This was a lethal streptococcal type A.
“We were very surprised,” Myers said. “I’ve never seen so many people come together in such a short time.”
Infection with Streptococcus pyogenes, or group A streptococci for short, usually causes mild symptoms such as rash, fever, and swollen tonsils, leading to the eponymous streptococcal sore throat. However, in recent months, cases linked to a rare invasive form of the common bacterium have emerged not only in Europe but throughout the United States. Sometimes confusing symptoms such as skin rash, fever, heart palpitations, and unexplained swelling.
The first confirmed pediatric deaths in the country were two infants in the Denver area. reported last weekAt least 16 children have died from it England7 in the Netherlands, 2 in the Netherlands France.
The rise of invasive streptococcus type A is one of the many unusual ways pathogens are interacting with us and each other this year as social distancing and masking in the coronavirus era come to an end. Both world health organization and the U.S. Centers for Disease Control and Prevention They said they were investigating the incident, including whether the virus storm that continues to make many people sick may be at least partially responsible.
Viral infections tend to compromise a person’s immune system, making it easier for secondary bacterial infections to become established, and in some cases, to intensify their effects.
Minnesota Health officials said they had confirmed 46 cases of invasive streptococcus A in all ages in November. This is more than double the previous month’s average of 20 cases. Colorado reported that they were investigating not only an increase in invasive streptococcal A cases, but also a possible increase in other severe or invasive bacterial infections in children.
Texas Children’s Hospital said it saw more than 60 patients with invasive Streptococcus A in October and November. That’s a four-fold increase from her year-ago quarter. James Versalovic, the medical center’s chief pathologist, said many of the affected children had current or recent viral infections. However, it is still too early to rule out other factors that may have contributed to the severity of their illness.
“The pandemic may have altered immune patterns, making us more vulnerable. But it could also be a different subspecies of Streptococcus ….” I don’t even know.”
Unlike SARS-CoV-2, Streptococcus A is what humans have been fighting for centuries.
Throughout history, it has been variously and erroneously described as being associated with phenomena such as comets and solar eclipses, or with the introduction of inanimate objects into humans. appeared grouped in chains of four or more and were later classified as bacteria. Bacteria can survive inside and outside the patient’s body, unlike viruses, which are collections of molecules that can replicate only within the host. Both are transmitted in similar ways through air, water, food, organisms, etc.
Streptococcus A infects millions of people in the United States each year, and in a modern world with an ample supply of antibiotics, it’s mostly a nuisance. After taking antibiotics, you may miss school or work during the 24 hours needed to stop being contagious.
“The good news is we know how to treat it and how to test it,” said Christine Moffitt, an infectious disease expert who studies bacterial infections at Boston Children’s Hospital. , is not cause for serious concern that I am extremely concerned about.”
However, in a few cases, Streptococcus A bacteria can become dangerous when they invade parts of the body that are normally free of bacteria. Entering such areas, including blood, cerebrospinal fluid, bone marrow, and organs such as the brain and heart, can spread rapidly and lead to death.
The first reports of unusual activity by invasive streptococcus A occurred in the Netherlands, mainly in children under 5 years of age, from March to July. It’s not just the number and severity of cases, doctors said. preprint research paper Posted on December 13, there is also the fact that many of the patients had been infected with viruses such as influenza and chickenpox. Not part of the vaccination program.)
Most of the children infected with invasive Streptococcus A in Dutch hospitals in 2018 and 2019 developed sepsis, a systemic infection or pneumonia. But this year, more people were diagnosed with necrotizing fasciitis, a carnivorous disease involving bacteria that destroy tissue under the skin. -Verhagen, and co-authors, urged the public to realize that early detection and prompt treatment can save lives.
“Clinicians and parents should be alert and aware of unusual childhood symptoms,” they wrote.
Serious illness in children has also been reported in the United Kingdom, the Netherlands, France, Ireland and Sweden, although the pattern is not always the same. caused by) was reported by doctors. However, it was not seen in the Netherlands.
Several US hospitals said they were not aware of unusual scarlet fever activity in their area.
Keeping track of what’s going on in the United States is more difficult than in some other countries because it doesn’t have a national healthcare system that facilitates case tracking. said it was too early to tell whether the number of cases was “just returning to pre-pandemic levels or exceeding normal expectations.”
“The CDC is closely monitoring these data and is speaking with monitoring sites and hospitals in multiple states to learn more about trends,” she said.
A mailing list service for pediatricians and infectious disease specialists in the country began bombing in October with questions from doctors in the Midwest.
As expected, the responses were mixed, given that such cases tend to cluster together. The Boston Children didn’t see anything related. But doctors in Kansas City, Houston, and Denver did.
Texas Children have children with hypotension and septic shock, bacterial pneumonia, and skin infections. He worries that some cases have been missed. To diagnose invasive streptococcus A, a doctor must take a sample of the patient’s blood, skin, or fluid from the lungs or other areas. But if your child needs urgent medical attention, you may not have time to think about the cause of the illness.
Invasive Streptococcus A “does not follow a simple linear progression,” he said.
In Denver, Samuel Dominguez, an infectious disease specialist at Colorado Children’s Hospital and a professor at the University of Colorado School of Medicine, said the cases he saw were in children of “a wide range of ages” and that children may be more susceptible. said to be sexual. This is because bacteria tend to colonize the throat and skin more aggressively than adults.
Dominguez tried to balance the reassurance that this is a relatively rare infection with calling attention to the warning signs.
Barsalovich agreed. “I don’t want to raise too many alarms, but these infections can progress very quickly,” he said.
Myers said all of the patients seen at Children’s Mercy in Missouri have recovered with treatment, but to prevent viral infections that could open the door to more serious bacterial infections, the child’s She urged parents to make sure their immunizations were up to date.
One of the troubling aspects of this disease is that it can look very different from child to child. A child who had difficulty moving his eyeball had an infection of the orbital soft tissue. A lump behind the ear, a bone infection in that area; a third patient has pus in the back of his throat.
Myers urged parents to be vigilant.
“If your child looks worse than he should after a fever, has trouble breathing, or notices anything else, it’s always a good idea to take him to the doctor. “Even if your eyes are swollen.”
