CDC warns of an increase in severe strep A infections among children

The Centers for Disease Control and Prevention warned the medical community on Thursday of an increase in pediatric cases of invasive group A strep infections.

Group A streptococci are the same bacteria that cause strep throat and scarlet fever, but invasive infections refer to more serious cases where the bacteria spread to areas of the body that such pathogens normally cannot reach, such as the bloodstream.

The CDC warned in its health advisory that, although rare, “these serious and invasive diseases are associated with high mortality rates and require immediate treatment, including appropriate antibiotic therapy.”

The CDC said the increase in invasive strep A was first detected in the US in November among children at a hospital in Colorado. After that, “potential increases in cases in other states were noted later,” according to the advisory.

Two young children in the Denver metropolitan area have died since November 1, according to the Colorado department of public health.

NBC News reported last week that many children’s hospitals in the US are detecting an increase in invasive group A strep infections. At the time, the CDC said it had “heard anecdotes from some U.S. doctors about a possible increase in infections among children” and is “still talking to detention centers and hospitals in many states to learn more.”

In its recommendation on Thursday, the agency noted that the increase in strep A infections occurred amid the rise in respiratory viruses, including RSV, influenza and Covid. According to data from the Department of Health and Human Services, 74% of pediatric inpatient beds nationwide were full as of Wednesday.

In some cases, children who develop severe strep A infection start with a viral respiratory infection.

However, the overall number of invasive group A strep infections among children remains low, and the condition is rare, according to the CDC.

Like other diseases, the risk of contracting strep A increases seasonally among all age groups, the CDC said. In general, people over the age of 65 and those with chronic illness are most susceptible to invasive strep infections.

That’s why the CDC stressed “the importance of early recognition, diagnosis, and appropriate treatment of these diseases in children and adults.”

Invasive group A strep infections can trigger:

  • Lower respiratory tract infections, such as pneumonia or empyema, characterized by pockets of pus in the fluid-filled space surrounding the lungs. Early symptoms include fever, chills, difficulty breathing or chest pain.
  • Skin infections such as cellulitis or necrotizing fasciitis, also known as meat-eating disease. Both involve a rash that is red, hot, swollen, or painful, but necrotizing fasciitis spreads quickly and can develop into ulcers, blisters, or blackheads.
  • Streptococcal toxic shock syndrome, an immune reaction that can lead to organ failure. The condition usually begins with fever, chills, muscle aches, nausea or vomiting, followed by rapid heartbeat or breathing.

At least 21 children have died from invasive group A strep in the UK since mid-September. The UK Health Safety Agency said on Thursday that 94 deaths across all age groups have been recorded in the UK.

The World Health Organization said last week that cases were also increasing in France, Ireland, the Netherlands and Sweden.

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