Maine CDC is investigating
an increase in the number and severity of invasive group A Streptococcal (GAS) infections
in the first half of 2015 compared to a similar time frame in previous
years. Maine CDC received reports of 15 cases of invasive GAS in April
and the first week of May alone, almost half of the 33 cases reported to date
this year. Of those 15 cases, six resulted in streptococcal toxic shock
syndrome (STSS), a more serious presentation in which the disease affects
multiple organs. At this time in 2014, Maine had reports of 23 cases of
invasive GAS and nine cases of STSS.
Most GAS infections are
relatively mild such as “strep throat,” scarlet fever or impetigo.
Invasive GAS disease is more severe and includes pneumonia, cellulitis and the
least common forms but most severe forms -- necrotizing fasciitis and
STSS.
Invasive GAS infections are seasonal,
peaking December through April. The spread of GAS can be prevented by good hand
washing, especially after coughing and sneezing. People with sore throats
diagnosed as strep throat should stay home from work, school or day care until
24 hours after taking antibiotics.
Recommendations:
Health care providers should
consider invasive GAS in any patient who presents with early signs of STSS and
should collect culture specimens and consider prompt antibiotic treatment.
Because invasive GAS infections can progress rapidly, providers are encouraged
to be familiar with early signs of STSS:
- Fever
- Abrupt onset of generalized or localized severe pain,
often in an arm or leg
- Dizziness
- Influenza-like syndrome
- Confusion
- A flat red rash over large areas of the body (occurs in
10% of cases)
Reporting requirements:
All cases of suspected invasive
GAS and STSS should be reported by phone to the Maine CDC at 1-800-821-5821, or
by fax to 1-800-293-7534.
For more information:
- Maine CDC’s Group A Strep webpage: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/group-a.shtml
