The alert first came from the other side of the Channel.
Health authorities in the United Kingdom called on the public to be vigilant at the end of last week after the death of eight children who had developed an invasive streptococcal A infection (IISGA).
These bacteria usually cause mild infections, such as angina or scarlet fever - which are on the rise in this country - which are easily treated with antibiotics.
But, in rare circumstances, they can enter the bloodstream and cause serious illness.
This Tuesday, France's turn to send a similar message to health personnel.
In its press release for practitioners, the Directorate General for Health thus indicates that “several pediatric cases of IISGA, in greater numbers than usual, have been reported in different regions (Occitanie, Auvergne-Rhône-Alpes, Nouvelle- Aquitaine) over the past fortnight.
Eight children, without identified risk factors, had to be hospitalized.
Among them, two died.
Three adult cases have also been reported, “including one deceased,” the statement said.
But the situation is probably not just about these proven cases.
The mobilization began "a fortnight ago", explains Christèle Gras Le Guen, the president of the French Society of Pediatrics.
Although "although exceptional, a few cases of severe form of streptococcal A infections, very unusual in their severity, have been identified".
As in the United Kingdom, this observation is established against the background of a "rather sudden increase in common streptococcal A infections", such as angina, impetigo -a skin infection-, or scarlet fever -generally not serious but very contagious -, adds Robert Cohen, pediatrician at the Intercommunal Hospital Center of Créteil.
“Different Strains”
The French and British authorities consider it unlikely that this upsurge is due to the emergence of a new, more virulent bacterial strain.
It would rather be an “unusual increase in the number of cases, linked to different strains”, estimates the Directorate General of Health.
The British Health Security Agency (UKHSA) for its part puts forward the hypothesis of an increase “in bacterial circulation and contacts”.
This increase in cases of streptococcal A infections, as well as its severe forms, is part of a particular context, with a strong comeback of winter viruses, such as influenza or bronchiolitis, which are not very present during confinements, underlines Robert Cohen .
"2022, the year post-health measures linked to Covid-19, is not quite like the other years in terms of infectious diseases", continues the specialist, who reiterates the possibility of an "immune debt".
Taken up by several paediatricians, this concept according to which our organisms have become more vulnerable to external pathogens after having been protected from them for two years of sanitary measures, is strongly criticized by many specialists, who find it “no solid scientific basis” and recall that many other hypotheses, starting with a Covid-19 infection, could potentially explain the increases observed.
Waiting for details
Investigations are underway in order to "objective and describe more precisely the multiplication of cases of IISGA at the national level and to clarify the epidemiological situation at the international level", indicates the DGS.
In the meantime, the health authority asks caregivers to systematically check using a test that angina is not linked to streptococcus A and to carry out a "throat swab in front of a clinical picture of scarlet fever" in the event of a negative test.
This outbreak of bacterial infections also occurs in a context of shortage of the main antibiotic used in children, amoxicillin.
"A referral to learned societies is underway to specify the recommendations for the management of cases and contact persons, particularly in the current context of tensions over amoxicillin", specifies the DGS.
