Health experts issue urgent warnings as a rare yet perilous bacterial infection rapidly spreads throughout Japan, leaving officials grappling to pinpoint its cause.
Bacterial
The incidence of this infection in 2024 is anticipated to surpass last year’s alarming figures, raising fears of a surge in the severest form of group A streptococcal disease—streptococcal toxic shock syndrome (STSS). Concern heightened with the confirmation of highly virulent and infectious strains within Japan.
The National Institute of Infectious Diseases (NIID) acknowledged the mystery shrouding the mechanisms driving the sudden and severe manifestations of streptococcus. “There are still many unknown factors regarding the mechanisms behind fulminant forms of streptococcus, and we are not at the stage where we can explain them,” stated the NIID.
Provisional data from the NIID revealed a staggering 941 cases of STSS reported last year. Within the initial two months of 2024, 378 cases have already surfaced, with infections documented in all but two of Japan’s 47 prefectures.
Despite older individuals being deemed at greater risk, the group A strain is now causing more fatalities among patients under 50, according to the NIID. Among the 65 individuals under 50 diagnosed with STSS between July and December 2023, approximately a third, or 21, succumbed to the infection.
STSS primarily originates from the streptococcus pyogenes bacterium, commonly known as strep A, which often presents as mild sore throats, particularly in children. However, in some instances, these highly contagious bacteria lead to severe illnesses, complications, and fatalities, particularly in adults over 30, with approximately 30% of STSS cases proving fatal.
While older individuals may initially experience cold-like symptoms, rare cases can escalate to strep throat, tonsillitis, pneumonia, and meningitis, with the gravest instances culminating in organ failure and necrosis.
Experts speculate that the surge in cases last year might be linked to the relaxation of restrictions imposed during the COVID-19 pandemic. In May 2023, the Japanese government downgraded COVID-19’s classification, leading to a decrease in preventive measures such as mask-wearing and hand sanitization. This shift potentially exposed individuals to increased risk and paved the way for the resurgence of streptococcus pyogenes infections.
Professor Ken Kikuchi from Tokyo Women’s Medical University expressed grave concern over the sharp rise in severe streptococcal infections this year, attributing it primarily to the reclassification of COVID-19. He suggests that over 50% of Japanese individuals may have been infected with Sars-CoV-2, altering their susceptibility to other microorganisms. Urgent measures are required to understand and control the infection cycle of severe invasive streptococcal pyogenes diseases.
Similar to COVID-19, streptococcal infections spread through droplets and physical contact, with the bacterium also capable of infecting wounds on the hands and feet. Treatment involves antibiotics, but severe cases necessitate a combination of antibiotics and intensive medical care.
In response, Japan’s health ministry urges the public to adhere to basic hygiene practices akin to those adopted during the COVID-19 pandemic, emphasizing hand hygiene and cough etiquette as crucial preventive measures.
The escalating threat of this bacterial infection underscores the critical importance of ongoing vigilance and adherence to public health guidelines in mitigating the spread of infectious diseases.
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