The Office of the Chief Medical Officer has updated its guidance on Group A Streptococcal (GAS) Disease to ensure that the public and clinicians have access to the most up-to-date information.

Recently, there have been reports from the UK about increased rates of Group A Streptococcal (GAS) Disease, including severe invasive cases that have resulted in the deaths of ten children. As of 14^th December 2022, no cases of Invasive Group A Streptococcal Disease in Bermuda have been reported recently.

Chief Medical Officer, Dr Ayoola Oyinloye explained: “Streptococcal infection remains a notifiable disease under the Public Health Act 1949 (Part V, Para 66). Medical practitioners have a legal duty to notify all cases to the Office of the Chief Medical Officer.

“Group A Streptococcus (GAS) is a common bacteria. Many of us carry it in our throats and on our skin, and it doesn't always result in illness. However, GAS does cause several infections, some mild (such as strep throat or scarlet fever) and some more serious.

“The most serious infections come from invasive GAS, known as iGAS. These invasive infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs, bloodstream or joints. In rare cases, an iGAS infection can be fatal. 

iGAS infections are uncommon (there have been no reported cases in Bermuda in 2022). Globally there has been an increase in cases this year, particularly in children under 10. Sadly there have been a small number of deaths. GAS is spread by close contact with an infected person and can be passed on through coughs, sneezes, or a wound.

Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections. While people without symptoms can pass it on, the risk of spread is much greater when a person is unwell. GAS infections cause symptoms such as sore throat, fever, chills and muscle aches.

If your child seems seriously unwell, you should trust your judgement.

Contact your GP:

• your child is getting worse
• your child is feeding or eating much less than normal
• your child has had a dry diaper for 12 hours or more or shows other signs of dehydration
• your baby is under 3 months and has a temperature of 101°F (38°C), or is older than 3 months and has a temperature of 102°F (39°C) or higher
• your baby feels hotter than usual when you touch their back or chest or feels sweaty
• your child is very tired or irritable 

Call 911 or go to Emergency Department at KEMH if:

• your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
• there are pauses when your child breathes
• your child’s skin, tongue or lips are blue
• your child is floppy and will not wake up or stay awake

Patients diagnosed with GAS will be prescribed a course of antibiotics by their doctor. They should start taking antibiotics as soon as possible and finish the complete course of antibiotics even if they feel better. Patients should stay off nursery/school/work for 24 hours after they take the first dose of antibiotics. 

For more information and guidance visit: https://www.gov.bm/health-information