Streptococcus A | Increase in serious infections in Quebec

In the past month, Quebec has noted an unusual increase in invasive group A streptococcal infections, which claimed the lives of two Montreal toddlers. At the same time, several countries reported an increase in these infections among children. Why are cases on the rise? Should we be worried? Overview of the situation in five questions.

What is group A streptococcus?

It is a bacterium that circulates every year in Quebec and is commonly found in the throat or on the skin of individuals. About one in five healthy people will carry the disease without being sick. The infection usually causes mild illnesses like tonsillitis, pharyngitis, and scarlet fever.

However, some people will develop a serious, so-called invasive infection. In Quebec, only these serious cases are listed. These infections can lead to “meningitis, pneumonia and toxic shock”, lists the medical chief, prevention and control of infectious diseases, at the Direction régionale de santé publique de Montréal, the D^D Genevieve Bergeron. The bacteria can also get under the skin, causing the infection commonly known as “flesh-eating bacteria.”

What is happening in Quebec… and elsewhere in the world?

In the last two weeks, 34 cases of invasive group A streptococcal infections were registered in Quebec. This is a higher number of cases than usual for this time of year, said spokesperson for the Ministry of Health and Social Services, Marjorie Larouche.

In addition, four Montreal children aged 2 and under have developed an invasive infection since mid-November. Two of them died of complications from the disease. This is an increase in infections in the metropolis, since in the last five years, there was rather between 0 and 1 case during this period.

In recent weeks, several countries, such as France, Ireland, the Netherlands, Sweden and the United Kingdom, have also reported an increase in invasive infections, according to the World Health Organization. In the UK, at least 19 children have died of complications from the disease.

Why are infections on the rise?

According to the D^r Christos Karatzios, pediatric infectious disease specialist at the Montreal Children’s Hospital, this increase is probably attributable to the many respiratory viruses that were circulating this fall. Indeed, respiratory viruses, including influenza, increase the risk of developing an invasive streptococcal A infection.

The D^D Bergeron adds that some cohorts of children were not exposed to the bacteria as much as usual during the pandemic, when contact was reduced. We therefore possibly see a “pandemic catch-up effect”, sums up the specialist.

Should we be worried?

“We don’t want the world to panic, but we have to remain vigilant”, replies the D^r Karatzios. “It remains an infection which is common, which often has no serious consequences and which can be treated with antibiotics. Serious infections remain very rare, ”adds the D^D Bergeron.

In Quebec, the antibiotic treatments used to fight against these infections are always in sufficient quantity despite the high demand, maintains Hugues Mousseau, general manager of the Quebec Association of drug distributors (AQDP). Amoxicillin in suspension, for children, is rare, but the capsule format remains available in good quantity for the moment in Quebec, he indicates.

How to protect yourself against streptococcus?

The bacteria is usually spread through contact with droplets from the nose or throat of people with the severe infection or through contact with infected skin wounds. To limit its transmission, wearing a mask in crowded places and isolation when a person has symptoms are suggested, says the D^D Bergeron.

Furthermore, since influenza increases the risk of developing a serious infection, D^r Karatzios recalls that vaccination against influenza can be a means of limiting infections. The vaccine is offered free of charge to people aged 6 months and over in Quebec. “Everyone 6 months and older should be vaccinated,” he says.

If children have severe symptoms, such as fever, difficulty breathing, severe headaches and painful sores, D^D Bergeron urges parents to call 811. If the child also has diarrhea, vomiting and rashes, parents should go straight to the emergency room, says Dr.^r Karatzios.