Treatment for suspected STSS should be delivered as rapidly as possible. Patients will require oxygen, intravenous fluids and even cardiac support, alongside antibiotics and intravenous immune antibodies to deactivate strep A toxins. Even if referral and treatment is given quickly, it may still take patients many weeks to recover from the physical effects.
STSS is more common in people who have a poor immune system – including the elderly, people taking steroid medications, people recovering from a recent illness (particularly chickenpox), those with type 2 diabetes, and people with drug and alcohol problems. The elderly are a large and growing component of Japan’s population, which may explain why cases of STSS are particularly high there.
The rise in STSS cases is probably also a consequence of fewer COVID-19 restrictions in this post-lockdown period. Public health measures such as mask wearing, washing and disinfecting hands and social distancing all helped to reduce the spread of strep A bacteria. People were exposed to larger numbers of bacteria when these controls were lifted.
Fortunately, strep A bacteria remain responsive to penicillin, although resistance has been identified in some strains. This means that strep A and STSS remain treatable.
Researchers are also working on developing a protective vaccine against strep A bacteria. If successful, this would not only protect against milder illnesses caused by streptococci, but also against rheumatic fever and perhaps the more acute severe illnesses such as STSS.
Strep A bacteria are estimated to contribute to more than half a million deaths globally each year. While relatively few of these are the consequence of STSS, this number highlights a need to better monitor group A streptococci, their evolution and the diseases they cause.
Protecting yourself against strep A bacteria remains relatively simple. Many of the practices we followed during the height of the pandemic – such as wearing masks, washing hands and avoiding crowds – can help us avoid strep A too.
Colin Michie is Deputy Lead, School of Medicine, University of Central Lancashire. This commentary first appeared in The Conversation.
Source: CNA
