Cases of invasive strep are rising in Canada and globally. (Getty Images)
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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.
A microbiologist holding a blood agar plate showing the beta-hemolysis caused by pathogenic bacteria Streptococcus pyogenes. This bacteria can cause a variety of diseases such as scarlet fever, streptococcal pharyngitis, rheumatic fever, rheumatic heart disease, impetigo and acute postinfectious glomerulonephritis. (Getty Images)
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.
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.
Pandemic restrictions could have lead to lower immunity to severe strep in children, experts say. (Getty Images)
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.”
A doctor says Canadians should use “common sense” when it comes to being cautious about strep.
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.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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