What to do if you suspect you or your child has a Strep A infection

Strep A is a bacterial infection which is usually mild in children but can potentially become very serious. There have been some alarming deaths recently from Strep A infections, so you should be on the lookout for the symptoms. Here’s what you need to know…

Streptococcus pyogenes, also known as Group Strep A or simply Strep A, is a pathogenic bacterium which can colonise the throat and skin. It can cause an array of different conditions, including:

• severe sore throat
• tonsillitis
• scarlet fever
• pneumonia
• impetigo
• cellulitis (and erysipelas)
• perianal and genital strep-dermatitis

In rare cases, some children may develop invasive post-streptococcal complications including rheumatic fever (causing painful joints and heart problems), glomerulonephritis (kidney damage) and in very rare cases the development of streptococcal toxic shock syndrome (STSS).

There is also a subset of kids with an autoimmune skew who can be affected neurologically by Group Strep A infections. This is called PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcus infections) which can lead to a sudden onset of tics, anxiety and OCD, very narrow food choices as well as decline in their schoolwork.

It is spread by close contact through both respiratory droplets (coughing, catarrh and saliva), as well as direct skin contact. It can also be spread through contact with contaminated objects, such as towels or bedding or by sharing food, drink, cups or cutlery.

Symptoms of upper respiratory Group Strep A infections

The key hallmark of the Group A streptococcus infections is that they tend to come on very quickly and abruptly (vs viral infections which tend to kick in more slowly). Symptoms of a strep A upper respiratory infection include:

• Abrupt onset of symptoms
• Difficulty or painful swallowing
• Red, swollen tonsils and throat
• Pus in the back of the throat
• White spots or patches on the tongue or on the throat
• Swollen or enlarged lymph nodes in the neck
• Body aches
• Fever, chills and/or headache

There is rarely a cough, and if there is, this will be probably mild at best. Viral induced infections on the other hand tend to be accompanied by a cough.

Seek medical advice fast
If you suspect a strep infection, it is always important to seek medical advice as soon as possible. It’s also important to take any prescribed antibiotics as the infection can escalate quickly and become very serious. For most kids, a course of antibiotics prescribed by their GP will quickly knock the bacterial infection on the head. The gut microbiome can then be built back up afterwards with the right diet and support over several weeks and months.

What about antibiotic resistance?
There are ongoing concerns about the effectiveness of the antibiotics in some children due to an increase in Group Strep A resistance to antibiotics. Research over the past few years has therefore been focused on finding non-resistant traditional remedies that can help to fight these strep infections with some promising outcomes. Even though the research is still in its infancy, it would still be prudent to go that extra mile and do a little more to help your child’s immune system fight this bacterial infection. This is through natural remedies, oral and gut microbiome support as well as nutrition to help them fight the infection as effectively as possible. These interventions should always be seen as companions to the antibiotics and not alternatives.

Another reason why Streptococcus pyogenes infections can be persistent and hard to treat, is that they love to live within biofilms. A biofilm is a slimy layer of bacteria and other microorganisms that grow and stick to the surface of the mucosal linings of the body such as the oral cavity. Biofilms form a matrix which can sometimes render the infections more persistent and chronic as well as the antibiotics less effective. Tonsil stones are an example of a biofilm and biofilms are also present in people with chronic and recurrent tonsillitis. Interestingly, Streptococcus pyogenes is often the dominant bacteria found in tonsils that have been removed via tonsillectomy.

There has been a push for more research into natural and herbal remedies in recent years because of this concern surrounding antibiotic resistance and the presence of biofilms.

Eight natural ways to help support Strep A infections

First, go to your GP and get medical advice. You may also want to support your child with these natural options if they have a sore throat, whether or not anything specific is diagnosed:

