US hospitals see rise in serious strep A infections in children after 15 UK deaths

By Aria Bendix —

Children's hospitals in Arizona, Colorado, Texas and Washington have reported an increase in group A strep infections, a serious and sometimes life-threatening illness that occurs when bacteria spread to normally germ-free areas of the body, such as the bloodstream. .

James Versalovic, chief pathologist at Texas Children's Hospital in Houston, said his pediatric center, the nation's largest, has seen

in infections in the past two months compared to the same period last year. .

In October and November about 60 cases were detected.

In the UK,

from invasive group A strep since mid-September.

Britain's Health Security Agency said in a statement last week that cases tend to rise sharply in the new year, but appear to have picked up sooner than expected.

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The Centers for Disease Control and Prevention (CDC) indicated that "some doctors have reported a possible increase in these infections among children in the United States," and that they are "in contact with surveillance centers and hospitals from various states for more information.”

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Group A strep are the same bacteria that cause strep throat, as well as skin conditions such as scarlet fever (a red rash that feels like sandpaper and can resemble a sunburn) and impetigo (itchy red sores with yellow scabs).

Some people with invasive group A strep can also develop these conditions, but in many cases the first sign of invasive group A strep is a secondary infection, such as

“These are cases that go beyond ordinary strep throat,” Versalovic says.

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An invasive infection can trigger the following

• Lower respiratory tract infections, such as pneumonia or emphysema, which are characterized by pockets of pus in the fluid-filled space surrounding the lungs.

  The first signs of these infections are fever, chills, shortness of breath, or chest pain.

• Skin infections such as cellulitis or necrotizing fasciitis, also known as carnivorous disease.

  Both conditions cause red, hot, swollen, or painful rashes.

  Necrotizing fasciitis spreads quickly and can develop into ulcers, blisters, or black spots.

• Streptococcal toxic shock syndrome, an immune reaction that can lead to organ failure.

  The condition usually begins with fever, chills, muscle aches, nausea, or vomiting, and then leads to rapid heartbeat or rapid breathing.

Anyone can get invasive strep A, including healthy adults, but people over the age of 65 and those with chronic illnesses are most susceptible.

It is not yet clear why hospitals are recording an increase in cases, especially among children.

The CDC states that it may be related to the rollback of COVID-19 mitigation measures and the increase in respiratory viruses such as influenza and RSV.

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“Often, children who develop severe group A strep infections start out with a viral respiratory infection,” says Sam Dominguez, an infectious disease specialist at Children's Hospital Colorado and a professor at the University of Colorado School of Medicine.

Several million cases of non-invasive group A strep occur each year in the US, but invasive infections are rare, with about 14,000 to 25,000 cases per year, according to the CDC.

Between 1,500 and 2,300 people die each year.

The CDC claims to have seen a decline in these infections in all age groups over the past two years.

In the UK, the last comparable peak in the number of cases was from 2017 to 2018, when 27 children died.

At Phoenix Children's Hospital, the number of cases has been rising since late October or early November, according to Wassim Ballan, chief of infectious diseases.

But he said the condition is rare compared to RSV, or the flu.

“Although we are seeing this is an uptick in cases, the absolute number itself is not huge,” Ballan said.

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Unlike RSV and the flu, which often pose the most serious threats to very young children, doctors say they are treating children of all ages for invasive group A strep right now.

"We've treated teenagers, toddlers and all kinds of kids," said Sara Vora, an infectious disease expert at Seattle Children's Hospital. on a ventilator for a few days and then he made a pretty quick recovery and is doing great," Vora added, "it's probably the worst case I've ever seen."

Children's hospitals in other states - including California, New York, Illinois and Minnesota - said they have detected no increase in invasive group A strep.

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Parents who are concerned about their children's health should consider seeking emergency medical attention if their children are drowsier or more lethargic than normal, have trouble eating or drinking, or are excessively dehydrated and not producing urine, Dominguez said.

Vora suggested that, as a general rule, "if your child isn't behaving well, seems to have symptoms that are worse than a cold, or lasts longer than a couple of days, then it's worth getting checked out."

It is important that children with strep are seen right away so they can be started on antibiotics such as penicillin.

After 24 hours on antibiotics, the patient is usually no longer contagious.

“The sooner someone is put on adequate antibiotic treatment, the faster they will recover

,” Domínguez warned.