Streptococcus A: What is the “flesh-eating bacteria” that worries Japan?

Since January 1, Japan has had an outbreak of the disease with 517 cases. A figure that worries health officials as SCTS is fatal in at least 30% of cases.

517 cases between 1^er January and March 17, depending on Japan Times. Japan is concerned about an explosion in cases of streptococcal toxic shock syndrome after 941 cases were reported throughout 2023, a record year. In the same year, SCTS caused 30% of the deaths of infected persons, viz. “extremely high death rate”, According to the Tokyo Metropolitan Government.

The Streptococcus A in question

SCTS is often caused by angina and impetigo in 80% of cases; More rarely, it is responsible for invasive infections.

GAS in particular causes very serious and often fatal invasive infections:

• Fasciitis or necrotizing dermohypodermatitis: These include “Complete destruction of soft tissue, hence its nickname “flesh-eating bacteria,” Public Health France recalls;
• Streptococcal toxic shock syndrome (SSTS) causes multiple organ failure;
• Meningitis, inflammation of the membrane surrounding the brain.

We also see endocarditis and septicemia in invasive infections associated with GAS.

Aggressive infections that are often fatal

According to statistics from Public Health France, 50% of meningitis cases are caused by S. Invasive infections caused by pyogenes are fatal in 40% of cases of SCTS, 20 to 45% of cases of necrotizing dermohypoderma. “With high epidemic potential, S. Pyogenes are transmitted through the air (drop, editor’s note) or direct contacts in the patient community”, Note Public Health France

According to Japan Times, transmission can also occur through injuries, especially to the hands. Diagnosis of invasive infection is based on detection of sterile bacteria.

Japanese authorities urge the population to seek medical advice quickly in case of pain, swelling of the extremities or fever. Treatment is based on taking antibiotics. However, Pasteur suggests an increase in the organization’s resistance S. pyogenes

For many families of antibiotics.

Cases rise in Europe

In 2021, the Pasteur Institute published “A real increase in invasive streptococcal A infections in industrialized countries and especially in Europe. In France, this invasive infection has been increasing since 2000, with an incidence rate rising from 1.2 to 3.3 per 100,000 inhabitants”.

In 2022 in particular, several European countries including France, Ireland, the Netherlands, the United Kingdom and Sweden reported an increase in the number of cases of invasive group A streptococcal infection in children under 10 years of age. “In France and the United Kingdom, the number of cases of invasive GAS infection in children is several times higher than the levels reported before the pandemic for the same period. The World Health Organization noted at the time.