GPs should be alert for cases of invasive group A streptococcal infection (iGAS), following a sharp rise in the number of reported cases of the infection.

The DoH has written this month to every GP in England to inform them that from November 2008 to February 2009, the Health Protection Agency identified over 500 cases of iGAS.

This is a 62 per cent rise compared with the previous year.

In the letter, Professor Brian Duerden, inspector of microbiology and infection control, urges GPs to 'maintain a high index of suspicion for any patients presenting with signs and symptoms consistent with iGAS'.

Symptoms include high fever, dizziness, severe muscle aches and diarrhoea and vomiting.

The letter stresses prompt identification and treatment as the infection has a fatality rate of around 25 per cent.

Possible iGAS cases should be assessed and treated promptly in hospital with antimicrobials effective against group A streptococci. Therapy is usually with IV penicillin and clindamycin.

Patients with the most severe forms of the infection, such as necrotising fasciitis, may benefit from treatment with IV immunoglobulin and antibiotics.

The letter also calls for GPs to report confirmed cases to their local Health Protection Unit.

Berkshire GP and RCGP immunisation spokesman Dr George Kassianos said cases of the infection had risen at his practice.

'We need to be vigilant and take swabs if we suspect a patient has the infection, to improve surveillance and detection,' he said.

He added that patients with iGAS should be given an emergency referral.

sanjay.tanday@haymarket.com

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