Rise in invasive group A strep infections adds to strain on children’s hospitals

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Kids Virus Surge
A sign stands outside Seattle Children’s Hospital on March 18, 2020, in Seattle. Children’s hospitals in parts of the country are seeing a distressing surge in RSV, a common respiratory illness that can cause severe breathing problems for babies. Elaine Thompson/AP

Rise in invasive group A strep infections adds to strain on children’s hospitals

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Several children’s hospitals are reporting elevated numbers of invasive group A strep infections, a severe and sometimes life-threatening illness that occurs when bacteria invade parts of the body, such as the bloodstream.

Children’s hospitals in Texas, Washington, and Colorado told the Washington Examiner that they have seen more patients with severe group A strep infections than in previous years, in addition to managing a particularly bad season for the flu and respiratory viruses such as respiratory syncytial virus or RSV.

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“The fact that we’re seeing this uptick, and, really, it’s fair to say a spike, recently in invasive infections is noteworthy because it’s not something that we were expecting. These are serious infections. As I said, they can be life-threatening. Fortunately, they’re relatively rare,” said Dr. James Versalovic, pathologist-in-chief at Texas Children’s Hospital in Houston. “These infections should be taken seriously. Any child with symptoms consistent with a strep throat should be evaluated of course by a pediatrician.”

Group A streptococci is a bacteria that causes a number of illnesses, most of which are mild, such as strep throat, though severe group A strep infections are more serious and can materialize into necrotizing fasciitis, an infection of the muscle and fat tissue, and streptococcal toxic shock syndrome.

Texas Children’s Hospital had 60 cases of invasive group A strep infections this October and November, more than four times as many cases observed during the same period last year, with the majority being young children.

Children’s Hospital Colorado in Aurora said it has also seen an “unusual” increase in the number of patients admitted with group A strep infections.

“This has been an atypical year for a number of pathogens, and in the last month, we’ve seen an abnormal increase in severe group A strep cases,” Dr. Sam Dominguez, infectious disease specialist at Children’s Hospital Colorado, said in a statement to the Washington Examiner.

Seattle Children’s Hospital in Washington said it has treated a handful of young children and teenagers over the past month for invasive group A strep infections.

The Centers for Disease Control and Prevention said the agency is looking into a possible rise in invasive group A strep infections. France, Ireland, the Netherlands, Sweden, the United Kingdom, and Northern Ireland have also reported an increase in cases of invasive group A infections and scarlet fever, particularly in children under 10 years old, the World Health Organization said Thursday. The U.K. reported that 16 children under 18 have died from group A strep infections since September.

Versalovic encouraged parents to monitor their child’s symptoms. Early signs of an invasive group A strep infection can include persistent and rapidly progressive symptoms, such as difficulty breathing and chest pain.

“The vast majority of cases of strep infections, again, are localized to strep throat in the upper respiratory tract, and as long as parents remain vigilant about their child’s symptoms, we can certainly rapidly test, diagnose, and treat these infections and prevent downstream complications,” Versalovic added.

The rise in invasive group A infections comes as some children’s hospitals continue to manage higher-than-average volumes of flu and RSV cases, with capacity staying at or near full at some facilities over the past few weeks.

“We do know that these bacterial infections can be secondary to a viral infection. So it could be that the increased number of cases of RSV and flu that we’re seeing could also be leading to greater susceptibility to these secondary bacterial infections. That’s something we are following,” said Versalovic.

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The American Academy of Pediatrics and the Children’s Hospital Association urged the Biden administration last month to issue an emergency declaration in light of the strain on children’s hospitals. The declaration would give hospitals more flexibility to manage the influx of patients and free up federal resources.

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