Several children’s hospitals in the US have seen an increase in invasive group A strep infections, a serious and sometimes life-threatening disease when the bacteria spreads to parts of the body that are normally germ-free, such as the bloodstream.
Children’s hospitals in Arizona, Colorado, Texas and Washington told NBC News they are seeing above-average cases this season compared to previous years.
Dr. James Versalovic, chief pathologist at Texas Children’s Hospital in Houston, said his institution — the largest children’s hospital in the U.S. — has seen a more than four-fold increase in cases over the past two months since the outbreak. same period last year.
In October and November, Texas Children’s reported 60 cases, he said.
At least 15 children have died of invasive group A strep in the UK since mid-September. Cases tend to rise sharply in the new year, but appear to have risen earlier than expected, the UK’s health agency advised last week.
The Centers for Disease Control and Prevention said it is “hearing stories from some American doctors that there may be an increase in cases.” [invasive group A strep] Infections in Children in the United States” and is “talking to surveillance sites and hospitals in several states to learn more.
Group A streptococci are bacteria that cause sore throats and skin diseases such as scarlet fever (a red rash that looks like sandpaper and can look like a sunburn) and impetigo (a red, yellow itchy rash).
Some people with invasive group A strep can develop those conditions, but in many cases the first symptom of invasive strep A is a secondary infection, such as pneumonia or flesh-eating disease.
“These are more than just sore throats,” Versalovic said.
Epidemic infection can cause:
- Lower airway infections, such as pneumonia or emphysema, are characterized by pockets of pitch in the fluid-filled space around the lungs. The first symptoms of this type of infection are fever, chills, difficulty breathing or chest pain.
- Skin infections such as cellulitis or necrotizing fasciitis, also known as flesh-eating disease. Both conditions involve red, hot, swollen, or painful rashes. Necrotizing fasciitis spreads quickly and can turn into ulcers, blisters or black spots.
- Streptococcal toxic shock syndrome, an immune response that leads to organ failure. The illness usually begins with fever, chills, muscle aches, nausea or vomiting, followed by a rapid heartbeat or difficulty breathing.
Anyone can get invasive strep A, including healthy adults, but people over age 65 and those with chronic medical conditions are at higher risk. It’s not yet clear why hospitals are seeing so much, especially in children. The CDC notes that it may be related to the rollback of Covid mitigation measures and the rise of respiratory viruses such as influenza, Covid and RSV.
“Often children with severe group A strep infection start with viral respiratory infections,” said Dr. Sam Dominguez, an infectious disease specialist at Children’s Hospital Colorado and a professor at the University of Colorado School of Medicine.
The U.S. records millions of noninvasive group A staph cases each year, but invasive infections are rare, with about 14,000 to 25,000 cases a year, according to the CDC. Between 1,500 and 2,300 people die from invasive infections each year.
The CDC notes that such infections have decreased in all age groups over the past two years.
The last comparable rise in case numbers in the UK was from 2017 to 2018, when 27 children died.
At Phoenix Children’s Hospital, the number of cases has been increasing since late October or early November, said Dr. Wasim Balan, chief of infectious diseases. But the disease is rare compared to RSV or the flu.
“Even though we’re seeing this rise in cases, the absolute number itself is not that big,” Balan said.
Doctors are now treating children of all ages for the invasive group A staph, unlike viruses like RSV and the flu, which pose the greatest risk to very young children.
“We had teenagers, younger kids,” said Dr. Sarah Vora, a pediatric infectious disease specialist in Seattle.
“Last week we had a very sick teenager who came in with what looked like a sepsis presentation and was in the ICU for a few days on a ventilator and then he recovered really quickly and is doing very well,” Vora added. Hardest cases I’ve ever seen.”
But children’s hospitals in several other states — California, New York, Illinois and Minnesota — reported no increase in invasive group A strains.
Parents concerned about their children’s health should consider seeking emergency medical attention if their children are sleeping more or more lethargic than usual, have trouble eating or drinking, or are excessively dehydrated and not urinating, Dominguez said.
“If your child isn’t doing well, seems to have symptoms that are worse than the average cold, or that last longer than two days,” Vora says, “then it’s worth getting them checked out.”
Children with strep should get care right away so they can take antibiotics like penicillin. After 24 hours of taking antibiotics, a patient usually stops being infected.
“The sooner you get the antibiotics right, the faster someone gets better,” Dominguez said.