Group A strep infections are beginning to rise across the United States as children settle back into classrooms, the Centers for Disease Control and Prevention said in a Sept. 18 update. Emergency department data show an uptick in visits for strep throat and scarlet fever, two common illnesses caused by the same bacteria.
The rise is expected. The CDC notes that group A strep reports are typically lowest in summer and start increasing as children return to school, with respiratory infections most common in winter and early spring. For parents, the season of sore throats and school absences is starting now.
The same bacteria can also cause rare but dangerous invasive infections, including streptococcal toxic shock syndrome and necrotizing fasciitis. Those cases remain uncommon, but knowing an ordinary sore throat from a medical emergency is the most useful takeaway for households.
An Early-Season Rise Seen in Emergency Rooms
The CDC flagged the increase on its page tracking other respiratory illnesses, where it highlights germs showing unusual or rising activity. The agency said group A strep reports are "beginning to increase in the United States as children return to school."
The update is based on national emergency department diagnosis data rather than a count of confirmed cases. The CDC does not publish local strep throat counts, so the data show direction, not scale.
Strep is not the only germ circulating. The same CDC page reports that rhinovirus and enterovirus, common causes of colds, are also increasing nationally. That matters because most sore throats are caused by viruses. According to CDC clinical guidance on strep throat, group A strep causes about 20% to 30% of sore throats in children and 5% to 15% in adults.
The local picture is limited. The CDC tracks the most serious strep infections through a surveillance network covering about 35 million people in 10 states, but it does not publish real-time strep throat counts for metro areas like New York City, Chicago, or Houston. Parents should watch school and county health notices.
Sorting Ordinary Strep Throat From the Rare Dangerous Kind
Strep throat typically starts suddenly with a painful sore throat, fever, red and swollen tonsils that may have white patches, and sometimes tiny red spots on the roof of the mouth. It usually appears 2 to 5 days after exposure and is most common in children 5 through 15. A cough, runny nose, or hoarse voice points more toward a virus. Scarlet fever is strep throat accompanied by a red rash that feels like sandpaper.
Children younger than 3 rarely develop classic strep throat. Instead, they may have a runny nose, fever, and irritability that can be harder to recognize.
Invasive group A strep is a different illness. A CDC-led study published in JAMA found that invasive infections more than doubled in 10 states from 2013 through 2022. Resistance to some antibiotics, including tetracycline and the macrolide and clindamycin drugs, rose over that period, although all samples remained susceptible to penicillin-type antibiotics. Dr. Joshua Osowicki, a pediatric infectious disease physician at Royal Children's Hospital Melbourne who co-wrote an accompanying editorial, described invasive disease as "a completely different beast, clinically."
Older adults and people with underlying health conditions face the highest risk, though children can be affected too. According to the CDC's group A strep overview, warning signs of severe infection include a red, warm, or swollen area of skin that spreads quickly, pain far worse than an injury would explain, and fever with signs of low blood pressure such as dizziness or confusion. These symptoms need emergency care, not a wait-and-see approach.
The evidence does not show that the current seasonal rise in strep throat is causing more invasive cases this fall. The CDC update describes a typical back-to-school pattern.
Testing, Antibiotics and the Return-to-School Clock
A rapid strep test at a pediatrician's office, urgent care clinic, or community health center can confirm the infection in minutes, and a throat culture may follow a negative rapid test in children. Strep throat is treated with antibiotics, usually penicillin or amoxicillin, which shorten illness, reduce spread, and help prevent complications such as rheumatic fever. Antibiotics do nothing for viral sore throats.
Under current CDC guidance, which follows the American Academy of Pediatrics, children with strep can return to school or child care once they look well and have taken appropriate antibiotics for at least 12 hours. In outbreak settings, staying home for at least 24 hours may be advised. Families should finish the full course of antibiotics even after symptoms improve.
Parents without insurance can ask about community health centers, which offer sliding-scale fees. Telehealth can help screen symptoms but cannot perform the throat swab needed for diagnosis.
Reasonable steps now include frequent handwashing, not sharing cups or utensils, and keeping sick children home. Demanding antibiotics for a child with clear cold symptoms, or keeping children out of school out of fear of invasive infection, is not recommended.
The CDC reviews its tracking page weekly, and activity typically builds into winter. MedicalDaily will report any regional advisory on invasive disease.
Key Questions Answered
Is strep throat increasing right now? Yes. The CDC said on Sept. 18 that group A strep reports are beginning to rise nationally as children return to school, a typical seasonal pattern.
How can I tell strep from a cold? Strep often brings a sudden sore throat, fever, and swollen tonsils without a cough. Only a test can confirm it.
Is invasive strep common? No. It remains rare, although CDC-led research found invasive cases more than doubled in 10 states between 2013 and 2022.
What are the emergency warning signs? A rapidly spreading red, swollen or very painful skin area, pain out of proportion to an injury, or fever with confusion or dizziness requires emergency care.
When can my child go back to school? Under current guidance, once they look well and have taken appropriate antibiotics for at least 12 hours.
Who is most at risk of severe infection? Older adults and people with underlying health conditions face the highest risk of invasive disease.
