Some Chicago-area doctors say strep cases have been rising in recent weeks and months, but as summer gets underway, doctors warn the symptoms may not always be obvious.
Dr. Neha Bhagi, a pediatrician at John H. Stroger Jr. Hospital of Cook County, said she’s among those seeing a rise in infections.
“The cases have been rising a lot, actually,” she told NBC Chicago in an interview Tuesday.
Bhagi said that while the typical season for strep might be in winter months, when children experience strep throat, there are other presentations the infection can take, particularly in warmer weather.
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“Usually around winter time you can see a lot of sore throat, you can see a lot of ear infections with strep. More to summertime you start seeing more skin infections with strep because, you know, you’re exposed, outside, you’re wearing less layers of clothes, you can get a staph infection of the skin, per se, for strep,” Bhagi said.
The recent cases come just months after health officials issued a warning about a dangerous and potentially deadly type of strep throat infection on the rise in Illinois, which caused a number of pediatric deaths in the state.
“We’re worried about children as we’re seeing group A strep outbreaks, just strep throat outbreaks rampant in a lot of communities and in schools,” Dr. Arti Barnes, chief medical officer for the Illinois Department of Public Health, said in March.
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The Centers for Disease Control and Prevention also said at the time it was “looking into an increase in invasive group A strep infections among children in the United States,” adding that such infections include things like necrotizing fasciitis and streptococcal toxic shock syndrome.
On March 10, IDPH Director Dr. Sameer Vohra said more cases of the group A strep throat leading to severe complications had been reported in 2023 “than in any of the past five years” and urged people to monitor for early symptoms.
According to Vohra, those symptoms could include “sudden onset of sore throat, pain when swallowing and fever.”
Beyond that, there are the typical symptoms many watch for with strep, and then there are the not-so-typical symptoms.
“[Strep is] very notorious,” Bhagi said. “So it can cause multiple signs and symptoms in your body. You can have strep-related ear infection; you can have strep-related sore throat; you can have strep-related brain infection – actually it can lead to meningitis, which we call brain infection going down; strep can also infect your skin, which is more in summer months rather than winter months obviously because of the exposure. Strep can also lead to very deep or very severe blood infection, which we call toxic shock syndrome that you can get with strep. Ultimately strep can infect your kidneys and your heart if left untreated.”
Bhagi recommends anyone showing symptoms gets tested.
Here’s what to know:
Some of the more common symptoms, according to Bhagi and the CDC, include:
Pain when swallowing
Throat may look red
Red and swollen tonsils
White patches or streaks of pus on the tonsils
Tiny, red spots on the roof of the mouth, called petechiae
Swollen lymph nodes in the front of the neck
“If you have the classic symptoms of strep, which is fever – whether it’s low grade, like, you know, 100.1 or even 101 or 102, which is high grade – you do not have much of cough symptoms but you’re having a lot of throat pain, you feel itchiness, you feel you’re having difficulty swallowing, you feel every time you drink or eat something it causes pain in your throat … you must always get tested. So that is classic strep.”
But strep can also infect the skin.
“Group A strep bacteria are very contagious. When group A strep bacteria infect the skin, they cause sores,” the CDC states. “The bacteria can spread to others if someone touches those sores or comes into contact with fluid from the sores.”
It can take up to 10 days for a sore to appear following exposure, experts say.
Symptoms for this type of infection could include “red, itchy sores that break open and leak a clear fluid or pus for a few days” and “a crusty yellow or ‘honey-colored’ scab forms over the sore.”
“If you’re feeling that you are developing infection of your skin, you’re seeing more yellowish color, pussy discharge or crusting around your skin, especially on your face … or you have an open wound, you just had a fracture or you just fell somewhere and you have an open wound where you’re seeing a puss kind of discharge coming out, it’s always good to swab it and send it to see if it’s growing strep infection.”
Less Common Symptoms
Some of the lesser-known symptoms might include:
Nausea or vomiting
Rash (scarlet fever)
Symptoms Not Associated With Strep
Symptoms you likely won’t see with strep infections include things like:
Hoarseness (changes in your voice that make it sound breathy, raspy, or strained)
Pink eye (conjunctivitis)
But that doesn’t mean you won’t see these in someone with strep.
“Usually you don’t have much of a cough, usually don’t have much of runny nose and congestion, but there’s always atypical findings, you know, as in any infection, there can always be atypical presentation.”
The 1 Symptom You Could See With All Strep Infections
According to Bhagi, one symptom is common across all types of strep infections.
“I think one thing with strep is mostly, mostly everybody gets a little bit of fever, whether it’s low-grade fever or high-grade fever,” she said.
What Can I Do to Protect My Child?
To prevent group A strep infections, the CDC recommends you:
Cover your mouth and nose with a tissue when you cough or sneeze.
Put your used tissue in the waste basket.
Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
Wash your hands often with soap and water for at least 20 seconds.
Use an alcohol-based hand rub if soap and water are not available.
To prevent skin infections:
Clean and care for wounds
Wash your hands and laundry often
Take antibiotics, if prescribed