Alarm at surge in invasive Strep A infections

3 minute read

After the UK saw a spike in cases last year, Australians are now on alert for signs of the disease.

A spike in infectious Group A streptococcus infections has prompted public health warnings in Victoria and NSW to be alert for symptoms.

Latest data from the National Notifiable Disease Surveillance System (NNDSS) shows there have been 65 cases in Australia so far this year (at January 16).

The bulk have been in NSW (23), followed by Queensland (19), Victoria (12), Western Australia (6), the Northern Territory (3) and South Australia (2). There have been no cases reported so far this year in the ACT or Tasmania.

Experts are warning to be on the lookout symptoms that include fevers, chills and/or sweats, dizziness, shortness of breath and/or chest pain, headache and/or stiff neck, nausea and vomiting, red, warm, and painful and rapidly spreading skin infection which may have pus or ulceration. Other symptoms include scarlet fever and cellulitis.

While Strep A bacteria generally cause mild disease such as sore throats and skin sores such as impetigo, it can lead to invasive Group A strep, a severe disease that can cause sepsis, meningitis and pneumonia. It may also cause other serious diseases including toxic shock syndrome, necrotising fasciitis, and maternal sepsis.

If invasive strep A infection is suspected, the Department of Health recommends the diagnosis be confirmed by means of a blood test and/or swabs of infected areas. The treatment is antibiotics, and the patient should isolate until they have completed their first day of treatment to prevent spreading Strep A bacteria to others.

Severe forms of the disease will usually require hospitalisation.

Last month The Medical Republic reported Australian experts were monitoring the increasingly concerning strep A situation in the UK, after more than a dozen children there had died from streptococcus-related complications in the final months of 2022.

At the time, Professor Robert Booy, a Sydney-based paediatric infectious diseases specialist, noted that “we’ve not seen the same surge here and we wouldn’t expect to at the same time,” but predicted “we could easily get a surge next year.”

There were 1163 cases of invasive Group A strep reported to the NNDSS in 2022, and 11 deaths. For some perspective, there were 1445 recorded cases of chickenpox last year, with 15 recorded to date in 2023.

However, it is important to note that national level data on invasive Group A strep infections have only been collated since the disease was added to the National Notifiable Disease List in 2022, with certain jurisdictions not routinely providing notification data until the second half of last year. Consequently, it is difficult to determine how severe the current outbreak is in comparison to previous years.

TRegardless of what the numbers may (or may not) be able to tell us, Professor Booy and his international colleagues have little doubt about what is happening at home and abroad.

“I, and most experts, have no doubt there’s a real surge right now,” he told TMR.

“There’s evidence from Europe, the US, the UK and Australia that there is a surge in invasive Group A strep disease.”

Professor Booy believes the underlying cause of the latest surge is multifactorial, with increases in socialisation after covid restrictions have been removed, the resurgence of respiratory viral infections, smoking, and certain genetic factors all contributing. In a statement provided to TMR, the Department of Health and Aged Care noted although “the overall risk of  [invasive Group A strep] for the general population remains low,” they “will continue to work with state and territory health agencies to closely monitor the situation in Australia.

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