• Infections of strep A or group A Streptococcus bacteria have increased this winter according to the CDC.
  • Cases have invasive group A strep have risen even higher than pre-pandemic levels.
  • Invasive disease means the bacteria spreads to other parts of the body instead of just staying in the throat.
  • This can cause severe infections such as necrotizing fasciitis or streptococcal toxic shock, which require care in a hospital and may cause death.
  • A short of amoxicillin is making treatment more difficult.

Infections caused by group A Streptococcus bacteria — commonly called strep throat or strep A — surged this past winter, a new report from the Centers for Disease Control and Prevention (CDC) shows.

This year invasive group A strep (iGAS) infections cases have risen even higher than pre-pandemic levels, according to the report.

According to the CDC “iGAS infections have remained high in children in some areas of the country even after respiratory viruses decreased in those areas” additionally officials said they have seen a rise in infections in adults over 65 as well.

This, coupled with a shortage in the United States of pediatric versions of the antibiotic amoxicillin, has added to an already difficult respiratory season this year.

Products designed for the younger crowd are liquid — and usually bubblegum pink — which is easier for kids to take than pills.

Dr. Muzna Atif, medical director of pediatric hospitalist services at Pomona Valley Hospital Medical Center in Pomona, Calif., told Healthline that the rise in cases is concerning in itself, but some children also have atypical symptoms, making it harder for doctors to diagnose this condition.

In general, strep throat is a mild infection, with common symptoms including fever, sore throat and swollen tonsils. It is more common in school-aged children, but can also affect adults.

Recently, some children with strep throat have had cold-like symptoms such as runny nose, nasal congestion or cough — symptoms that don’t usually occur with strep A infections.

Atif said less commonly, strep A infection can “result in invasive disease or cases of rheumatic fever as complications.”

Invasive disease means the bacteria spreads to other parts of the body instead of just staying in the throat. This can cause severe infections such as necrotizing fasciitis or streptococcal toxic shock, which require care in a hospital and may cause death.

During the pandemic, severe infections caused by strep A dropped by about 25% compared to the years leading up to this, the CDC found.

This was likely due to mitigation measures taken to slow the spread of COVID-19 and other respiratory diseases, such as masking, physical distancing and school and workplace closures, the agency said.

Less severe strep A infections in children are currently at high levels through the country, preliminary CDC data shows — at “levels similar to or higher than those seen in pre-pandemic years.”

In addition, severe strep A infections have remained high in children in parts of the United States, the agency said. Some areas have also seen an increase in severe infections in adults, particularly in those 65 years or older.

Strep A infections are usually highest between December and April.

Regardless of what kind of strep someone has, the infection needs to be treated with an antibiotic to prevent complications.

This year, though, the jump in strep A infections coincides with a shortage of pediatric amoxicillin, which the Food and Drug Administration (FDA) added in October 2022 to its list of drug shortages.

The shortage continues to affect multiple brands, including those manufactured by Teva and Sandoz. Some companies have reported to the FDA that their shortage is due to increased demand for the drug.

Erin Fox, PharmD, an expert on drug shortages at the University of Utah in Salt Lake City, told NPR that companies usually look at their sales of the drug for the prior year in deciding how much to manufacture.

This year, there was a “mismatch” between what companies produced and what consumers needed, she said.

Atif said while certain amoxicillin products commonly used for children are not available, parents have other options.

“For example, amoxicillin is also available in pills that can be crushed, as chewable pills, or as capsules that can be opened and the powder mixed in food,” she said. “There is currently no shortage of the antibiotic [in these forms].”

She said doctors and pharmacists can also recommend other antibiotics such as penicillin VK, intramuscular penicillin G and cephalexin.