There are increasing cases of invasive Group A strep infection in Canada, sometimes necessitating amputation or intensive care in hospital, and sometimes causing death. Health officials are not sure why the numbers have gone up over the last 15 years.
Group A Streptococcus may not look like much under an electron microscope but it can be invasive and cause death.
Photo Credit: National Institute of Allergy and Infectious Diseases/Associated Press
Bacteria can invade the blood
Many people carry the strep A bacteria and it does not affect them. Others may get a sore throat from it and need antibiotics. But in some cases, the bacteria get into the blood stream and can quickly attack organs or cause flesh-eating disease. There are some ideas about why this sometimes happens.
“The bacteria…can have multiple strains so sometimes there might be a more invasive strain or a strain that is more prone to causing severe illness that’s circulating,” says Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital.
“Sometimes it’s the person that’s…the issue. There might be something unique about the person…that the bacteria is on that might predispose it to becoming invasive. So, it’s a bit of a dance between the bacteria and the person that the bacteria is infecting…There’s still a lot we don’t know.”
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Dr. Isaac Bogoch says there is ‘still a lot we don’t know’ about invasive strep A.
Cari Kirkness has no idea why she got invasive strep A and had to have her arm and both legs amputated. Her’s is one of several cases that seem mysterious. She is not among those who have a higher risk of getting this infection. They include people who are homeless, living in very crowded conditions or users of injection drugs. Health care workers worry that people in these groups are less likely to get the quick care they need if infected with invasive strep A.
‘Jumping on this early is extremely important’
“We know that timeliness and really jumping on this (infection) early is extremely important and this is certainly an uphill battle because unfortunately there are access to care issues in certain populations, especially homeless or under housed populations and we really want to do our best to ensure everyone has equitable access to care,” says Bogoch.
While Canada has a public health care system which provides free services for everyone, there are several reasons why those in higher risk groups might not access it including mental health issues or a reluctance to deal with authorities.
100 died last year
In 2002, there were 866 cases of invasive strep A in Canada, reports CBC. By 2017 there were more than 2,178 counting only cases in half the provinces and territories. More than 100 people died of the infection in 2017 according to information collected from public health agencies in the various jurisdictions by CBC.
The issue has been in the news. Earlier this month a hospital north of Toronto, confirmed to CBC that there had been three cases of infection in its childbirth unit in February and that a mother had died from a severe form of it. The Middlesex-London Health Unit in southwestern Ontario reported in November 2017 that it had 132 cases over the previous 18 months and nine people died.The Public Health Agency of Canada is investigating the cause of the increasing cases.
‘Wash your hands, wash your hands, wash your hands,” says Dr. Bogoch.
How to avoid strep A and other nasty things
In the meantime, Bogoch says people can take steps to prevent strep A and other infections by thoroughly and frequently washing their hands. Those who get a sore throat that won’t go away should see a doctor. And anyone who has a cut and finds the surrounding skin turns red, hot or painful should get medical help immediately.
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