2023-11-18 09:00:00
The 42-year-old woman is still grateful to have had the pain to scream, to border on hysteria. It was worse than childbirth, in her experience.
“Otherwise I might not have consulted. I would have waited. I was caught on time.”
It all started with a banal cut to her right thumb on a damaged Pyrex dish, while she was washing the dishes at the end of April. The scratch only bled a little.
But 48 hours later, Streptococcus A quickly infected his arm. The mother of two was left screaming in pain, and she is not the only one to have experienced such an ordeal this year.
From 27 to 91 cases
Mauricie-Centre-du-Québec counted 27 cases of invasive streptococcal A infection annually for 2021 and 2022, slightly fewer cases than in previous years. As of October 14, 2023, the CIUSSS recorded 91 since the start of the year.
The picture is similar across the province. Invasive streptococcal A infections increased from 392 cases in 2022 to 837 as of October 14.
“We are looking for possible explanations throughout Canada and around the world to try to see why there is an increase and what possible courses of action might be taken,” explains the medical director of the Quebec Public Health Laboratory, Judith Fafard.
She says one hypothesis is a new strain of Group A Strep from the United Kingdom that is now in the West and might cause more invasive infections.
Generally speaking, group A streptococcus is quite common and can remain asymptomatic on the skin, or cause mild infections in the throat or a cut for example. However, sometimes more aggressive bacteria can lodge in places that should be sterile, and these infections are serious.
An “invasive” group A streptococcus infection can take the form of a flesh-eating bacteria, but also other infections such as meningitis or pneumonia.
These serious infections can particularly develop from a weakened respiratory system, or when there is an injury to the skin. Strong seasons of respiratory viruses, as we have seen since the end of the pandemic, can present an increased risk of an increase in cases.
This is because many people end up with weakened lining in their respiratory system. This mucous membrane acts as a barrier and when damaged, it can serve as an entry point for the bacteria. Another risk factor is chickenpox, since there are many lesions on the skin.
Before the pandemic
Dr. Fafard confirms that the situation is worrying, but reminds us that we must not lose sight of the fact that in an entire population, cases remain rare.
She points out that the first increases were noticed before the pandemic.
“This is not a consequence of the pandemic. But we had less during the pandemic because of isolation.”
— The medical director of the Quebec Public Health Laboratory, Judith Fafard.
She also adds that disinfection, isolation and hand washing do not weaken the immune system.
To watch for: rash that progresses quickly with fever, chills, dizziness and excruciating, unbearable pain.
Otherwise, there isn’t much you can do to protect yourself other than wash your hands and avoid spreading respiratory viruses.
In the hotel
Stéphanie Bastien was in a hotel in Valleyfield with her children and her partner for a hockey tournament when the pain started to degenerate, two days following the small cut on the Pyrex dish.
“I mightn’t stay put, I had to move. It hurt, enough to say that we were leaving the hotel and going to Valleyfield, which we don’t know, to go see the emergency room.”
She finally had a telemedicine appointment, where it was thought to be a skin infection. The pain was so bad that she returned to the emergency room in the followingnoon.
“It made no sense, evil. My hand became more and more swollen from hour to hour. It was red. It was like I had my hand in the fire.”
She waited four hours in the emergency room, walking because she still mightn’t sit still. At some point, one staff change later, a triage nurse anticipated the severity of the situation and moved it to the top of the list.
Shortly following, the patient learned that she possibly had the flesh-eating bacteria, and that her arm would have to be operated on to clean it out. She immediately imagined one arm missing, but the surgeon reassured her as much as he might. Normally, he shouldn’t amputate it.
Stéphanie Bastien still had her right arm when she woke up. The results of the analyzes confirmed the flesh-eating bacteria.
She was hospitalized for a week, and spent three months on sick leave. The rehabilitation of his right hand, in occupational therapy and physiotherapy in particular, took a long time. It took a good month for the left-handed person to be able to close her right hand.
“Just having some toast, it felt like razor blades. The pain feels like my brain is sending me waves that aren’t working. Just grabbing the fridge handle feels like I’m burning myself. It’s really the nerves, and the brain that no longer understands.”
— Stéphanie Bastien
She escaped with a scar on the inside of her right forearm, fortunate in the context where the flesh-eating bacteria can kill in a few hours. No less than 45 deaths had been recorded in the provinces by mid-October.
The mother still feels slight numbness at the tips of her index and middle fingers, fingers which are now the first to freeze these days.
“But it’s nothing…”
This might well end up passing over the next few months. The event, for its part, will not be forgotten.
“I skinned my finger this week, and I definitely think regarding it right away.”
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