Understanding Streptococcal Toxic Shock Syndrome and the Rise in Cases: A Comprehensive Guide

2024-03-26 05:15:00

517 cases between January 1 and March 17, according to the Japan Times. Japan is concerned about the explosion in cases of streptococcal toxic shock syndrome when 941 cases had been recorded over the whole of 2023, already a record year. That same year, SCTS caused the death of 30% of infected individuals, “an extremely high mortality rate”, according to the Tokyo metropolitan government.

Streptococcus A in question

SCTS is most commonly caused by Group A Streptococcus (GAS) or Streptococcus pyogenes, a bacteria that is only transmitted from human to human. Responsible for benign infections such as angina and impetigo in 80% of cases, it is, more rarely, responsible for invasive infections.

GAS is particularly the cause of very serious and often fatal invasive infections:

  • Fasciitis or necrotizing dermohypodermatitis: this is “a complete destruction of soft tissues, hence its nickname “flesh-eating bacteria”, recalls Public Health France;
  • Streptococcal toxic shock syndrome (SSTS) causes multiple organ failure;
  • Meningitis, the inflammation of the membranes surrounding the brain.

Among the invasive infections linked to GAS we also find endocarditis and septicemia.

Invasive infections that are often fatal

According to figures from Public Health France, invasive infection caused by S. pyogenes is fatal in 50% of cases of meningitis, 40% of cases of SCTS, 20 to 45% of cases of necrotizing dermohypoderma. “With a high epidemic potential, S. pyogenes is transmitted by air (droplets, editor’s note) or direct contact in those around patients,” notes Public Health France.

According to the Japan Times, transmission can also occur through injuries, particularly to the hands. The diagnosis of invasive infections is based on the detection of sterile bacteria.

The Japanese authorities urge the population to seek medical advice quickly in the event of pain, swelling of the limbs or a fever. The treatment is based on takingantibiotics. However, the Pasteur Institute indicates an increase in the resistance of S. pyogenes to several families of antibiotics.

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Rise in cases in Europe

In 2021, the Pasteur Institute highlighted “a real increase in invasive streptococcal A infections in industrialized countries and particularly in Europe. In France, these invasive infections have been increasing since 2000, the incidence rate having increased from 1.2 to 3.3 per 100,000 inhabitants.

In 2022 in particular, several European countries including France, Ireland, the Netherlands, the United Kingdom and Sweden had recorded an increase in the number of cases of invasive group A streptococcal infections in children under the age of 10 years.

“In France and the United Kingdom, the number of cases of invasive GAS infections observed in children is several times higher than the levels recorded before the pandemic for the equivalent period” noted the World Health Organization at the time.

Source: The Japan Times, Public Health France, WHO, Pasteur Institute

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