In STSS, the bacteria produces a toxin that can result in an overwhelming immune response in some people.
The illness can progress to become life-threatening in a matter of hours and has a high mortality rate – up to 40% of people who develop STSS will die.
However, the early signs and symptoms of STSS can overlap with common viral illnesses, particularly in children, making it hard to diagnose.
Symptoms are vague in early invasive group A streptococcal infections – things like fever, rash and nausea. But it’s important to look out for signs of sepsis, which suggests something more serious might be going on.
Signs of more severe invasive group A streptococcal disease, including STSS, are similar to those seen in other bacterial causes of sepsis (such as meningococcal disease). These include lethargy (drowsiness), fast breathing, a rapidly changing rash, aching muscles and confusion.
STSS sometimes co-occurs with a condition called necrotizing fasciitis, also caused by Strep A, which is the “flesh-eating” presentation of the infection. This is when the skin cells die in response to the toxins produced by the bacteria.
Parents of young children should trust their gut. If you’re worried your child is sicker than they usually would be with a common bug, and particularly if they have cold limbs, a red rash (like sunburn), or are less responsive, seek medical attention quickly at your nearest emergency department.