June 18, 2024

Vita Nectar

Health is the main investment in life

Strep surge: While flu has peaked out, doctors seeing record numbers of throat illness

7 min read

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Edmonton hospitals are seeing hikes in strep throat that are taking a toll on some Albertans.

Numbers of group A streptococcal (GAS) and especially its more deadly cousin, invasive group A streptococcal (iGAS), are impacting hospitals in Alberta.

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According to the B.C. Centre for Disease Control, four B.C. children under the age of 10 have died from iGAS just since mid-December. Six children in Ontario died from it between last Oct. 1 and Dec. 31. In that same period, 48 people died from iGAS in Ontario, according to numbers from the Ontario government.

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As of Friday, Alberta had stats for 2023 as a whole available.

“In 2023 there were 54 deaths and 669 hospitalizations, however we are still compiling the data and do not have any further breakdown at this time,” said Charity Wallace, assistant director of communications for Alberta Health.

“There has been an increase in group A streptococcal and invasive group A streptococcal infections in Alberta, however, only invasive group A strep cases are reportable to Alberta Health.”

There were 768 reported cases of iGAS in Alberta in 2023. That’s a jump from 434 total cases in 2022 and 359 cases in 2021.

A breakdown of the 768 cases showed 98 cases were among kids ages nine and under, and 32 cases in children 10-19 years of age.

On average, nationwide, iGAS is fatal for about one in 10 patients.

Rates of iGAS have been increasing since 2017, Wallace said.

According to the Government of Alberta website, between 2000 and 2022, incidents of iGAS have steadily increased in the province. The number of cases in the province has roughly tripled to 434 in 2022 from 150 in 2000, while Alberta’s population has risen about 50 per cent in the same time period, going to 4.54 million from roughly just over three million.

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“The majority of iGAS cases and deaths occur in adults, particularly those that are vulnerable, unstably housed and/or suffer from substance abuse-related issues,” she said.

“Alberta Health is actively monitoring the situation and encourages health-care providers to be aware of GAS signs and symptoms, testing and treatment options.”

‘It scared me a little bit’

Dr. Louis Francescutti, an emergency room physician at the Royal Alexander Hospital who also teaches at the U of A, said he was troubled by reports of a strep spike.

“It scared me a little bit, you see so many sore throats,” he said.

It’s important for patients and health-care providers not to blow concerns of strep off, he said. His advice to parents who suspect their child’s illness might be strep, “Come right out and say, ‘Is this one of those weird sore throats?’ ”

Parents often have the best initial sense of whether a child is ill.

“If the parents feel the child is ill, the child is usually ill,” he said. “Advocate for your kid. If you think something’s wrong with your kid, don’t be afraid to seek a second opinion,” he said.

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Dr. Shazma Mithani is an emergency physician at Royal Alexandra Hospital and Stollery Children’s Hospital, and an assistant clinical professor at the U of A.

She said while group A Strep can usually be treated with a simple course of antibiotics, rare strains can cause invasive disease that can lead to death.

“We know that influenza infection is a risk factor for contracting invasive group A streptococcus, which is yet another reason it’s important to get your entire family vaccinated for the flu,” she said.

‘Huge influx of patients’

One Edmonton-area nurse said he is seeing 40 per cent more cases this winter than they’ve ever seen before.

Ben Gronberg is an RN at Sturgeon Hospital, where he’s seeing people waiting for hours in the ER just to get a swab that will test for strep, COVID-19, flu and RSV — the “trifecta” of winter illnesses.

“We are seeing a huge influx of patients getting strep throat treatment,” he said. “I think pharmacy testing is huge. It’s incredibly helpful to alleviate the pressures we’re seeing. I’ve heard a lot of people saying to me that they just went to the pharmacy.”

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Gronberg said he’s frustrated that the cost of the quicker pharmacy test isn’t typically covered by the government.

Most health-care facilities can offer testing with results in a day or two. A number of pharmacy clinics are popping up around the province. Pharmacies with clinics attached may have the capacity to analyze strep test results within 15 minutes or so and typically charge $30.

Eddie Wong, a pharmacist at the Kingsway Mall Shopper’s Drug Mart, said as long as there’s a pharmacist certified to prescribe, they can typically prescribe and fill antibiotics prescriptions for strep in one step.

“There’s a time savings. When we swab you, if we detect bacteria, we can prescribe antibiotics if they’re appropriate, and get you back on your way,” he said.

He cited stats that 6.5 million Canadians don’t have a family doctor.

“That’s one in five, across the country. Any little bit helps — if we can do our part, that’s a nice contribution, I hope.”

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Strep throat symptoms

Symptoms of non-invasive group A streptococcus may include fever, painful swallowing, and mild skin infections like rash, sores, and blisters.

Invasive group A streptococcal infections (iGAS) are rare. They can cause severe symptoms like trouble breathing (pneumonia).

Both invasive and non-invasive GAS call for antibiotics. Early treatment may keep symptoms and complications from becoming severe.

In rare cases, a GAS infection can lead to invasive, more severe disease. This can include lung infections, such as pneumonia, flesh-eating disease (necrotizing fasciitis) — a quickly progressing infection that destroys skin and muscle tissues — and toxic shock syndrome with symptoms including fever, unsafe drop in blood pressure, vomiting and diarrhea when bacteria produce toxins, causing organs to shut down.

A federal report said in rare cases, non-invasive group A streptococcus can lead to severe muscle pain and tenderness (myalgia), kidney disease, and inflammation of the joints, heart, skin and central nervous system — acute rheumatic fever.

The bacteria that cause GAS diseases normally live on our skin or in our throat — people can carry them and be asymptomatic.

They spread with direct contact with infected wounds, and with fluids when an infected person coughs or sneezes.

Prevention measures include handwashing before and after eating, and after coughing or sneezing.

Sneezing into the bend of your arm protects others. Used tissues should be thrown away.

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