Invasive strep: Experts say post-pandemic behaviours could be behind the spike
One researcher says the average Canadian shouldn't be worried about the disease, but should "use common sense."
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Two experts say Canadians don't need to "lose sleep" over the recent spike in invasive strep cases in the country, but they should be informed.
They say the spike could likely be due to the removal of COVID-19 pandemic restrictions and a lack of immunity in children.
What is invasive group A streptococcus (iGAS)?
Group A streptococcus (GAS) is a common bacterial infection that grows inside the nose, throat and sometimes on the skin. It most often affects children and seniors, but anyone can have it.
Toronto infectious disease specialist Dr. Anna Banerji says it often causes strep throat and sinus infections, and it can escalate and cause issues like ulcers.
But, if it goes into a person's bloodstream it can serious conditions, including meningitis and toxic shock syndrome — which could become fatal.
Group A streptococcus is common, and "is more severe than other types of streptococcus," Banerji told Yahoo Canada.
The invasive type — one that enters the bloodstream — is less common and rising.
In December of 2022, the World Health Organization reported several European countries were seeing an increase in cases of invasive group A streptococcus, "mostly affecting children under 10 years of age."
In past months, Canada has seen a similar spike, with Ontario reporting 706 cases of invasive GAS (iGAS) between Oct. 1, 2022 and Mar. 31, 2023.
The province's public health said "an increasing trend in iGAS cases among all ages has been observed since January 2023," in a recent report. About 78.8 per cent of cases in the season until Mar. 31 required hospitalization, it said.
Last month, a five-year-old girl from Kitchener, Ont. died from the disease.
Why are we seeing a spike in invasive strep cases?
Banerji explained there are several reasons for the increasing case numbers of iGAS — including some "post-pandemic" behaviours.
"We were all practicing public health measures before with masking and strep, that's in the throat, is generally spread by droplets. If you use masking, then you reduce the spread," she said.
"In the fall, when the kids when back to school and took off their masks, a lot of viruses and bacteria spread."
But, Banerji said many kids also had't been exposed to strep previously because of the pandemic restrictions, and "didn't have a lot of immunity." That's why younger patients tend to have more severe strep.
The expert said while strep lives in the throat, any virus infection could cause strep symptoms to develop.
"Because we had a horrible viral season this fall, we also saw more strep than usual."
John McCormick, a professor of immunology and epidemiology at Western University, says research now shows that about 10 per cent of children will carry strep in their throats without any problems.
"But sometimes it does," he said. In the "rare" case of invasive strep, the bacteria can become "quite dangerous."
Though case numbers are increasing, they're not high and "it happen to essentially anybody."
McCormick echoed Banerji in saying the lack of immunity in children is likely the reason behind the recent spike.
"When there's less transmission, there's less strep," he added.
What Canadians should know about invasive strep
Should the average person worry about the recent spike in invasive strep? McCormick says no, but says Canadians should stay informed.
"Mortality rates from invasive streptococcal disease... can be quite high. That would obviously be the worst consequence," he said.
However, other severe consequences can include the need to remove tissue and even amputation, according to McCormick.
"In general, people should not be really that worried," he said. "But they should just be... using common sense."
McCormick said if your child is experiencing what looks like strep throat, they should see a health care professional and get diagnosed.
"If they have strep throat, (parents) probably shouldn't be sending their kids to school. If you have any kind of an open cut or sore, you should be using normal hygienic practices," he explained.
"If you have these types of symptoms, you shouldn't ignore them."
Banerji agrees.
"I don't think the average Canadian should lose sleep, cause we've just been through a major pandemic and it doesn't compare to (the strep increase)," she said.
"If you are sick, stay home because you don't want it to spread," Banerji advised. "The main thing is trying to reduce spread."
For those who are diagnosed, her advice is to "start the antibiotics early."
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