Acute Communicable
Disease Control

Contact Information
County of Los Angeles
Department of Public Health
Acute Communicable Disease Control
313 N. Figueroa Street, #212
Los Angeles, CA 90012
Phone: (213) 240-7941
Fax: (213) 482-4856

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Acute Communicable Disease Control
Streptococcal Infections, Group A (IGAS) and
Toxic Shock Syndrome (STSS)

Invasive Group A Streptococcal (IGAS) disease is caused by the group A beta-hemolytic Streptococcus pyogenes bacterium. Transmission is by direct or, rarely, indirect contact. Illness manifests as various overlapping clinical syndromes including bacteremia without focus, sepsis, cutaneous wound or deep soft-tissue infection, septic arthritis, and pneumonia. It is the most common cause of necrotizing fasciitis, commonly known as “flesh eating bacteria.” IGAS occurs in all age groups but more frequently among the very old. Infection can result in severe illness, including death.

Streptococcal toxic shock syndrome (STSS) is a rare but extremely severe illness characterized by rapid onset of hypotension (low blood pressure) and shock. Other symptoms can include renal (kidney) impairment, coagulopathy (abnormality in the blood's ability to clot), adult acute respiratory distress syndrome, rash and local tissue destruction. Death occurs in up to 70% of people who develop streptococcal toxic shock syndrome.

For surveillance purposes in LAC, IGAS is defined as isolation of S. pyogenes from a normally sterile body site (e.g., blood, cerebrospinal fluid, synovial fluid, or from tissue collected during surgical procedures). Isolation can include a non-sterile site if associated with STSS or necrotizing fasciitis (NF). IGAS cases are characterized as STSS if the diagnosis fulfills the CDC or Council of State and Territorial Epidemiologists (CSTE) case definitions for this syndrome; and as NF if the diagnosis was made by the treating physician.

Los Angeles County Annual Reports
Los Angeles County Special Study Reports
News and Updates
CDC Health Advisory: Increase in Pediatric Invasive Group A Streptococcal Infections (12-23-22)

Additional Resources

STSS Resources
Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.
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