Canada’s public health agency has logged a record number of potentially deadly strep A infections, particularly in children under the age of 15. At least six children have died in Ontario.
“The concern is that it can be rapidly progressive and life-threatening,” Dr. Kwadwo Kyeremanteng, head of critical care at The Ottawa Hospital, told CTV News Channel. “We’ve seen more cases of this in our intensive care unit, and the results have been pretty significant where people have lost their limbs, people have passed away.”
As of Jan. 9, the Public Health Agency of Canada (PHAC) has received more than 4,600 invasive group A streptococcus samples from 2023, which is the highest annual total ever recorded in Canada and a more than 40 per cent increase over a previous 2019 peak of 3,236 cases. According to PHAC, invasive group A streptococcus is endemic in the country, with 2,000 to 3,000 cases reported annually in recent years.
“Early laboratory data indicates that [invasive group A streptococcus] disease activity in 2023 was higher compared to pre-pandemic years,” a PHAC spokesperson said in an emailed statement shared with CTVNews.ca. “The largest increases continue to be detected in children under 15 years of age.”
Infections from group A streptococcus bacteria are typically mild and can cause strep throat, which is usually treated with antibiotics. More severe and invasive infections are much less common, but potentially deadly.
Invasive group A streptococcus occurs when strep A bacteria causes a deeper infection that can lead to lung infections like pneumonia, debilitating flesh-eating disease, or even toxic shock syndrome, which is when bacteria produces toxins that cause organs in the body to stop functioning. Approximately one in 10 people die from invasive infections, according to a U.S. study. Serious outcomes can include amputation and major organ damage.
“An invasive infection really means the bacteria has moved to a site that should normally be sterile, such as the blood or under the skin in soft tissue or muscle,” University of Western Ontario microbiology and immunology professor John McCormick told CTVNews.ca. “This is what is sometimes called the flesh-eating disease and can progress very quickly. These infections can present in different ways but severe pain that is out of proportion to what you see is a common symptom, or something that would suggest a spreading infection or skin colour changes.”
A Jan. 11 report from Public Health Ontario says that 48 people have died from strep A infections in the province since October, including 23 people aged 65 or older and six children under the age of nine.
“This is higher than the proportion of [invasive group A streptococcus] cases within the same age group that had a fatal outcome reported in the same reporting period for the previous season… and exactly half of the total number of pediatric deaths reported in the entire 2022-23 season,” the Ontario report said.
Dr. David Fisman is a physician and epidemiologist, as well as a professor at the University of Toronto’s school of public health. Fisman says that viral infections like COVID, influenza and RSV can make people more vulnerable to subsequent bacterial infections, which could be driving new strep cases.
“They seem to do this by killing some of the immune defences in the upper airway, ‘setting the table’ for invasive infection,” Fisman told CTVNews.ca. “Canadians should be aware and appropriately concerned about this, as invasive group A streptococcal infections [as opposed to ‘strep throat’] is a serious and life threatening infection.”
Health officials say you should seek medical attention if you believe you have an infection.
Initial symptoms may include fever, sore throat and mild skin infections like rashes, sores and blisters. Streptococcus bacteria can be transmitted through direct contact with infected skin wounds, or from fluids in the nose and throat that can be spread when an infected person coughs or sneezes.
“Antibiotics are used to treat both invasive and non-invasive [group A streptococcus] diseases,” PHAC explains. “Early treatment may make symptoms less severe or prevent more serious complications.”
Kyeremanteng from the Ottawa Hospital says that when it comes to treatment, “time is of the essence.”
“One of the main messages that I’m hoping to [get] across… is that if you are having signs and symptoms, not to ignore them and to seek medical attention as soon as you can,” Kyeremanteng added. “The key is to have early antibiotics provided, and monitoring.”
PHAC says invasive group A streptococcus has been “a priority for monitoring and control” by provincial, territorial and federal authorities for more than two decades, and that all cases “must be reported” to public health authorities.
“Group A streptococcal infections are complicated infections,” Dr. Dale Kalina, chief medical information officer at the Brant Community Healthcare System in Brantford, Ont., told CTV News Channel. “It doesn’t matter how busy your local emergency department is: if you’re concerned, if you’re feeling unsafe, if you have any of these red flag symptoms, come into the hospital, reach out for medical attention, that is why we’re here.”
“They seem to do this by killing some of the immune defences in the upper airway, ‘setting the table’ for invasive infection,” Fisman explained. “Canadians should be aware and appropriately concerned about this, as invasive group A streptococcal infections (as opposed to ‘strep throat’) is a serious and life threatening infection.”
Health officials say you should seek medical attention if you believe you have a group A streptococcus infection. Initial symptoms may include fever, sore throat and mild skin infections like rashes, sores and blisters. Streptococcus bacteria can be transmitted through direct contact with infected skin wounds, or from fluids in the nose and throat that can be spread when an infected person coughs or sneezes.
“Antibiotics are used to treat both invasive and non-invasive [group A streptococcus] diseases,” PHAC explains. “Early treatment may make symptoms less severe or prevent more serious complications.”
PHAC says invasive group A streptococcus has been “a priority for monitoring and control” by provincial, territorial and federal authorities for more than two decades, and that all cases “must be reported” to public health authorities.
McCormick from the University of Western Ontario is studying deadly streptococcus bacteria at his lab with the aim of finding a vaccine. He estimates that 10 per cent of school-aged children carry the bacteria without showing symptoms.
“Some of the new strains have a mutation that causes them to be more toxic which is very likely contributing to the bacteria causing more aggressive infections,” McCormick said. “If you believe you have a strep infection such as strep throat with painful swallowing, fever, swollen tonsils or a rash, people should go and see their family physician. A rapid strep test can be done and if positive antibiotics should be used.”
VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
