A Kitchener mom whose daughter died of complications from invasive Group A streptococcus is warning about the rare consequences of the bacterial infection, which has been circulating in Ontario at rates not seen in nearly a decade.
Quin Henderson, 5, was home from school with a cough and a fever in the days before her death March 25.
Christina Hecktus says no one seemed to pick up on the fact her daughter’s symptoms might be something more than a bad cold.
“I did everything that I was told to do. I called the doctor, I called 811. I did all those things that a mother or a parent would do in this situation and was told multiple times: it’s not necessarily needed [to take her to the doctor],” said Hecktus.
Earlier on the day Quin died, her parents had decided to take her to an emergency department in Kitchener. The family says she was admitted “in less than 15 minutes,” put on oxygen, and given intravenous (IV) fluids and antibiotics while blood was drawn and X-rays were done.
Quin loved YouTube and had just started making her own videos on an old tablet, videos that are now a ‘precious memory’ for her parents. (Submitted by Christina Hecktus)
Quin was diagnosed with pneumonia. That afternoon, she was transferred to McMaster Children’s Hospital in Hamilton, where she was found to be septic — meaning the infection from harmful bacteria had become serious — from invasive Group A strep in her blood.
Quin died just 12 hours after they had taken her to the ER in Kitchener.
Now, Hecktus says she wants to shield others from the pain her family has endured.
“I don’t ever want somebody to feel like they didn’t do enough for their child, like I did. I don’t blame anybody — because blame doesn’t do anything for anybody — but I want to inform.”
What makes this strep ‘invasive’?
In Group A streptococcus, common bacteria live on the nose and skin, and in the throat. It can cause minor infections like strep throat and affect the skin in the form of cellulitis.
It becomes “invasive” when the bacteria gets into a sterile bacteria-free area, explains David Aoki, director of infectious disease at Region of Waterloo Public Health.
“Invasive means it’s gotten beyond that first line of defence and it ends up somewhere it shouldn’t; so either a blood infection or something else that can be more serious. It’s a very rare complication, but it does occur.”
Dr. Jeffrey Pernica on when to take your child to the ER
At McMaster Children’s Hospital, Dr. Jeffrey Pernica said he has seen more cases of invasive Group A strep this year and his colleagues across Canada are noticing it as well. He says parents should take their children to the hospital if they have difficulty breathing, can’t keep liquids down, have severe pain, or are not responsive.
Although rare, invasive Group A streptococcus infections are on the rise: globally, across Canada and in Waterloo region, specifically.
In the region, there have been 21 infections between January and the end of April; there were 25 infections in all of 2022.
Five of the 21 people diagnosed with invasive Group A strep in 2023 died — the highest number since 2014.
In Ontario, pre-pandemic, the five-year average was about 550 cases over the course of a cold and flu season, according to numbers from Public Health Ontario. For the 2022/2023 flu season, there have been about 900 cases — a spike of 63 per cent.
In Quebec, infections increased 56 per cent over a similar period, according to data collected by the province’s Ministry of Health and Social Services.
Doctors alerted, not public
Public Health Ontario is concerned about the increased spread, said Dr. Liane Macdonald, one of the agency’s public health physicians. Catching the infection early can be tricky, but health-care providers do know what to look for, Macdonald said.
“This is one of the really difficult challenges with invasive Group A streptococcal disease, because it’s caused by a really common bacteria that has milder forms of illness that can mimic viral infections certainly,” she said.
“But there are certain characteristics that trained health-care providers are aware of and can help them to think about a potential bacterial infection with Group A streptococcal disease.”
Dr. Liane Macdonald of Public Health Ontario says catching a strep infection early can be tricky, but health-care providers know what to look for. (Craig Chivers/CBC)
Region of Waterloo Public Health issued an advisory to local doctors about spread in the community three days after Quin’s death, confirmed Aoki. But while a public alert was made after just two deaths in Montreal, a public alert has not yet been made in Waterloo region.
Aoki said public health weighs a variety of factors before making a public alert. Those factors include how an infection is spreading, if cases are linked and how local rates compare to provincial numbers.
“There’s no, ‘Oh, you hit X number of cases and it means we’re sending out an advisory,'” said Aoki. “We’re constantly looking for those trends to see where we should be alerting. That’s an ongoing process for us.”
Hecktus said she can’t help but wonder if her daughter’s death led to the alert.
“That is their scope. That is their domain. If public health had said something, I feel like it should be the doctor’s responsibility to be aware.”
But she remains focused on educating other parents about the risks.
“I’m not the kind of person to do ‘shoulda coulda woulda.’ That’s not the kind of person I am. But I don’t want anyone else to deal with this if I can help prevent it,” said Hecktus. “I want to inform and give people the knowledge so that they can make those decisions themselves and they don’t feel like they never had the choice or the options.”
Group A streptococcus has been in the headlines recently after 15 kids died in the U.K. Dr. Joanne Langley, a Halifax pediatrician specializing in infectious diseases, discussed what guardians and adults should know about this bacteria that can cause a range of illnesses.
LISTEN | Dr. Joanne Langley, a Nova Scotia pediatrician, dispels Group A strep myths:
The Dose21:13What should I know about group A strep?
Group A streptococcus has been in the headlines recently after 15 kids died in the U.K. Dr. Joanne Langley, a pediatrician specializing in infectious diseases, discussed what guardians and adults should know about this bacteria that can cause a range of illnesses.
At McMaster Children’s Hospital, Dr. Jeffrey Pernica said he has seen more cases of invasive Group A strep this year and his colleagues across Canada are noticing it as well.
“I don’t think there’s anything special that parents need to do,” he told CBC News. “I think a lot of parents are worried that they’re going to miss things and I do not think that they will.
“The reasons to go to the emergency department now are the same as that they always were: difficulty breathing, not being able to keep liquids down, severe pain, not being responsive. Those are the reasons to go now — but those have always been the reasons. And so I am confident that parents in our region are going to continue to do the same good job they’ve always done.”
Public health says the people who are most at risk are kids under four and adults over 65 and people who are pregnant or have recently given birth.
And while there is no vaccine for invasive Group A stretococcal disease, Macdonald reminds people that chicken pox vaccines can decrease the odds of children contracting the invasive bacterial infection.
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.
