A child with a sore throat and fever, a rash that feels rough like sandpaper, scabby sores on the skin — all of these can come from the same bacteria. The UK National Health Service (NHS) describes Strep A (group A strep) as a common type of bacteria and says most infections are mild and easily treated, but some are more serious. Most get better on their own after about a week, and anyone with a strep A infection or prescribed antibiotics for it stays away from nursery, school or work for 24 hours after starting the antibiotics. Rarely it causes serious problems, called invasive group A strep (iGAS). Here is the NHS page on symptoms, when to get urgent help or call 999 for a child, treatment and prevention, with a baby temperature check.
1. Symptoms range from a sore throat to a rash and skin sores — more common in children, and most get better on their own.
2. Started antibiotics? Stay off nursery, school or work for 24 hours — to stop it spreading.
3. Urgent help for a baby under 3 months at 38C, or 3 to 6 months at 39C or higher — call 999 (119 in Korea) for breathing difficulty or blue lips.
Symptoms — NHS
The NHS says strep A can cause a range of symptoms, including:
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Flu-like | A high temperature, swollen glands, an aching body | — |
| Throat | A sore throat — strep throat or tonsillitis | See tonsillitis |
| Rash | A rash that feels rough, like sandpaper — scarlet fever | Covered in scarlet fever |
| Scabs | Scabs and sores — impetigo | — |
| Swollen skin | Painful, hot and swollen skin — cellulitis | — |
| Muscles | Severe muscle aches | — |
Strep A infections are more common in children, but adults can also get them. Most are not serious and get better on their own. But rarely the infection can cause serious problems, called invasive group A strep (iGAS). The page does not list iGAS symptoms separately; it gives the urgent and 999 signs below.
If your child is unwell — NHS
It can be hard to tell when a child is seriously ill, but the main thing is to trust your instincts, says the NHS. You know better than anyone what your child is usually like, so you will know when something is seriously wrong.
If they don’t seem seriously ill, you can usually look after them at home, and they should feel better in a few days. If they’re uncomfortable, give children’s paracetamol or children’s ibuprofen, checking the leaflet that it suits your child and how much to give. A pharmacist can advise on easing symptoms and whether you need a doctor. Managing a child’s fever is also in baby fever.
Urgent help and 999 — NHS
| If | Where | Worth noting (ours) |
|---|---|---|
| Your child is unwell and getting worse or not improving | Urgent GP appointment or NHS 111 | In Korea, a paediatric or out-of-hours clinic (ours) |
| Feeding or eating much less than normal | Urgent GP appointment or NHS 111 | — |
| Fewer wet nappies or peeing less, or other signs of dehydration | Urgent GP appointment or NHS 111 | — |
| Under 3 months at 38C, or 3 to 6 months at 39C or higher | Urgent GP appointment or NHS 111 | Use the check below |
| A very high or low temperature, hot or cold to the touch, or shivering | Urgent GP appointment or NHS 111 | — |
| Very tired or irritable | Urgent GP appointment or NHS 111 | — |
| Difficulty breathing — grunting, breathing very quickly, tummy sucking under the ribs | 999 or A&E | A&E or 999 (119 in Korea) |
| Pauses when your child breathes | 999 or A&E | 119 in Korea |
| Skin, tongue or lips blue or grey — on black or brown skin easier to see on palms and soles | 999 or A&E | 119 in Korea |
| Floppy and won’t wake up or stay awake | 999 or A&E | 119 in Korea |
The NHS says to check symptoms on 111 online for children aged 5 and over, or call 111 for children under 5. Don’t drive to A&E: ask someone to drive you or call 999 for an ambulance, and bring any medicines you take. It repeats: trust your instincts, and get medical help if you think you need it.
Baby temperature check
The page gives two figures — 38C under 3 months and 39C or higher at 3 to 6 months. Enter age and temperature to see whether this criterion is met (a reading aid we built).
Updates as you type. The page says a baby under 3 months with a temperature of 38C, or 3 to 6 months with 39C or higher; we read the under-3-months figure as 38C or higher, and count a 6-month-old as 3 to 6 months (our reading). It is a reading aid, not a diagnosis: trust your instincts and the other signs.
Treatment — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Most | Get better on their own after about a week | — |
| More serious | May be treated with antibiotics | Prescribing is for clinicians |
| Staying off | With a strep A infection or antibiotics for it, stay away from nursery, school or work for 24 hours after you start taking antibiotics — to stop it spreading | E.g. first dose 9am Monday 2 November: off until 9am Tuesday 3 November (our example) |
| iGAS | Serious infections are treated in hospital with antibiotics | — |
The 24 hours run from when the antibiotics are started, not from the diagnosis. As in the example, a first dose at 9am on Monday means 9am on Tuesday (our example). It is the same rule as in scarlet fever.
How it spreads and who is more at risk — NHS
Strep A spreads through close contact with an infected person, through coughs and sneezes or from a wound. In some people the bacteria live in the body without causing symptoms, but they can still pass them on, says the NHS.
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Immunity | A weakened immune system | — |
| Skin | Open sores or wounds | Keep wounds covered (ours) |
| Viruses | Some viral infections, such as a cold or flu | Watch more closely after a winter cold (ours) |
Prevention — NHS
- Avoid close contact with someone you know is infected
- Wash your hands often with soap and water — see handwashing
- Cover your mouth and nose with a tissue when you cough or sneeze
- Bin used tissues as quickly as possible
Checklist
- ☐ Sore throat, sandpaper rash, scabs, or swollen skin?
- ☐ Started antibiotics? Count 24 hours from the first dose
- ☐ Under 3 months at 38C, or 3 to 6 months at 39C or higher: urgent help
- ☐ Breathing difficulty, pauses, blue lips or floppiness: 999 (119 in Korea)
- ☐ Hand washing and tissues
Questions that remain
Are strep A and scarlet fever different illnesses?
This NHS page lists scarlet fever as one of the symptoms strep A can cause (the sandpaper rash). How long it lasts and stays infectious is in scarlet fever.
Does a sore throat need antibiotics?
The page says most get better on their own and more serious infections may be treated with antibiotics; prescribing is for clinicians. For ordinary sore throats, see sore throat.
Sources
- NHS — Strep A — source (page shows: reviewed 7 January 2026, next review due 7 January 2029; checked 29 October 2026). Definition; six symptoms (flu-like, sore throat, scarlet fever rash, impetigo, cellulitis, muscle aches); iGAS; caring for a child at home; six urgent GP/111 signs and four 999 signs; 111 online (5 and over) or by phone (under 5); treatment (about a week, antibiotics, 24 hours, hospital); spread and risk; four prevention steps.
- Not read. NHS pages on scarlet fever, impetigo, cellulitis and high temperature in children; separate iGAS guidance; Korean infection guidance.
- What we added. The “worth noting” column and the Korean care gloss.
Where to check further
- 119 or an emergency department — don’t wait if breathing is hard or a child is floppy.
- A paediatrician — if a fever won’t come down or a child is eating less.
Written on 29 October 2026. The content is from the NHS; the glosses are ours.
