem right to you or there's a very high fever, muscle aches, chills — things that would make you a little more suspicious that other things are going on, it's very important to go earlier to seek medical care than waiting longer," Eckard says.

    Non-invasive Group A strep and Strep Throat are very common, Eckard says. Invasive Group A Strep means the same bacteria that causes Strep throat is more aggressive and severe. Eckard says doctors started seeing an increase amount of invasive Group A Strep in December.

    Strep throat is more common in school-aged children between the ages of 5 and 15 years old. Invasive Group A Strep can be found across age ranges but is common in children less than one. Eckard says it's important to watch for more serious signs and symptoms when it comes to your child.

    She goes on to say there are a number of theories right now as to why they're seeing more cases in invasive group A Strep: One is that people weren't exposed to this bacteria much during the pandemic, and a second suggests they're seeing a cluster of cases around this short period of time that they would normally see over a two-year span.

    "It's not something that you need to panic about; it's just about increasing your awareness, and if your child or you, for example, has a bad sore throat and a high fever, to take it seriously because this bacteria can be very bad and progress very rapidly," Eckard says.

    The earlier you can start on antibiotics, she says, the better chance you have of not advancing to a more severe infection.


    Doctors See Rise In Ear Infections, Strep Throat In Kids

    KARE-TV Minneapolis-St. Paul 2 hrs ago Gordon Severson

    © Provided by KARE-TV Minneapolis-St. Paul

    If you have visited a pediatrician lately, you've likely been met by very busy waiting rooms.

    You're not alone.

    Doctors are seeing a lot of kids with ear infections and strep throat right now. So, what's the explanation for this?

    Dr. Stacene Maroushek is a pediatric infectious disease specialist at Hennepin Healthcare. She says pediatricians are seeing a lot of viruses right now and viral infections can often cause an ear infection in young kids.

    "If you get a cold, an upper respiratory viral infection, it causes a lot of nasal congestion, but it also causes a lot of congestion and clogging of the tube that drains your ear — the eustachian tube," she said. "That can cause some fluid to back up in your ears and that can be a nice spot for bacteria to grow, and that's how you can get a bacterial infection in your ear."

    Maroushek says it makes sense that if more viruses are going around right now, kids would be more likely to get an ear infection as a result of a viral infection.

    "We're still seeing a lot of viruses right now; they're different now. The viruses are different. We were seeing a lot of rhinovirus, enterovirus, RSV [respiratory syncytial virus] and influenza before. Now, we're seeing adenovirus, and we're seeing parainfluenza virus and we're also seeing some influenza B. We had a couple of kids in this morning who had influenza," Maroushek said.

    Medical Director of Children's Minnesota's Minneapolis Primary Care Clinic, Dr. Chase Shutak, said the same is true for the patients in their care. 

    "Usually, things are getting better at this point. Usually, infections are going down. This is a bit of a surprise," Dr. Chase Shutak said

    Shutak says a separate viral infection like a cold could make a child more susceptible to getting other infections, like strep throat.

    "If strep throat is going around in a community and people aren't washing their hands well, and we're not identifying it and treating it, then kids can keep spreading it around," Shutak explained.

    Shutak said doctors are still trying to figure out why these viruses are hanging around so long. They believe it could be connected to some lingering effects from the pandemic, with kids having less exposure to other kids these past few years, and many who are still behind on their routine vaccinations.

    Shutak is hoping the numbers will go down once kids get out of school for summer vacation.

    "I would expect it to get better just from history and what we've seen over the years. However, the pandemic really did adjust the seasonality for all of the viruses and all of the infections. So, it could be that we're still adjusting to that."

    According to the Centers for Disease Control and Prevention (CDC), some common symptoms of an ear infection in children include ear pain, fever, fussiness or irritability, rubbing or tugging at an ear and difficulty sleeping.

    The CDC says many ear infections can be treated at home, but parents should seek medical care if their child has a fever of 102.2 degrees or higher.

    The agency also says parents should consider medical care if there is pus, discharge or fluid coming from the ear, worsening symptoms, symptoms that last more than two to three days, or hearing loss.

    For more information from the CDC, click here.

    For information about strep throat, you can visit the CDC's website here, or the Minnesota Department of Health's guide on strep throat here.

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