1. Gargle with warm salt water several times a day. Gargling with salt helps to draw water out of the tissue in the mouth, while creating a salty barrier that locks out water and harmful pathogens from getting back inside the oral tissue. When you spit out the salty water, you’re also getting rid the pathogenic bacteria. This is only suitable for children old enough to be able to gargle and spit out easily.
2. Slurp on ice lollies, ice cream and sorbet. When you consume icy cold foods, they lower the temperature of the nerve endings in your throat and numb the area, which in turn reduces pain signals, easing a throat that often feels raw. Try my therapeutic chamomile and apple ice lollies. This option is suitable for all ages from 6 months plus.
3. Eat the rainbow! Infections damage cells and this oxidative stress is often still present in children at least a month after they have recovered from a throat or tonsil infection. This is why children who regularly suffer with bacterial infections or are recuperating need to eat a wide range of brightly coloured polyphenol-rich foods such as berries, dark green vegetables, cacao and fruits. Smoothies, smoothie bowls, freshly squeezed juices and ice-lollies are a great way to get more goodness into your children.
4. Top up on mineral-rich foods. Some studies have found that children with recurrent throat and tonsil infections are often low in key minerals such as selenium, iron and zinc. Foods that can bolster up these levels include nuts, seeds, red meat, liver, seafood, fish, dairy products, eggs, pulses and dark green vegetables. If they are not keen on eating these foods, then top up with food supplements.
5. Active honeys. Manuka and Jarrah honeys are very soothing on a sore and swollen throat or tonsils and research has found that these honeys may also help to break down Streptococcus pyogenes biofilms. Jarrah is a toffee flavoured wild honey with more antimicrobial oomph than Manuka. Kids can slurp it directly off a spoon. Honey is suitable for anyone over the age of 12 months. Honey can also be applied topically for group strep A skin infections.
6. Spray Nano-silver. Silver has well-established antimicrobial properties against both viruses and bacteria and research suggests that it has specific antibacterial effect against Streptococcus pyogenes. As well as anti-bacterial activity, nano silver is also known to have anti-biofilm activity and can help to prevent these building up in the first place. It is relatively tasteless and so easy to give young children when they have a very sore mouth. It can also be applied to group strep A skin infections.
7. Xylitol – a natural tooth-friendly sugar found in fruits and vegetables, xylitol is often used in sugar-free food supplements, toothpaste and chewing gums. Xylitol has been found specifically to help prevent tonsil abscesses caused by Streptococcus pyogenes. Research has found that xylitol has a positive effect on the immune system and unlike sugar it does not upset blood glucose levels.
8. Suck on BLIS K12 – officially called Streptococcus salivarius K12, this friendly bacterial strain has been used in a number of studies on nursery-aged children. It is a very specific beneficial oral bacterial strain that helps to create the right balance of flora in the oral microbiome. Even though it has strep in the name, it is helpful at targeting the pathogenic Streptococcus pyogenes in the oral cavity. In a nutshell, it crowds out the “bad” strep by displacing it with the “good” strep.

Round Up

Group strep A bacterial infections can be painful and distressing for little ones. However, there are lots of easy wins you can use to support their health and immunity when an infection strikes. We hope that this has been helpful, and of course if you have any specific questions, please pop them below.

References

• Group A Streptococcal Infection – NHS
• Group A streptococcal infections
• Diseases Caused by Group A Strep
• Antibiotic Treatment, Mechanisms for Failure, and Adjunctive Therapies for Infections by Group A Streptococcus
• Targeting the Holy Triangle of Quorum Sensing, Biofilm Formation, and Antibiotic Resistance in Pathogenic Bacteria
• Bacterial Biofilm and its Role in the Pathogenesis of Disease
• Chronic tonsillitis and biofilms: a brief overview of treatment modalities
• Evidence of Bacterial Biofilms among Infected and Hypertrophied Tonsils in Correlation with the Microbiology, Histopathology, and Clinical Symptoms of Tonsillar Diseases
• National Institute of Mental Health – PANDAS
• Streptococcal Infections and Exacerbations in PANDAS
• Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus infections
• Bacteria Patterns on Tonsillar Surface and Tonsillar Core Tissue among Patients Scheduled for Tonsillectomy at Bugando Medical Centre, Mwanza, Tanzania
• Detection of group A Streptococcus in tonsils from pediatric patients reveals high rate of asymptomatic streptococcal carriage
• Honey: its medicinal property and antibacterial activity
• Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins 
• A comparative study of antibacterial and antivirulence activities of four selected honeys to Manuka honey
• In vitro antibacterial activity of Western Australian honeys, and manuka honey, against bacteria implicated in impetigo
• Effect of Honey on Streptococcus mutans Growth and Biofilm Formation
• Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis
• Effects of artificial honey and epigallocatechin-3-gallate on streptococcus pyogenes
• Antibacterial Activity of Colloidal Silver against Gram-Negative and Gram-Positive Bacteria
• The Anti-bacterial Effect of Colloidal silver on Streptococcus pyogenes and Staphylococcus aureus in vitro
• Tackling Multidrug Resistance in Streptococci – From Novel Biotherapeutic Strategies to Nanomedicines 
• Mechanistic Basis of Antimicrobial Actions of Silver Nanoparticles
• Silver nanoparticles as an alternative strategy against bacterial biofilms 
• Selenium, Zinc, Copper, and Total Antioxidant Status in the Serum of Patients with Chronic Tonsillitis
• Evaluation of iron and zinc levels in recurrent tonsillitis and tonsillar hypertrophy
• Effect of erythritol and xylitol on Streptococcus pyogenes causing peritonsillar abscesses 
• Health benefits of xylitol
• Natural antibacterial remedy for respiratory tract infections
• Influence of Oral Probiotic Streptococcus salivarius K12 on Ear and Oral Cavity Health in Humans: Systematic Review
• Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children
• Use of Streptococcus salivarius K12 in the prevention of streptococcal and viral pharyngotonsillitis in children
• Pilot study to explore the prophylactic efficacy of oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngo-tonsillar episodes in pediatric patients