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CDC Issues Warning Over Invasive Strep a Cases After at Least 2 Kids Die in US

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The U.S. Centers for Disease Control and Prevention have issued a warning about a recent increase in invasive infections of strep A in children after at least two kids in the U.S. and 15 in the U.K. have died.

Group A streptococcus is a type of bacteria that can cause a range of illness, from strep throat and scarlet fever to skin infections. An invasive case of strep A refers to when the bacteria spread to parts of the body that they don’t normally reach, like the bloodstream. This can cause severe and even fatal illness and requires immediate treatment with antibiotics, according to the CDC warning.

The CDC said it was first notified about a rise in infections in the U.S. in November 2022, when a hospital in Colorado saw a possible increase strep A cases, followed by a potential increase “in other states,” per the warning. It did not specify which states. The agency added that in some parts of the country, the increase in strep A is occurring at the same time as “increased circulation” of respiratory syncytial virus, influenza, COVID-19 and other respiratory viruses.

“While the overall number of cases has remained relatively low and (invasive Group A strep) infections remain rare in children, CDC is investigating these reports,” the agency said.

NBC News previously reported that hospitals in Arizona, Colorado, Texas and Washington confirmed that they’ve seen more cases than usual of invasive Group A strep. In Colorado, two children, who were less than school age, have died from the infection since Nov. 1; the last time anyone in the state died from strep A was in 2018. The Denver Health Department told NBC News it has received reports of 11 cases — all in children between 10 months and 6 years old — since Nov. 1. In Texas, one hospital has seen an increase of four times in the number cases of invasive strep A this year, NBC News reported.

The CDC estimates that there are several million cases of noninvasive strep A in the U.S. every year — which includes strep throat, scarlet fever and the bacterial skin infection impetigo. Over the past five years, there have been between 14,000 and 25,000 cases of invasive strep per year and 1,500 to 2,300 deaths per year.

In the U.K., at least 21 children have died from invasive strep A since September, per the U.K. Health Security AgencyAccording to the World Health Organization, at least five countries in Europe (U.K., France, Ireland, the Netherlands, Sweden) have seen an increase in invasive strep A cases, primarily in kids under 10.

What is invasive strep A?

Strep A refers to the diseases that come from being infected with the bacteria called Group A streptococcus. Noninvasive illnesses from strep A, according to the CDC, include:

  • Strep throat, which causes sore throat, pain with swallowing and fever. It’s “a mild and common condition that can be easily treated,” according to the Colorado Department of Public Health and Environment.
  • Scarlet fever, which commonly causes rash and fever.
  • Impetigo, a highly contagious bacterial skin infection that starts as raised bumps on the skin followed by blisters containing pus followed by crusty lesions.

An invasive strep A infection — which is what the CDC is currently investigating — refers to when the bacteria spread outside the throat or skin (where they tend to cause only mild symptoms) and into the bloodstream, lungs, fluid in the spinal cord or “other places inside the body they would not typically live,” per the Colorado health department.

Conditions that result from an invasive strep A infection include:

  • Cellulitis (a bacterial infection in the tissue under the skin) with a blood infection.
  • Pneumonia, an infection in the lungs.
  • Necrotizing fasciitis, popularly known as flesh-eating disease.
  • Streptococcal toxic shock syndrome (STSS), “which can develop very quickly into low blood pressure, multiple organ failure, and even death,” per the CDC.

Strep A is spread through contact with droplets from an infected person when they cough, sneeze or talk. Cases of Group A strep tend to follow a seasonal pattern, peaking between December and April in the U.S. It’s most common in kids 5 to 15 years old.

Why is strep A causing more severe infections?

It’s not currently known whether the spike in cases is due to one specific Group A strep strain, Dr. Michael Green, medical director of infection prevention and antimicrobial stewardship at the UPMC Children’s Hospital of Pittsburgh and a professor of pediatrics and surgery at the University of Pittsburgh, tells TODAY.com.

There are several hundred strains of Group A strep, and it’s possible that “a particularly nasty strain” has become more prominent in the parts of the country reporting increases, Green says, adding that until all the information on the strains from those places has been analyzed we won’t know.

Unlike COVID-19, where one variant can become dominant, “different areas of the country can have different strains of Group A in circulation,” Green says. “You can have a nasty Group A strep in Ohio, but not in Pittsburgh. But you worry that it might get here from people who are traveling.”

