Alarm over deaths as strep A infections spike in Victoria

Victorian hospitals are on high alert over group A streptococcus infections after a spike in cases and the death of two children.

Hospitals have been put on alert over the infectious disease caused by the group A streptococcus bacteria. Picture: David Crosling

Victorian hospitals have been put on alert over the dangerous bacterial infection invasive group A streptococcus following a spike in cases and the death of two children.

Victoria’s chief health officer and hospital quality watchdog have both issued warnings over the infectious disease caused by the group A streptococcus bacteria

It generally causes mild symptoms such as a sore throat, or strep throat, but in rare cases can cause death via sepsis, as well as flesh-eating bacteria and rheumatic fever which can affect the heart and kidney.

The local warning follows health authorities in the US and UK issuing similar warnings, with a shortage of antibiotics adding to the problem.

At least 30 children have died in the UK from the strep A bacterial infection since September.

Safer Care Victoria said there had been more than 60 children with group A streptococcal infections admitted to the Royal Children’s Hospital in 2022.

This included 30 invasive infections with 21 of those coming since September, the agency said in a warning issued in late December.

Prior to the pandemic the RCH logged about 20 to 25 invasive cases a year. Picture: David Crosling

Prior to the pandemic the RCH logged about 20 to 25 invasive cases a year.

Monash Children’s Hospital logged 12 cases of invasive group A streptococcal infection in 2022.

Two children were killed by invasive infections in 2022 and “many other children with Group A streptococcal sepsis have required intensive care”, Safer Care said.

Chief health officer Brett Sutton has issued his own warning, saying a recent increase in cases of invasive group A streptococcal disease has been observed in Victoria and internationally.

RCH pediatrician and infectious diseases physician Andrew Steer said the outbreak was “a cause for concern”.

“We have seen an increase in the number of (invasive) cases in the last few months in Victoria,” Professor Steer told ABC radio on Friday.

“Strep throat is incredibly common, it affects around one-quarter of children each year, so it’s a common thing for people to get.

“When it crosses into the blood stream that is actually very, very rare. Despite the number of cases we are seeing at the moment, which is cause for concern, it is still a very, very rare condition and uncommon in our population.”

Professor Steer said it wasn’t clear what was driving the new outbreak, saying increased mixing and weakened immunity brought about by lockdowns could be factors.

Alternatively, a new strain could have emerged although health authorities have no evidence that is the case at this stage, he said.

“It may be because we had a period of time in Victoria in lockdown where we weren’t seeing a lot of strep and so maybe our immune system has forgotten about strep a little bit so we have some decreased immune protection,” he said.

Professor Steer said children who were lethargic, had limb pain and didn’t want to walk or who were running a fever and had a rash should go to their GP.

Chief health officer Brett Sutton says a recent increase in cases of invasive group A streptococcal disease has been observed in Victoria and internationally. Picture: Ian Currie

Signs of invasive streptococcal disease

Signs of invasive streptococcal disease are non-specific but include more than one of:

fever

· erythematous sunburn-like rash (scarlet fever rash, which may be subtle or florid)

· cold or mottled limbs

· limb pain

· not wanting to walk

· poor feeding

· abdominal pain, vomiting

· lethargy

· throat infection

· pneumonia and pleural effusion

· oliguria (low urine output)