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For Immediate Release

Children's Researchers Find Elementary School Students May Harbor Strep Infections That Put Them at Risk for Serious Complications

Researchers at Children's Hospital of Pittsburgh have found an extremely high frequency of infections from Group A streptococci (GAS) - the bacteria that cause strep throat - among school children. The researchers also found that many of these children serve as carriers of strep and carriers are at risk for developing serious complications, including rheumatic fever.

Judith Martin, MD, an infectious disease specialist at Children's, and colleagues found that 60 percent of school-age children at a Pittsburgh-area elementary school tested positive for strep at least once during the school year. About half of these children were carriers, meaning they had the bacteria in their throats but showed no symptoms. The average length of time a child was a carrier was three months, but some children were carriers for as long as four years. Carriers are at risk because they can harbor GAS for years before suddenly exhibiting symptoms, making them less likely to be quickly diagnosed and treated.

This is the first study in more than 35 years to document the rate of strep infection among a large group of school children over several years. Researchers found that students in the study who were strep carriers could suddenly switch the type of strep that they are carrying, meaning the child could develop symptoms of strep throat and possibly be at serious risk for developing rheumatic fever.

"We were surprised to find out how common strep infections are. Only four in 10 kids are going to get through the school year without an infection, and we think parents and physicians need to be aware of that," said Dr. Martin, the study's first author and principal investigator. "The real danger with strep throat is that if kids aren't treated with antibiotics within nine days, they can develop rheumatic fever. Before this study, no one thought that children who are carriers of GAS were at risk to develop rheumatic fever. "

Rheumatic fever is a serious complication of strep throat that can cause heart damage, arthritis and chorea (involuntary movements of the arms and legs). It is rare - Children's treats about 12 cases a year - because people diagnosed with strep throat are typically treated with an antibiotic within nine days. However, strep carriers are at risk because they could harbor the bacteria in their throats for months and then suddenly become sick, making timely diagnosis and treatment difficult.

The findings of this four-year study, conducted from 1998-2002, are published in the November issue of Pediatrics. Dr. Martin and colleagues studied 125 local school children over four years and performed throat cultures on the students every two weeks during the school year, for a total of 5,658 throat cultures.

This is one of several important findings to come from Children's strep study. Previously, Dr. Martin and her colleagues reported that 48 percent of the throat cultures taken from these students were resistant to erythromycin, an antibiotic commonly used to treat infections. These findings, the first in the United States to document antibiotic resistance to such a degree, were reported in the New England Journal of Medicine in 2002.

Additionally, the researchers found in February 2004 that Pittsburgh has a rate of antibiotic resistance that is twice the national average and that the rates skyrocketed during the months of April and May.

Marc Lukasiak, 412-692-5016,
Melanie Finnigan, 412-692-5016,

Last Update
February 19, 2008
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Last Update
February 19, 2008