Introduction to Invasive Strep Infections
Severe, possibly life-threatening strep infections are rising in the United States.
The number of invasive group A strep infections more than doubled from 2013 to 2022, according to a study from the Centers for Disease Control and Prevention published Monday in the Journal of the American Medical Association. Prior to that, rates of invasive strep had been stable for 17 years.
What are Invasive Group A Strep Infections?
Invasive group A strep occurs when bacteria spread to areas of the body that are normally germ-free, such as the lungs or bloodstream. The same type of bacteria, group A streptococcus, is responsible for strep throat — a far milder infection.
Invasive strep can trigger necrotizing fasciitis, a soft tissue infection also known as flesh-eating disease, or streptococcal toxic shock syndrome, an immune reaction akin to sepsis that can lead to organ failure.
The U.S. Department of Health and Human Services manages government-funded health insurance programs, monitors infectious diseases, inspects foods and hospitals, and more.
Symptoms and Deterioration
“Within 24 to 48 hours, you could have very, very rapid deterioration,” said Dr. Victor Nizet, a professor of pediatrics at the University of California, San Diego. Cases can transition from “seeming like a routine flu-like illness to rushing the patient to the ICU, fearing for their recovery,” he added.
Study Findings
The data came from 10 states, with roughly 35 million people total, that track the infections.
In 2013, around 4 out of 100,000 people were diagnosed with invasive strep. By 2022, that rate had risen to around 8 out of 100,000. The number of cases rose from 1,082 in 2013 to 2,759 in 2022.
The study identified more than 21,000 total cases of the infection over the nine-year period, including almost 2,000 deaths.
Impact and Concerns
“When you see this high number of deaths, extrapolate that across the country — we’re probably well into more than 10,000 deaths,” Nizet said.
Dr. Christopher Gregory, a CDC researcher and an author of the study, said the threat of invasive strep to both the general population and high-risk groups has “substantially increased.”
The study calls for “accelerated efforts” to prevent and control infections. It also offered a few possible explanations for the rise in cases.
The Food and Drug Administration is a federal agency that regulates drug, food and other products to protect public’s health.
Possible Explanations for the Rise in Cases
First, rising rates of diabetes and obesity, among other underlying health conditions, over the study period made some people more vulnerable to invasive strep. Both diabetes and obesity can lead to skin infections or compromise the immune system.
Second, invasive strep is increasing among people who inject drugs, which can allow the bacteria to enter the bloodstream. Infections have also increased in people experiencing homelessness — in 2022, the rate of infections among this population was 807 out of 100,000. Gregory said the rate was “among the highest ever documented worldwide.”
Finally, strains of group A strep appear to be expanding and becoming more diverse, which could create new opportunities for infection. Strains that have expanded in recent years seem more likely to cause skin infections than throat infections, according to the study.
Antibiotic Resistance and Vaccine Development
Those strains may also be driving resistance to antibiotics used to treat certain cases of invasive group A strep, macrolides and clindamycin. While penicillin is the go-to antibiotic to treat strep infections, it can be used in combination with clindamycin to treat toxic shock syndrome, and doctors sometimes prescribe a macrolide if a patient has a penicillin allergy.
Doctors said the rise in group A strep infections also points to the need for a vaccine, especially given the rise in antibiotic resistance. However, Nizet questioned whether that would be feasible now, with top vaccine scientists leaving the Food and Drug Administration.
Conclusion
The rise in invasive strep infections is a concerning trend that requires immediate attention and action. The need for a vaccine and the increasing antibiotic resistance underscore the importance of continued research and development in this area. As the number of cases continues to grow, it is essential that healthcare professionals, researchers, and the general public work together to prevent and control the spread of this potentially life-threatening infection.
FAQs
Q: What is invasive group A strep?
A: Invasive group A strep occurs when bacteria spread to areas of the body that are normally germ-free, such as the lungs or bloodstream.
Q: What are the symptoms of invasive strep?
A: Symptoms can include rapid deterioration, necrotizing fasciitis, and streptococcal toxic shock syndrome.
Q: What are the possible explanations for the rise in cases?
A: Possible explanations include rising rates of diabetes and obesity, increasing cases among people who inject drugs, and the expansion of strains of group A strep.
Q: Is there a vaccine available for invasive strep?
A: Currently, there is no vaccine available for invasive strep, but researchers and doctors are calling for accelerated efforts to develop one.
Q: How can I protect myself from invasive strep?
A: Practicing good hygiene, avoiding close contact with people who have strep throat, and getting medical attention immediately if symptoms occur can help prevent the spread of invasive strep.
