6 Children Die in Ontario From Invasive Strep A as Cases Rise Across Canada

A sign directing visitors to the emergency department is shown at the Childrens Hospital of Eastern Ontario in Ottawa on May 15, 2015. Adrian Wyld/The Canadian Press

Six children under the age of 10 have died of invasive group A streptococcus (iGAS) in Ontario since October, according to the province’s public health agency.

The number of cases and hospitalizations from the disease between October and December of last year was nearly twice as high as those during the same time period in 2022, Public Health Ontario said in a recently released report.

Of the 540 cases reported among all age groups during the final three months of last year, 412 required hospitalization and 48 died. That compares to 309 cases in 2022 when there were 228 hospitalizations and 44 deaths.

The majority of the deaths between October and December last year were in children aged four and younger making up 46.3 percent of all fatal cases.

Adult seniors over the age of 65 made up 12.6 percent of all fatal cases while deaths among adults aged 18 to 64 sat at 6.7 percent. Among children aged five to nine, 5.3 percent of the cases had a fatal outcome. There were no deaths among children aged 10 to 17.

The news coincides with a recent statement by the country’s public health agency that a record number of potentially severe strep A infections was recorded last year, particularly in children.

The Public Health Agency of Canada (PHAC), in an emailed statement to The Epoch Times, said early laboratory data shows invasive strep A activity was higher in 2023 compared to pre-pandemic years.

“As of Jan. 9, the total number of iGAS samples submitted to the [the National Microbiology Laboratory] in 2023 has surpassed 4,600, which is now the highest annual iGAS total,” the agency said. “The previous peak occurred in 2019, with 3,236 isolates submitted. The largest increases continue to be detected in children under 15 years of age.”

PHAC noted that invasive strep A is considered “endemic” in Canada.

Strep A is an infection caused by bacteria that spreads through direct contact with the nose, throat, respiratory droplets, or wound secretions. The most common illnesses associated with strep A are strep throat, skin infections, such as impetigo, and scarlet fever, and can typically be treated with antibiotics, the provincial health agency said.

Invasive strep A occurs when bacteria invades the lungs, blood, or spreads along the layers of tissue that surround muscle. This can result in severe and life-threatening illnesses such as meningitis, pneumonia, and sepsis.

Other Provinces Impacted

Ontario is not the only province to sound the warning about a rise in iGAS. British Columbia and Manitoba have both said they are experiencing higher levels of invasive strep A infections in children.

Manitoba issued a bulletin on Jan. 11 to announce an increase in the number of cases, with eight identified in the past month. Six of those infected are adults and two are children.

“Public health investigations are underway,” public health officials said in a statement. “At this time there are no known links between cases.”

A government spokesperson said the number of lab-confirmed iGAS cases rose from 114 in 2021 to 200 cases in 2023, a 75 percent increase.

The BC Centre for Disease Control, BC Children’s Hospital, and the Provincial Health Services Authority, in a joint Dec. 22 statement said there have been 51 cases of iGAS in 2023 for people under the age of 20; more than “twice as many as expected.” In 2022, there were 20 cases among this age group.

“Rates of iGAS infections have been increasing in B.C. since 2016, where there were 303 cases reported in B.C. across all age groups at a rate of 6.2 cases per 100,000 people,” the hospital said. “In 2022, there were 466 cases across all ages. There have been 547 cases to date in 2023 at a rate of 10.1 cases per 100,000 people. Several other countries and regions in Canada have also seen a higher frequency of these infections in children.”

New Brunswick averaged six deaths per year prior to 2022, but logged 10 deaths in 2023 and has already had two deaths this year.

Acting Chief Medical Officer of Health Dr. Yves Léger, in a recent CBC interview, called the rise in iGAS “a concerning trend.”

“While most of our cases occur in older individuals, we’ve seen a rise in cases in most of the other age groups as well,” he said.

Quebec has reported a 55 percent increase in infections last year over its pre-pandemic average. Health Montreal issued an alert in late 2022 after two children under the age of two died.

Alberta had a total of 739 confirmed iGAS cases in 2023, although the majority were in adults, an Alberta Health spokesperson told Global News. This represented a 41 percent increase over 2022 when 434 iGAS cases were reported.

According to Health Canada, iGAS “became nationally notifiable in January 2000” and has been steadily increasing ever since. The rate had doubled from 2.7 cases per 100,000 people in 2004, to 6.2 cases per 100,000 people in 2016.

What to Watch For

While serious infections remain rare, knowing what to watch for is important, Manitoba health officials said. Signs of an invasive strain of strep A include a dark purple rash, high fever, severe headache, stiff neck, upset stomach, severe aches or pains, weakness, drowsiness, and sensitivity to light.

“It can result in serious outcomes including amputations and in about 10 percent of cases, can result in death,” the agency said. “Rapid treatment is necessary including antibiotics and other care, depending on the symptoms.”

BC Children’s Hospital noted that iGAS infections can sometimes develop in children after a viral respiratory illness. Parents should be concerned if their child has a fever for more than five days, has a full body rash or a red, swollen tongue, is working hard to breathe, has pale skin and whitish or blue lips, is very sleepy, or has difficulty waking up.