Mary Wilson
Well-known member
Distributed via the CDC Health Alert Network
December 22, 2022, 1:45 PM ET
CDCHAN-00484
Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and public health authorities of a recent increase in pediatric invasive group A streptococcal (iGAS) infections. In November 2022, CDC was notified of a possible increase in iGAS infections among children at a hospital in Colorado. Potential increases in pediatric iGAS cases in other states were subsequently noted by contributors to the Infectious Diseases Society of America’s provider-based Emerging Infections Networkand by certain jurisdictions participating in CDC’s Active Bacterial Core Surveillance System (ABCs). This increased number of pediatric iGAS cases in some jurisdictions has occurred in the setting of increased circulation of respiratory syncytial virus (RSV), influenza viruses, SARS-CoV-2, and other respiratory viruses. While the overall number of cases has remained relatively low and iGAS infections remain rare in children, CDC is investigating these reports.
This Health Advisory highlights the recent rise in iGAS infections in children, the increased seasonal risk of iGAS disease for all age groups, and the importance of early recognition, diagnosis, and appropriate treatment of these diseases in children and adults.
Background
Group A Streptococcus (GAS) bacteria can cause a range of illnesses, from pharyngitis (i.e., strep throat) and skin and soft tissue infections to uncommon but severe diseases such as sepsis, streptococcal toxic shock syndrome, and necrotizing fasciitis. These severe and invasive diseases are associated with high mortality rates and require immediate treatment, including appropriate antibiotic therapy.
Similar to other agents spread primarily by the respiratory route, cases of GAS, including both iGAS and streptococcal pharyngitis (“strep throat”), tend to have a pronounced seasonal pattern with a peak in December through April in the United States. Strep throat is most common among school-aged children (i.e., 5–15 years of age), and exposure to someone with strep throat is a risk factor for iGAS infection. In addition, increased rates of iGAS infection have been noted during times of increased influenza activity. Seasonal influenza activity is currently high in the US and above the levels seen in recent years.
People with concurrent or preceding viral infections, such as influenza and varicella (chickenpox), are at increased risk for iGAS infection. Other groups at higher risk for iGAS include:
- People aged 65 years or older
- American Indian and Alaska Native populations
- Residents of long-term care facilities
- People with medical conditions such as diabetes, malignancy, immunosuppression, chronic kidney, cardiac, or respiratory disease
- People with wounds or skin disease
- People who inject drugs or who are experiencing homelessness
- Offer prompt vaccination against influenza and varicella to all eligible persons who are not up to date.