Never really thought about strep much. As a kid I had strep throat. Normal kid-in-classroom type illness, right?
Before I gave birth, they tested for “strep” and I came back positive, so they gave me a special IV drip to help prevent it passing along to my baby during the birthing process. Hmm… okay? I had no idea strep behaved like that.
Now tonight, many years after the birth of my child, my mother explains to me that her mom (my grandmother) actually died slowly from complications of strep, causing my grandmother’s organs to gradually fail over time first in the hospital, then the ICU.
My grandma’s slow death is a core memory, but at the time my mother didn’t give much explanation for what was happening. She probably assumed I was too young. She wanted to protect me.
But now I’m concerned. How does strep migrate from some childhood disease of the throat to something passed along the vaginal canal to (in the case of my grandmother) heart and kidney failure, leading to death? Should I be concerned for my family’s health?
I thought it was just a sore throat. ELI5.
In: Biology
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So when you say “Strep” you’re actually referring to different species of the bacteria called *Streptococcus.* There are a bunch of different species of *Strep* that cause different types of infections. So Group A Strep (or *Streptococcus pyogenes*) is the type of *Streptococcus* that causes your childhood strep throat type of illness. Group B Strep (*Streptococcus agalactiae*) can colonize the vagina and lead to infections in newborns that way. As another example there’s a species of strep called *Streptococcus pneumoniae* that can cause, you guessed it, pneumonia.
These infections are not related, but they’re being caused by different species of bacteria that are just very similar to each other in shape, the way they grow, etc. so they’re classified by a similar name.
Strep is a type of bacteria (streptococcus) and there are a lot of types of bacteria in that family. Strep throat is caused by one type of what you were born with was likely Group B Streptococcus (gbs) which is the most common cause of meningitis in newborns. Pregnant people may be carriers of GBS without any symptoms or harm and pass it along to their children for whom it is dangerous. Something like 25% people have GBS but they don’t know it because they don’t have any symptoms and their body eventually fight it off. But for newborns or people with compromised immune systems it can be bad. I dont know what your grandmother had but it may have been a strep related toxic shock syndrome where strep enters through a wound and then attacks the bloodstream. It could have been an autoimmune response to an earlier strep infection.
Long story short, “strep” is a bacteria that is really common. There are lots of types of bacteria in the “strep” family and they may cause different issues in different populations (in the same way that tigers, housecats, and lions are all types of the feline family but they all are different, the types of strep are related but not identical). You shouldn’t necessarily be overly concerned about strep, it just has impacted your family so much because it is a really common bacteria in humans. Follow general hygiene advice (wash hands often, use soap, etc) to avoid it as much as you can.
Group A strep also have an unusual pathophysiology where they can trigger what is essentially an autoimmune disorder. Common sites affected are heart valves, kidneys and also apparently brain although that is very rare. All of these affect children though; it rare but not unheard of affect adults. That being said, the long term consequences of acute rheumatic fever (rheumatic heart disease) can cause disease in adults. Your grandmother is unlikey to have had the acute version (ARF) as adult, but might have had it as a child amd then RHD as an adult.
https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease
https://www.cdc.gov/groupastrep/diseases-public/post-streptococcal.html
https://www.webmd.com/children/what-is-pandas-syndrome
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