Experts watch closely for rise in invasive Streptococcus A after pandemic subsides

At the height of the pandemic, when people were social distancing, wearing masks, and staying out of school and work, invasive group A streptococcal infections were lower than normal.

But late last year, the UK, which has served as a harbinger of what would happen to the US, began reporting: Increase in Childhood Group A Streptococcal Infections, including more than two dozen dead. In the United States, the CDC is also closely monitoring cases, which are on the rise this season compared to previous years.

As infectious disease experts gather new insights, they urge parents to watch out for certain symptoms in children and not neglect their own health. But the verdict is still out on whether these infections are actually a bigger problem this year than they have been in years past.

William Schaffner, M.D., professor of infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee, said: MedPage Today UK report ‘no doubt’ a ‘warning’ for US infectious disease and public health communities

These reports “increased sensitivity and stimulated many email communications across the country,” he added, noting that there are several factors to consider when investigating the current state of Group A streptococcal infections. pointed out.

The interventions implemented against COVID-19 “had the secondary benefit of reducing many other infections,” he said. It is important to consider whether it is a “return to the conventional level of” or “more than that”.

“That question will continue to be investigated,” he noted.

Schaffner added that at this time, the recent Group A streptococcal infections do not appear to be the result of streptococcal strains with new virulence attributes. However, he noted that there has been a markedly early spike in influenza this season, and Group A streptococcal infections “may have been partially fueled by previous influenza infections.”

Many people have group A streptococci in their throats asymptomatically, but influenza infection and the associated inflammation of the mucous membranes can sometimes cause group A streptococci to circumvent normal protection and enter the bloodstream, resulting in sepsis. He explained that it can cause

Adam Ratner, MD, M.P.H., director of the Division of Pediatric Infectious Diseases at New York University’s Grossman School of Medicine and member of the Infectious Diseases Board of the American Academy of Pediatrics, says that the spread of certain circulating viruses, including influenza, As for group A streptococcal infections, it is a contributing factor.

“If you have a viral infection, you may have a bacterial infection, especially the flu,” says Ratner.

This is also true for COVID and respiratory syncytial virus (RSV), he adds, adding that when someone gets the virus, the bacteria that normally reside in the nose and throat can easily reach other parts of the body. I explained that there is. It shouldn’t be.

As far as surveillance is concerned, it is important to determine whether Group A streptococcal infections are likely to increase above normal levels in a particular location or more broadly nationally.

In fact, the CDC is collecting data on recent infections.

“The CDC will monitor the data closely and talk to monitoring sites and hospitals in multiple states to learn more about the trends in Group A streptococcal infections they may be seeing,” said an agency spokesperson. said. MedPage Today on mail. “We will share more information as it becomes available.”

Just last month, the agency issued health consultation Inform clinicians and public health authorities about the increase in pediatric invasive group A streptococcal infections.

“Group A Streptococcus bacteria can cause illness Rare but severe infections such as streptococcal pharyngitis, skin infections, sepsis, septic shock, streptococcal toxic shock syndrome, and necrotizing fasciitis. Invasive Group A streptococcal infections reported were lower than normal in all age groups during the COVID-19 pandemic. CDC Active Bacterial Core Surveillance shows a confirmed childhood increase [group A strep] This increase is above what the CDC has seen in the same period in 2020 and 2021, suggesting that the number of child cases has returned to levels similar to those seen in the pre-pandemic years. “

At the same time, “it is too early to say whether the number of invasive group A streptococcal cases is increasing beyond what would normally be expected from the pre-pandemic seasonal pattern of group A streptococci,” said a spokeswoman. continued, “The total number is [invasive] The number of cases is relatively small, [invasive] Infection is rare. “

CDC data A Case of Invasive Group A Streptococcus count about 25,000 in 2018 When 2019and at about 20,200 2020.

A CDC spokesperson noted that immediate treatment with antibiotics, usually given intravenously, is critical for these infections.

“Streptococcal pharyngitis requires prompt antibiotic treatment to prevent serious complications and spread of infection, often provided as liquid amoxicillin,” the spokesperson added. “Given the current shortage of liquid amoxicillin, CDC recommends that health care providers consider it. Alternate Antibiotic Options When treating children with strep throat as advised by the American Academy of Pediatrics. “

Availability of childhood immunizations is also important, Ratner said. Although there is no vaccine against Group A Streptococcus, it is not too late for children and adults to get vaccinated against influenza and COVID.

As for what parents should be aware of, Schaffner says that when it comes to early invasive sepsis, symptoms may be nonspecific, but they can make the child look sick.

“Suddenly the child is lethargic, not eating, active and unattractive,” he explained.

It’s also important to note that invasive group A streptococcal infections can also affect adults. You may put off getting treatment on your own.

Overall, “Invasive group A streptococcal disease is a serious disease that, if not treated, can lead to death for individuals,” Schaffner said. The vast majority of people have been successfully treated and have been discharged from the hospital to continue with their daily lives.”