Invasive Group A Strep (iGAS)
Invasive Group A Strep (iGAS) Playbook
To help infection preventionists quickly activate iGAS prevention efforts, APIC’s Emerging Infectious Diseases Task Force has created an iGAS Playbook that IPs can download and customize for use in their facilities. The Playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs. Access the APIC iGAS Playbook.
About iGAS
- Group A Streptococcus (GAS), Streptococcus pyogenes, is a common bacterium that typically causes mild infections such as strep throat or impetigo
- Invasive Group A Streptococcal disease (iGAS) occurs when the bacterium invade sterile sites of the body
- GAS is primarily spread through respiratory droplets, direct contact with infected wounds, or contact with contaminated surfaces
- Risk increases in crowded settings, long-term care facilities, and childcare settings
- Person-to-person transmission of GAS is common, but progression to iGAS is rare
- Incubation Period: Variable depending on infection type, but generally 1 to 5 days after exposure
- iGAS infections include necrotizing fasciitis and streptococcal toxic shock syndrome
- GAS is a long-recognized pathogen, but invasive forms surged in the 1980s-1990s
- In the United States, the annual incidence of iGAS is about 20,000 to 27,000 cases each year, with 1,800 to 2,400 deaths (CDC, 2024)
Current Situation
- The CDC has reported an increase in iGAS infections among children in the United States. Several regions have also noted a rise in adult iGAS cases, especially in adults over the age of 65 with underlying conditions
- iGAS infections include necrotizing fasciitis and streptococcal toxic shock syndrome
- Similar surges have been reported internationally, with outbreaks in Europe and Asia
- While GAS infections are common, iGAS remains rare but severe, requiring heightened surveillance and rapid response in healthcare settings
Infection Preventionists should ensure facility readiness for iGAS by:
- Screening and early recognition of severe strep infections
- Implementing standard and droplet precautions for suspected or confirmed cases
- Strengthening wound care protocols
- Promote hand hygiene compliance across patient care areas
APIC Resources and Tools
Click here to download the APIC iGAS Playbook
- Developed by the APIC Emerging Infectious Diseases Task Force to help infection preventionists rapidly activate iGAS prevention efforts
- The playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs.
