Increased Invasive Group A Streptococcal Disease in Ontario

Advisory Alert

December 18, 2023

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To: Local Health System Partners


The Ministry of Health is closely monitoring invasive Group A Streptococcal Disease (iGAS) trends in Ontario and is requesting that health care providers be alert for the signs and symptoms of iGAS in patients. Please see the attached memo from Dr. Barbara Yaffe, Associate Chief Medical Officer of Health.

Group A Streptococcus (GAS) is a common cause of bacterial infections including strep pharyngitis, impetigo, scarlet fever, and cellulitis. We ask that you be on the alert for potential complications of GAS infections. While uncommon, iGAS can occur and quickly progress leading to serious conditions such as streptococcal toxic shock syndrome, sepsis, soft tissue necrosis, meningitis, and pneumonia.

Manifestations preceding the onset of iGAS vary; however, symptoms may include:


If you suspect iGAS, you must obtain appropriate specimens for routine bacterial culture or DNA detection by nucleic acid amplification testing. See further testing guidance on Public Health Ontario’s website.

Note: If an individual meets provincial iGAS case definition, you must immediately report the case to your local public health unit for case and contact management purposes. See the Diseases of Public Health Significance reporting process on Public Health Sudbury & Districts’ website.

Case and Contact Management

As a reminder, please refer to the Advisory Alert issued May 25, 2023, for details on case and contact management.

To help prevent iGAS, educate patients and/or parents/guardians on signs and symptoms of serious bacterial infections and when to seek medical attention. Encourage patients to stay up to date on routine vaccinations such as COVID-19, influenza, and chickenpox. For more information about Group A Streptococcal disease, visit Public Health Sudbury & Districts’ website or contact our Control of Infectious Diseases program at 705.522.9200, ext. 772 or toll-free at 1.866.522.9200.


Original Signed By

Dr. Marlene Spruyt

Acting Medical Officer of Health
On behalf of Dr. Penny Sutcliffe Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

This item was last modified on December 18, 2023