- Streptococcus A: how many cases and deaths in France?
- What are the symptoms of a strep A infection?
- What diseases cause strep A infection?
- How is type A streptococcus transmitted?
- What causes these infections?
- How is a type A streptococcal infection diagnosed?
- Type A streptococcus: what treatment?
- Type A streptococcus: how to avoid infection?
Streptococcus A: how many cases and deaths in France?
First reported across the Channel, deaths linked to invasive streptococcal A infections (IISGA) also affect France. Since the second half of November, pediatric professionals have been reporting higher numbers of AGII than usual in their departments, some of which have been fatal. “These reports came from different regions (Occitanie, Auvergne-Rhône-Alpes, Nouvelle-Aquitaine) and mainly concerned children under the age of 10.“, indicates Public Health France in its balance sheet published on February 7.
As of January 29, 2023, among the 121 cases identified, 11 died, two more deaths. Six other deaths from invasive type 1 streptococcal infection before admission to hospital have been reported. Santé Publique France notes a further increase in the number of consultations and visits to the emergency room for non-invasive infections with streptococcus A (angina and scarlet fever) since the beginning of January, after a drop noted during the Christmas school holidays.
What is this upsurge in cases due to? “The recrudescence of IISGA could result, at least in part, from a post-barrier rebound in children whose immune system has not been in contact with the strains of GAS that usually circulate“, says SPF. The organization nevertheless specifies that the situation “is not linked to the emergence of a new bacterial strain but possibly to the increase in the frequency of the already known emm1 genotype“.
What are the symptoms of a strep A infection?
THE symptoms of an invasive streptococcal A infection are the following:
- Pain when swallowing;
- Fever ;
- Swollen tonsils with white spots;
- Swollen neck glands;
- A high temperature;
- A skin rash.
In rare cases of invasive group A streptococcus, the warning signs may be fever with a temperature above 38°C and severe muscle pain.
What diseases cause strep A infection?
In most cases, the type A streptococci (bacteria located in the back of the throat) are responsible for benign diseases such as red (erythematous) or red with white spots, a skin disease called impetigo or even scarlet fever. Nevertheless, they can sometimes reach the blood system and cause much more serious and invasive pathologies such as bacteremia, necrotizing skin infections, puerperal infections, pleuropneumopathy or even meningitis that can be associated with a streptococcal toxic shock syndrome.
How is type A streptococcus transmitted?
Type A Streptococcus is transmitted exclusively from human to human, by inhaling droplets from the nose and throat when coughing or sneezing. Bacteria can also be transmitted in contact with an infected wound.
What causes these infections?
If the authorities deem the emergence of a new, more virulent bacterial strain unlikely, they would instead rely on “an unusual increase in the number of cases, linked to different strains“, indicates the DGS.
The British health security agency (UKSHA) suspects an increase in traffic and contacts due to the end of barrier gestures and the drop in immunity linked to two years of health measures. This increase in cases is part of an already tense context with the return of influenza and bronchiolitis viruses, linked to a 9e wave of Covid-19. “The recrudescence of IISGA could result, at least in part, from a post-barrier rebound in children whose immune system has not been in contact with the strains of GAS that usually circulate“, confirms Public Health France.
The mortality rate nevertheless remains very low according to the Pasteur Institute, and is estimated at 10% all pathologies combined. It nevertheless increases in the event of serious infections, 30% in the event of toxic shock against 20% in the event of meningitis.
How is a type A streptococcal infection diagnosed?
When a child or an adult shows clinical signs of a type A streptococcal infection (high fever, poor general condition, etc.), an experienced doctor can recognize it and then perform a rapid diagnostic test for the infection. strep throat or blood samples (blood culture).
Faced with the resurgence of cases in December 2022, the DGS called on all health professionals to carry out this Rapid Diagnostic Orientation Test (TROD) Streptococcus A in the event of angina, as well as a throat swab in the event of a clinical picture of scarlet fever, if the TROD comes back negative.
Type A streptococcus: what treatment?
Currently, type A streptococcal infections are treated with antibiotics, ß-lactams. The best treatment remains amoxicillin, the most prescribed antibiotic in children but which currently suffers from shortages and is running out on the shelves of pharmacies in France.
“A referral to learned societies is underway to specify the recommendations for the management of cases and contact persons, particularly in the current context of tensions over amoxicillin.specifies the DGS.
He there is no vaccine against streptococcal A infections.
Type A streptococcus: how to avoid infection?
Faced with type A streptococcal infections, the best way to protect yourself is hygiene by keeping reflexes such as washing hands before meals, before preparing food and after coughing or sneezing as well as winter barrier gestures: washing hands, wearing a mask for people with respiratory infections and sneezing or cough into the bend of his elbow.
Sources:
- Streptococci A and BPastor Institute
- Resurgence of invasive streptococcal A infections, General Directorate of Health
- Invasive Group A streptococcal infection: epidemiological update as of January 29, 2023, Public Health France