Cases of invasive group A strep — a bacterial infection that can be deadly — are on the rise in Nova Scotia, according to figures provided by Nova Scotia Health.
According to the data, there were 96 cases last year, compared to 57 cases in 2018. There have been 10 cases so far this year.
Invasive group A streptococcal disease occurs when the common strep A bacteria spreads beyond the places it typically infects (such as the throat or skin) into sterile parts of the body, such as the bloodstream or the liquid around the brain, or into soft tissue, where it can cause necrotizing fasciitis, known as flesh-eating disease.
Dr. Ryan Sommers, the senior regional medical officer of health at Nova Scotia Health, notes that the trend is not unique to the province.
The CBC’s Mainstreet spoke with Sommers about what’s driving the increase, and how to protect yourself.
Tell me about the number of cases we’ve seen in this province over the last few years.
In this past year, we’ve seen an increased number of cases of invasive group A strep in our province. Interestingly, we had some of the lowest rates during the first three years of the pandemic. As you may recall, during that time, one of the public health measures we used was to decrease the number of interactions with people. What we found was that those same measures prevented the spread of all kinds of other communicable diseases, so we saw a drop in invasive group A infections. And then as of mid-2022, with the removal of the public health measures throughout the world, we saw an increase in the number of cases of invasive group A strep. So we started seeing signs of this in places like the United Kingdom in the fall of last year and we’ve seen the trend continue in other parts of the world now too.
What age groups are we seeing affected by group A step?
Here in Nova Scotia, our trend has been primarily seeing disease in those over the age of 65. With this disease, the pattern usually is that the extremes of ages, so children under 5 and then those over 65, tend to be prone to getting it. And also those individuals who have certain chronic diseases or weakened immune systems. Young children are still developing their immune systems and they haven’t been exposed to these infections in the past. And as people get older, their immune system doesn’t work as well, or they have other chronic conditions that doesn’t allow their immune system to function as properly. So those are the groups that are most at risk in terms of deaths in Nova Scotia.
This table shows the number of Group A strep cases in Nova Scotia since 2018. (Nova Scotia Health Authority)
Is it normal to see cases as high as we did last year?
In the past, we’ve had times where we’ve seen more activity in those certain populations. What makes the past year or two interesting is, first of all, there’s a lot of kids who weren’t exposed to infections during the high point of the pandemic, so we did see a lot more of invasive group A strep. But probably the most important thing we saw in 2022 and from 2023 to 2024 is that a lot more people are getting viral infections. We know viruses like COVID-19, influenza virus and RSV — when you get those, you can be predisposed to getting a bacterial infection. Your immune system is busy fighting a viral illness and then a bacterial illness can come in and cause disease as well. So probably it’s a combination of factors. We had a really busy flu season last year. So as more people get exposed to viruses, there’s also a higher chance of them getting these secondary bacterial infections at the same time.
We’ve already seen 10 cases so far this year. Is that normal?
This year has been a little bit higher than than last year. It was interesting that other jurisdictions, they saw peaks in their invasive group A strep in the fall of 2022. We didn’t have that same type of increase. We’ve definitely seen more of it now in the 2023-2024 year. What we’re seeing this year is a typical flu season that matches the trends pre-pandemic. Flu seasons can start as early as November in the Maritimes and then sometime around the end of December and January is when we see peak numbers. Couple that with the holidays, when we have more people gathering together, we tend to see a lot more disease activity when it comes to the viral infections.
Mainstreet NS10:34Why strep throat infections are on the rise in Nova Scotia
Last year, Nova Scotia had its highest number of Group A Strep cases in six years with 96 cases across a range of ages. In 2024, there have already been 10 reported cases of the infection. Mainstreet’s Alex Guye is joined by Dr. Ryan Sommers, a senior regional medical officer with Nova Scotia Health, to learn more.
How can we mitigate the risk of getting group A strep?
The first thing to realize is that group A strep is a common bacteria. It’s part of the natural flora that exists in humans. The biggest thing to do is to be educated and be aware of the red flags. So what we tell people is if you have a fever that’s getting progressively worse, if you have someone — it could be a child or older person — that is not drinking as much, has decreased food intake or not producing as much urine as they usually do, or if they get more sleepy, lethargic, or they have a rash that’s worsening, those are big red flags that something else is going on and should be investigated by a health-care provider. Invasive group A strep infections can come on quickly, so it really is important to get assessed if someone has these worsening signs and symptoms. Having a viral infection before this can predispose someone to getting the bacterial infection, so we encourage people to be up to date on their annual vaccines, in particular the COVID-19 and influenza vaccines.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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.
