Strep diseases may increase in winter
This winter is shaping up to be a bad one for deadly bacterial diseases, including the so-called flesh-eating disease, an Ontario researcher said yesterday. If a developing pattern continues, there will be dozens of new cases of toxic shock and necrotizing fasciitis in the province, said Dr. Donald Low, chief of microbiology at Mount Sinai Hospital and Princess Margaret Hospital in Toronto.
It is rare to see these bacterial infections develop in the warm months, he noted, but a number of cases have been reported this summer, including several in the area around Oakville, west of Toronto.
The research is a follow-up to a study of streptococcal group A infections in Ontario reported yesterday in the New England Journal of Medicine.
“This may reflect different strains of the bacteria coming into the province,” he said. But the research team, which also included researchers from the Hospital for Sick Children, believes these diseases are not newly emerged killers.
Dr. Low noted that the bacteria are closely related to strains that caused deadly epidemics of scarlet fever in the early part of the century. That bacterial infection, which caused high fever and turned the skin bright red, “deserved a lot of respect,” he said. “Infection was cause to put a person in quarantine.”
For some reason, cycles that saw epidemics of scarlet fever virtually disappeared in the 1930s. The outbreaks that emerged in the 1980s of toxic shock syndrome, which dangerously reduces blood pressure, and flesh-eating disease, which ravages body tissue, seem to follow similar wave-like patterns.
Usually the victims are either elderly or already run down from a chronic condition such as heart or lung disease, diabetes or infection with HIV, Dr. Low said. Children suffering from chicken pox are also at risk.
Invasive infections kill about 15 per cent of people who developed them, but in people over 64, the death rate was 29 per cent. For toxic shock, the death rate among the elderly was 81 per cent.
People living in a house with an infected family member or in hospitals or care centres are also at increased risk of developing the diseases. The study found that people who have four or more hours of contact a day with an infected person run the greatest risk of also developing the disease, and the risk is highest among the elderly.
Strep includes more than 100 different bacteria, only a few of which cause rapid invasion of body tissues. The bacteria can be treated with antibiotics and provincial regulations suggest that people who live in homes with infected people be given protective doses of antibiotics. The researchers said their study could not evaluate whether such protective antibiotic treatment is effective.
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