Strep surge alarms B.C. officials
VANCOUVER — Faced with surging numbers of severe, invasive group A streptococcus infections across B.C., mystified public-health officials are seeking feedback from Canadian and U.S. counterparts and preparing to publish reports to draw attention to the problem.
A soon-to-be-released report shows that in 2016, there were 303 confirmed cases of invasive Group A Streptococcal disease (iGAS) in B.C., or 6.4 cases per 100,000 population. That’s the highest rate since 1997, when it became a mandatory reportable disease.
Such illnesses as scarlet fever, strep throat and impetigo are caused by strep A bacteria — but so, too, is potentially deadly toxic shock syndrome and flesh-eating disease (necrotizing fasciitis). That is what an 11-year old Richmond boy contracted four months ago when he was one of two boys in the same classroom who came down with iGAS.
John Chen has been in hospital since March. A classmate was hospitalized a week earlier with different complications from the infection.
Dr. Monika Naus, a medical director at the B.C. Centre for Disease Control, said experts are unsure how to turn iGAS incidence trends around.
She said she does not think the increase has anything to do with cases being miscategorized because lab confirmation is required. Experts have consulted addiction specialists because injection-drug users might be at higher risk of such infections, but “they’ve informed us that injection frequency among users in not thought to be higher than in prior years.”
The symptoms of iGAS include fever, chills, fatigue, vomiting and pain. Naus said the most important piece of advice she can give patients is to seek medical attention promptly when they develop symptoms so that they can be prescribed penicillin or other antibiotics.
“The cardinal sign of necrotizing fasciitis is pain out of proportion to the injury.”
Sam Chen, father of John, said he took his son to a doctor in Richmond when he developed a fever and severe pain in his leg, but he was advised to take ibuprofen (Advil). Research has shown that such medication could raise the risk of developing complications in children.
John was eventually rushed to B.C. Children’s Hospital, where doctors diagnosed necrotizing fasciitis and immediately began the first of 18 operations to save his limbs.
Sam Chen has questioned why Vancouver public health officials did not send a notification letter to parents of children in the classroom until after two cases were identified.
“I know nothing can change the fact my son got so ill, but what is the harm in notifying parents right away, so that they can watch for symptoms and take their children to the doctor or hospital if they see any symptoms?” he asked.
Dr. Althea Hayden, a medical health officer with Vancouver Coastal Health, said publichealth officials don’t want to cause “undue alarm among people who are not truly at increased risk.”