Well, it’s official. USA has a GAS problem, where GAS stands for Group A Streptococcus or group A strep. The Centers for Disease Control and Prevention (CDC) has confirmed that there has indeed been an increase in the number of invasive group A strep (iGAS) infections among children. Now, you may have already heard of possible increases in such infections in different states. For example, on December 15, the Colorado Department of Public Health and Environment reported 11 cases since November 1, 2022 in the Denver metropolitan area with two deaths among these cases. But “possible” is not the same as “hey, let’s alert everyone to this situation,” which is what the CDC did by issuing a Health Alert Network (HAN) health advisory on December 22.
So add this increase in bacterial infections to the increases in respiratory virus infections like Covid-19, influenza, and respiratory syncytial virus (RSV) infections that the US has been facing, and the winter of 2022-2023 has become quite a cough, cough affair. iGAS infections are caused by Group A, which is not surprising. Streptococcus bacteria It is actually quite common to get GAS—GAS bacterial infections. Group A strep can cause a variety of common skin and soft tissue infections. And chances are you’ve heard of strep throat, which is a sore throat or inflammation of the throat caused by GAS bacteria. This is usually not a deep throat problem because a course of oral antibiotics can usually clear up the infection when taken in a timely manner.
iGAS infections are a different story. Although they are generally much rarer, much bigger problems can arise when the bacteria become more invasive. In this case, invasive doesn’t mean the bacteria will ask you a bunch of very personal questions like how many partners you’ve had and why you have wives in the closet. Rather, it means the bacteria goes deeper into your body and causes bad things like sepsis, strep toxic shock syndrome, and necrotizing fasciitis. All of these things can be quite life threatening.
Sepsis is when the infection spreads into your bloodstream and causes a pretty extreme reaction from your immune system and body. It can lead to changes in your mental state, severe drops in your blood pressure, very rapid breathing, and eventually organ failure. Having sepsis is not a positive thing. When sepsis progresses to septic shock, mortality can increase to around 40%.
Toxic shock syndrome may sound like the name of a punk rock band, but it’s when toxins secreted by bacteria cause a variety of systemic problems in your body. This can include fever, lethargy, confusion, rash, peeling skin, drops in blood pressure, and damage to different organs. Clearly, anything with the words “toxic” and “shock” are no good, unless you’re saying something like “I’m surprised you’re not as toxic as I thought.”
Necrotizing fasciitis is a severe form of skin and soft tissue infection. If your date calls you necrotizing, then that doesn’t bode well for a second date. To necrotize means to cause necrosis, which is the death of living tissue. Therefore, necrotizing fasciitis is when parts of the skin and underlying tissue begin to die and potentially slough off your body. That’s clearly not a positive either.
Yes, all these possibilities are not good. So when you or your child have a GAS infection, you certainly need to watch out for any signs that things are becoming more invasive. Watch for any indication that the bacteria is spreading beyond the throat or the initial part of the affected skin. Contact your doctor if antibiotics do not seem to improve symptoms in two to three days.
However, vigilance does not mean panic. It also doesn’t mean waving your arms above you and yelling, “It’s like the Covid-19 pandemic! It’s like the Covid-19 pandemic!” It’s not. Before you call it quits and start hoarding toilet paper again, keep in mind that the CDC noted that the total number of these more serious invasive cases among children “remained relatively low.” Therefore, if you or your child have a GAS infection, it is likely that you will not progress to iGAS as long as you receive appropriate treatment in a timely manner. However, any increase in such serious, albeit very rare, diseases warrants oversight by the CDC, other public health authorities, health care systems, and health professionals. Hence the CDC alert.
It is not entirely surprising that iGAS infections among children have been on the rise. During the years leading up to the Covid-19 pandemic, cases of GAS infections in the US tended to follow a seasonal pattern, increasing during the winter months, peaking from December to April and declining at the end of the year. of spring and summer. In the last two winters, GAS infections have actually been lower than normal, probably because people took precautions against covid-19. Such precautions could have directly prevented GAS transmission, which occurs through direct contact, respiratory droplets, or contaminated objects and is typically highest among school-age children ages five to 15.
Furthermore, such precautions might have indirectly decreased GAS infection by decreasing the activity of viruses such as influenza. In the past, iGAS infections tended to increase when flu activity was high. A flu infection can make you more likely to get bacterial infections because your immune system is busy fighting the virus.
So what do you do to prevent a GAS infection, which could turn into iGAS? Here are several things:
- Wash your hands often and thoroughly.. If you haven’t realized that good hand hygiene is important after the last three years, then don’t touch anyone else’s food.
- Regularly clean and disinfect high-touch surfaces. Likewise, this is a practice you should already have mastered.
- Get up to date on all recommended vaccinations. This includes getting the flu, chickenpox, and covid-19 vaccines. Having the flu or chickenpox can increase your risk of iGAS infection.
- Keep your wounds clean and properly covered. You probably won’t come across many people telling you that open, dirty wounds are sexy. Also, wounds and other things that cause cracks and openings in the skin can create a revolving door for bacteria.
- Do not come into close contact with someone who has GAS, that is, a GAS infection. This can be easy to remember if you keep repeating: “Stay away from anyone who has any type of gas.”
- Keep Covid-19 precautions. Again, it is probably not a coincidence that iGAS infections have declined over the past two winters when many more people were wearing face masks while out in public indoors and practicing more social distancing.
Most recently reported cases of iGAS have been in children between 10 months and 6 years of age. But remember Group A Streptococcus Bacteria, like most of these pathogens, do not discriminate by age. The bacteria won’t say, “You’re too old for me,” and will avoid infecting you if you’re over a certain age range. In fact, those over the age of 65 are at greater risk of suffering an iGAS. Those who live in long-term care facilities, have chronic medical conditions such as diabetes, heart disease, lung disease, kidney disease, or cancer, inject drugs, or are homeless are also at higher risk.
Again, this new CDC warning doesn’t mean you should panic. It is not the same as the Covid-19 pandemic. Just try to keep the aforementioned precautions. And if you or your child do get a GAS infection, get the right antibiotic treatment as soon as possible. In the meantime, watch for any signs that the GAS infection may worsen and become invasive. After all, you don’t want to add “i” to the GAS problem you have.
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