Management of single cases of iGAS infection
For a single probable or confirmed case of invasive group A streptococcal (iGAS) infection, discuss the role of antibiotic prophylaxis for close contacts with an expert (eg an infectious diseases physician or clinical microbiologist). Report all confirmed and probable iGAS cases to the local public health authority, because iGAS infection is a notifiable disease1. In the absence of expert advice, the following approach should be taken.
Antibiotic prophylaxis should be given to household contacts who are at highest risk of infection; consider antibiotic prophylaxis for other household and close contacts at high risk of infection.
Give antibiotic prophylaxis to:
- neonate–birthing parent (eg mother) contacts, if either the birthing parent or neonate develops iGAS infection during the first 28 days after birth.
Consider antibiotic prophylaxis for:
- household contacts older than 65 years (older than 60 years in Aboriginal and Torres Strait Islander people)Adebanjo, 2020Mearkle, 20172.
Antibiotic prophylaxis may also be considered for other household and close contacts based on individual circumstances – seek expert advice.
Provide written information about the possible symptoms of superficial and invasive group A streptococcal infection to close contacts of patients, regardless of whether antibiotic prophylaxis is given. Superficial infections (eg pharyngitis) should be treated, even if in other circumstances they are usually not treated (ie because they are considered to be self-limiting). This is because superficial infection increases the patient’s risk of developing an iGAS infection. It is important to discuss these risks with household contacts. Advise close contacts to seek urgent medical attention if they develop symptoms suggestive of infection within 30 days of their last contact with the index case.