Explainer: What Is the Deadly Strep Hitting Canada in Record Numbers

A physician's assistant checks the throat of a sick child in this file photo. John Moore/Getty Images

The type of strep that has infected an increasing number of people across several Canadian provinces in the past few months can be life-threatening, according to experts.

“There are many types of Group A strep,” UBC professor of microbiology and immunology Bob Hancock told The Epoch Times. “There’s also things like Strep throat, but this is the worst manifestation of it basically because of this flesh-eating disease, which can cause people to lose limbs or go into very, very serious disease or even die.”

“It produces toxins that are called super antigens and essentially they make the body’s immune system go bananas that starts to cause the body to destroy itself.”

Group A strep disease is caused by bacteria that spread from person to person through nasal, throat, or wound secretions or respiratory droplets, Public Health Ontario (PHO) says on its website.

The health agency said that people can have the bacteria in their throat or skin but have no symptoms or a mild illness.

“In rare cases, it becomes ‘invasive’, or iGAS, when bacteria enter the blood or deep tissue. This can result in severe life-threatening illness,” the PHO website said.

According to the B.C. Centre for Disease Control (BCCDC) website, there are some severe but rare infections that iGAS can cause, including “flesh-eating disease,” where the disease destroys muscles, fat, and skin tissue.

Infection can also lead to streptococcal toxic shock syndrome and cause a drop in blood pressure, leading to organs like the kidneys, liver, or lungs to stop working. iGAS can also cause pneumonia and blood poisoning, BCCDC said.

Some of the symptoms to watch for include severe pain and swelling, fever, redness around a wound, dizziness, confusion, and flat red rash over parts of the body, the website said.

COVID Connection

Mr. Hancock said that no one is sure exactly why the number of cases is increasing, but one reason could be the COVID-19 pandemic.

“During the COVID era, people started to get really serious about hygiene,” Mr. Hancock explained. “This means things like washing your hands frequently, using disinfectants capable of killing microbes, and keeping your environment clean.”

He said that once the COVID-19 vaccines arrived, more people started to be confident about going back out in public.

“I think a lot of those public health measures became low priority.”

There are antibiotics that can be used to clear the bacteria out of the body, but it is very resistant, Mr. Hancock said.

“The problem is with these superantigen variants. You don’t need a huge number,” he said. “They are destroying your immune system in the area where the infection occurs. The antibodies have no assistance from your immune response and getting rid of it.”

He added that treatment may even eliminate the bacteria, but toxins are still in the patient’s system.

“It can cause disease to propagate even if you cure the infection.”

In Ontario, the number of cases of Group A strep has nearly doubled, and six children under the age of 10 have already died since October 2023, according to a PHO report.

During the last three months of 2023, there were 540 cases reported among all age groups, with 48 deaths and 412 hospitalizations, the PHO said. In 2022, there were 309 cases, 44 deaths, and 228 hospitalizations.

“Invasive Group A streptococcus (iGAS) cases have been increasing over a number of years. However, the recent surge in iGAS cases is not fully understood and likely involves multiple factors,” Dr. Liane Macdonald, a public health physician at PHO, told The Epoch Times in an email.

“PHO is monitoring the situation closely, including monitoring the strains of the bacteria found in people with the invasive form of Group A strep,” Dr. Macdonald added.

B.C. has also reported higher-than-expected cases of iGAS, according to a government news release.

As of Dec. 23, 2023, there were 547 cases of the disease, compared with 466 cases in 2022, the release said.

The Public Health Agency of Canada told The Epoch Times in an emailed statement that strep A cases were 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.”

Precautions for Children

Dr. Macdonald said there was no vaccine to protect individuals, including children, from Group A strep, but suggested children should stay up-to-date with other vaccinations as “some viral infections can increase the risk of invasive Group A strep.”

It’s also important for parents and guardians to watch the symptoms of children who appear sick.

“It is important to be aware of the signs and symptoms of serious bacterial illness and general signs and symptoms in children that need urgent medical attention (e.g., changes in responsiveness, change in breathing), and when to see a health care provider for milder illness,” she said.

The BCCDC advises caregivers to keep an eye out for the following symptoms:

• Fever for over five days
• Fever and “fine red rash” over the body
• Child that is struggling to breathe
• Pale skin, white or blue lips
• Very sleepy, difficult to wake up

If these symptoms are present, they advise getting medical attention quickly.

It’s also important to maintain general illness prevention practices such as hand washing, Dr. Macdonald said in the email.

“If diagnosed with a more common Group A strep infection (e.g., throat or skin infection), individuals should follow healthcare provider advice, complete antibiotic courses, and take precautions to prevent further spread, including staying home for 24 hours after starting treatment.”

In 2023, 46.3 percent of fatal cases of Group A strep were in children four or younger. Canadians over 65 accounted for 12.6 percent of fatal cases and adults aged 18 to 64 were 6.7 percent. There were no deaths in those aged 10 to 17.

Jennifer Cowan contributed to this report.