Pilar Pérez Madrid
Madrid
Updated Friday, March 22, 2024-02:17
After the
alarms at the end of 2022
and beginning of 2023 in the
United Kingdom and Spain
, group A streptococcus has appeared abruptly in Japan. Diego García Martínez de Artola, spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc) explains that the increases in cases of invasive infections due to this bacteria have been on the rise for some time. "The first to issue an alert report was the United Kingdom on that date. Then, during the year 2023, they have occurred in different areas of Europe and now also in Japan," García details.
This expert remembers that also "
since the end of last year, this increase in cases began to be recorded in the Asian country.
Now is when the last ones have come to the fore, but there was already a higher incidence globally."
For García it is not a significant alert, "it is something to keep under surveillance." If there are more or fewer cases it is due to "
greater surveillance activity, yes, but we are not facing a notifiable infection
. It is the CCAA that monitor and compile the infections."
To know more
Health.
Is there really a public health alert in Japan due to the spread of "flesh-eating bacteria"?
Editor: LUCAS DE LA CAL (Asia Correspondent)
Is there really a public health alert in Japan due to the spread of "flesh-eating bacteria"?
After Covid, surveillance systems have improved and therefore, as García says, "
the population must get used to more pathogens being detected
." And he puts on the table the complicated balance between "watching without alarming."
Why are there more cases after the pandemic?
García is betting on the combination of factors:
more surveillance, immunological debt and a new strain
. "There is a new serotype that is more capable of producing toxins. It is
M1UK
, detected in the United Kingdom, but which is already circulating globally."
The
M1UK
is behind the
increased capacity for greater production of a number of toxins
. "This production is what leads to a greater probability of developing an invasive infection, either in bacteremia (the circulation of bacteria in the blood) or pneumonia." This is linked to this increase in invasive cases, adds García.
The new strain is studied and analyzed in several publications throughout 2023. One of them, published in
Microbial Genomics
, noted that "recent epidemiological studies found a
high rate of secondary infection (44%) in schoolchildren and household contacts of a case of scarlet fever caused by M1UK
, which points to a possible transmission advantage in comparison with other S. pyogenes lineages".
In the US Centers for Disease Control and Prevention (CDC), this lineage change with greater potential for transmission and virulence is also recorded with follow-up work in the country in the observation period between 2019 and 2021.
What is group A strep infection?
As the Seimc spokesperson states, it is an infection that is potentially fatal in a small percentage, 30%. "
In very few cases, invasive infection occurs
, which is potentially fatal or serious, less than 1%."
Group A streptococci
(
Streptococcus
pyogenes
) are a group of
bacteria
that usually cause mild infectious symptoms in children.
What are the symptoms that this pathogen produces?
Generally in minors, the infection manifests itself through mild symptoms, which can be
respiratory [tonsillitis] or cutaneous
, which are known as scarlet fever due to the rash they cause.
The Seimc lists some of the clues:
persistent fever
, drowsiness
(
sleep),
alterations in the level of consciousness
,
bluish discoloration in the palms
of the feet and hands. "With this, the doctor should be consulted and the test will be performed to detect this streptococcal disease," the experts emphasize.
HOW DO YOU PREVENT CONTAGION AND INFECTION BY STREPTOCOCCUS A?
The prevention measures that we must maintain are
the usual ones for all these types of infectious diseases
in both children and adults. The main one is not to expose older children with one of these diseases in social environments, families, daycare centers and schools. Also maintain proper hand hygiene and cleaning.
How is group A strep infection treated?
In these cases the drug of choice will be an
antibiotic
. "It must be used at the beginning of the infection, to prevent it from becoming invasive inside the body, since this is the moment in which its approach becomes complicated," says the Seimc spokesperson.
Luckily, as García points out, "
we have not detected cases of resistance and that is good
." A possibility that could develop by changing the strain, "which we have not observed so far."
In what other countries have cases occurred?
In 2022 the alarms went off in the United Kingdom. According to the latest 2023 data from the Health Security Agency (UKSHA), so far this season (from September 12, 2022 to May 7, 2023), there have been 55,872 notifications, compared to 54,394 in the last update on April 20. In the last comparable peak season (September 2017 to September 2018), there were 30,768 notifications in total throughout the year.
Have any cases of streptococcus A M1UK been found in Spain?
A recent study published in our country analyzes the increase recorded between March 2022 and September 2023.
A total of 130 cases
of
S. pyogenes
causing infection were included in the microbiological study: 102 were invasive cases and 28 were controls. The 102 invasives came from isolations in 20 hospitals in 10 autonomous regions. The new serotype M1UK was found in a high percentage of the cases studied.