Strep throat is experiencing a surge among children in certain regions of the country, raising concerns about a potential shortage of antibiotics to treat it as winter approaches (source). Dr. Jennifer Stevenson, head of the emergency department at Henry Ford Medical Center—Fairlane in Dearborn, Michigan, has witnessed an unprecedented number of otherwise healthy adults and children coming in with strep throat. She mentioned that in her 25 years of practicing emergency medicine, she has never seen strep throat as frequently as in the past six to eight months.
Strep throat has become the second most common diagnosis in Stevenson’s emergency department since March, following chest pain. Many of the patients also had Covid-19. The prevalence of strep throat has been on the rise for months in the mid-Atlantic and Southeastern regions of the United States (source). Dr. Thomas Lacy, division chief for Nemours Children’s Primary Care, has also observed a significant increase in strep throat cases since the beginning of the school year in Delaware, Pennsylvania, and Florida. The number of strep cases in Florida is more than double compared to last year at the same time.
Why is strep throat more prevalent now?
The prevalence of invasive strep A, a similar bacterium that causes scarlet fever and impetigo, has been increasing over the past decade. However, it’s the common form of strep throat that is affecting children in hospitals currently. The disruption caused by the Covid pandemic has possibly affected the usual pattern of seasonal illnesses like RSV and the flu, contributing to strep throat’s strong comeback this year.
Epic Research, which analyzes electronic health records nationwide, has highlighted a steady increase in strep throat cases among children aged 4 to 12 since August. Notably, major medical centers in Cleveland, Pittsburgh, San Diego, and Seattle have not reported significant increases in strep throat cases. It is important to note that strep throat diagnoses are not usually required to be reported to local or state health departments, unlike other illnesses such as Covid-19 or measles. However, the Centers for Disease Control and Prevention estimates that 5 million outpatient visits each year are due to noninvasive group A strep infections.
According to Dr. Victoria Valencia, the interim director of the Health Center for Student Care at Tulane University, her team has observed a rise in strep cases on campus after the fall semester began. Valencia believes that the numbers are similar to those seen in 2019 before the pandemic.
What are the symptoms of strep throat?
Dr. Stevenson and Dr. Valencia have listed the common symptoms of strep throat:
- Red, scratchy throat
- High fever
Children aged 12 and younger may also experience:
- Abdominal pain
- Nausea
- Vomiting
- Inflamed lymph nodes in the gut, leading to pain in small children
- Swollen tonsils triggering gag reflexes
If left untreated, strep infections can lead to complications, including kidney disease (source).
A shortage in treatment
Strep throat can be easily treated with the widely used antibiotic amoxicillin. However, there has been a shortage of this drug, especially in the form given to young children, for about a year according to the Food and Drug Administration. This has led doctors to turn to alternative antibiotics, which may not be the first-line treatment for strep throat. While most pharmacies in the affected areas have managed to stock amoxicillin, difficulties in finding the medication for children are expected to arise as the cooler months approach. Amoxicillin typically alleviates strep throat symptoms within 24 hours and reduces contagiousness, preventing the spread of the infection. Therefore, the shortage poses a significant challenge to treating strep throat effectively (source).
