The recent deaths of six children in Ontario and four children in British Columbia from a bacterial infection is grabbing parents’ attention. Doctors say severe cases of invasive Group A streptococcal infection are extremely rare. Here’s what to know about the disease that is showing up in record numbers this season and also puts adults, especially those aged 65 and older, at risk.
What is Group A streptococcus?
Streptococci bacteria are commonly found in the throat and on skin. Dr. Monika Naus, medical director of immunization programs and vaccine preventable diseases at the BC Centre for Disease Control, said some people have no symptoms but others may get strep throat, a mild illness often accompanied by a fever. It resolves on its own within a few days or is treated with antibiotics. A sore throat, on the other hand, usually comes with a cough, runny nose or other cold-like symptoms.
How does someone get infected with invasive Group A streptococcal infection, or iGAS?
The illness becomes invasive when bacteria enter the bloodstream or deep tissue, sometimes through an open wound or the nose and throat. It is passed on through direct contact with discharges from those membranes or with infected skin lesions, Naus said.
What are some ways to prevent infection?
Washing hands, especially before cooking or eating, is one protective measure, as is keeping any cuts or wounds clean and watching for redness or other signs of infection. Staying home when sick and getting vaccinated against influenza and COVID-19 is also important.
Naus said even a paper cut could lead to infection.
“I’m not meaning to scare anyone but it doesn’t have to be a serious trauma. Sometimes strep infections can be initiated by what’s called blunt trauma, which means the skin wasn’t even pierced. But the organisms were on the skin and entered the body that way.”
A viral infection, such as the flu, can allow Strep A bacteria to invade the body, making those infections more common in the winter months.
British Columbia has had 60 cases of the invasive illness in people under age 20 compared with thousands of cases of influenza and respiratory syncytial virus, or RSV, which is more likely to sicken young children and older adults.
What should parents be watching for?
“It’s a fine line trying to tell the difference between a child who’s miserable because they’re on their first or second day of a fever from the flu and a child who’s getting into trouble.” Naus said.
However, parents should be on the lookout for prolonged fever, difficulty breathing, sandpapery red rash or a swollen tongue, sometimes called strawberry tongue. A child who is groggy and has a tough time waking up should also raise concerns.
A child whose condition is deteriorating could also have pneumococcus disease, though children are vaccinated against it starting at two months.
While there is no vaccine for invasive Group A streptococcus, Naus urged parents to at least get their kids vaccinated against influenza and COVID-19.
“It can prevent those infections, and those infections can be a precursor to a more serious bacterial infection.”
Who is most at risk?
Dr. Upton Allen, head of infectious diseases at Toronto’s Hospital for Sick Children, said people with a weakened immune system are most susceptible to infection. In Ontario, children between five and nine have become ill, as have adults 65 and older, he said.
“Among adults, those with long-term illnesses such as cancer, diabetes, kidney disease and on special medications such as corticosteroids may be at higher risk,” Allen said. “Some of these infections may be mild but some may have severe outcomes.”
Families should be mindful that lesions sometimes caused by chickenpox may become infected and cause Step A infection, he said, urging parents to ensure their kids get routine vaccinations.
“Certainly, we have had concerns during the COVID period, and we all should advocate for there to be strong efforts to ensure that vaccines are up-to-date.”
What are severe but rare forms of Group A strep?
In very rare cases, Group A strep can cause necrotizing fasciitis, a flesh-eating disease; meningitis; cerebral spinal infection; toxic shock syndrome, which causes multi-organ failure; low blood pressure and kidney failure.
Naus said none of the four children who died in British Columbia were believed to have developed any of those conditions.
This report by The Canadian Press was first published Jan. 20, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