Green says the Children’s Hospital of Pittsburgh has not seen a bump in the number of cases this year as compared to those 2014 to 2017, but there may be an increase in the severity of this year’s cases.

It’s likely that the rise in cases in some locations is tied to the increase in viral illnesses — the flu, RSV and possibly COVID-19, Green says. Viruses like the flu can damage the small airways and make them more vulnerable to bacterial infections, he explains.

“Whenever we see a huge amount of respiratory viruses, we know we are going to see a bump up in bacterial infections,” Green says.

A factor that has confused the issue is that viruses such as RSV and influenza have sparked early this year, says Dr. Jason Zucker, an assistant professor of medicine at the Columbia University Vagelos College of Physicians and Surgeons in New York City.

“We’re seeing a lot of things in different seasons this year than we normally would,” Zucker tells TODAY.com. “So it’s not clear if there’s a change in the epidemiological pattern.”

The CDC noted in its warning that, in the past, the U.S. has seen increased rates of invasive strep A when flu activity has also been high. The current U.S. flu season is one of the worst in recent years.

Currently there doesn’t seem to be an increase in invasive Group A strep in New York City hospitals, Dr. Ethan Wiener, chief of emergency medicine at NYU Langone Health Hassenfeld Children’s Hospital, tells TODAY.com. “In speaking to people locally, there have been only sporadic cases that I am aware of.”

Signs of severe strep A infections

Because a viral infection can make a bacterial infection more likely, parents of kids who recently had a viral illness should be vigilant about possible Group A strep infections, Dr. Ishminder Kaur, a specialist in pediatric infectious diseases at the UCLA, David Geffen School of Medicine, tells TODAY.com.

Signs of a Group A strep infection, per the Colorado health department, include:

  • Sore throat
  • Fever
  • Chills
  • New rashes
  • Skin bumps
  • Painful red patches on the skin

High fever and labored breathing, as well as “difficulty coordinating swallowing with breathing” in young kids, “should trigger parents to call their provider or to seek emergency care, depending on the seriousness of the situation,” Kaur says.

Wiener adds that a high fever by itself doesn’t signal Group A strep and is “in no way harmful or dangerous.” Parents should remember that if a child is very sick, it could be the flu, he says.

Signs a child’s strep A infection may be invasive include:

  • A change in mental status. “Maybe you’re not able to arouse the child, or the child may not be responding normally,” Wiener says. “That’s different from the child feeling blah or lying on the couch all day.”
  • Early signs of necrotizing fasciitis, which, per the CDC, include: a red, warm or swollen area of skin that spreads quickly; severe pain, including pain beyond the area of the skin that is red, warm, or swollen; fever. Later-stage signs are: ulcers, blisters, or black spots on the skin; changes in the color of the skin; pus or oozing from the infected area; dizziness; fatigue; diarrhea or nausea.
  • Early signs of streptococcal toxic shock syndrome, which, per the CDC, include: fever and chills, muscle aches, nausea and vomiting. Later signs, which usually develop 24 to 48 hours after the first symptoms, include: low blood pressure; faster than normal heart rate; rapid breathing; signs of organ failure, such as inability to produce urine or yellowing eyes.

While both necrotizing fasciitis and streptococcal toxic shock syndrome are rare, their symptoms can get worse quickly. So, in light of the strep A investigation, the CDC is urging parents to know the symptoms of both diseases and seek medical care quickly if they think their child has either.

Parents should also contact a health care provider right away if their child develops new or worsening symptoms during a viral infection, the Colorado health department advised.

How to prevent strep A infections

The CDC is also urging parents to make sure their children get chickenpox vaccines and flu shot, as a strep A infection can be a complication of both viruses. Group A strep infections had been going down since 1995, when the chickenpox vaccine became available, Wiener says.

Some children might need to flu shots this year, and it’s not too late in the season to get them, TODAY.com previously reported.

In addition to getting vaccinated, to prevent strep A infections, the CDC recommends washing your hands often for at least 20 seconds or using an alcohol-based hand sanitizer, especially after coughing or sneezing and before preparing food or eating. You should also cover your coughs and sneezes with a tissue and dispose of it right away. If you don’t have a tissue, use your upper sleeve or elbow and not your hands.

When in doubt about your child’s condition, seek medical care. Even if it turns out it wasn’t necessary, “it’s better than having a bad outcome,” Wiener says.

This story first appeared on TODAY.com. More from TODAY:

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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