A surge in invasive group A streptococcal reports in Australia has prompted The Kids Research Institute Australia researchers to call for a unified national public health response, with cases tipped to increase.
The contagious bacteria – which has no vaccine yet – can cause flesh eating necrosis, strep throat, toxic shock, skin infections, acute rheumatic fever and rheumatic heart disease, with 20 per cent of invasive cases causing death.
Necrotising fasciitis, which eats away at the flesh, can have reported death rates as high as 70 to 80 per cent.
Reported invasive Strep A cases increased in Europe last year with the World Health Organisation (WHO) releasing a statement noting a spike in cases in France, Ireland, Netherlands, Sweden and the UK in children under 10.
Australia followed with the National Communicable Diseases Surveillance (NCDS) recording 1,184 cases in 2022, prompting Victoria to issue an advisory.
Western Australia, New South Wales and the Australian Capital Territory issued similar advisories in January 2023, bumping up case numbers to 547 in the first quarter of this year.
The bacteria spreads rapidly among household contacts up to 200 times higher than the general population 30 days following exposure.
The Kids Research Institute Australia analysis, published in the Medical Journal of Australia, noted the current surge in invasive Strep A cases could be caused by new strains, relaxed hygiene standards after the Covid-19 pandemic along with reduced immunity.
Lead researcher Dr Thel Hla from the Wesfarmers Centre of Vaccines and Infectious Diseases based at The Kids Research Institute Australia, said wide variations of Strep A definitions and health advice nationally could underestimate the true burden of the disease.
“The national surveillance system for Invasive Strep A came into effect fairly recently in July 2021 to allow us to examine and track patterns of disease, but it is still in its infancy,” Dr Hla said.
There remains a broad lack of consensus about public health management for invasive Strep A so there’s an urgent need to synthesise clinical and public health prevention priorities to guide a national public health response
“This means agreeing on what constitutes a close contact, the types of drugs to administer for treatment and developing national guidelines - this should be a priority while Strep A vaccine development is underway.”
While the disease can be treated with penicillin and other antibiotics, deaths and disability still occur even with treatment.
Global efforts to eradicate Strep A is a high priority with significant investment directed into vaccine development but availability will take years with clinical trials and regulatory approvals needed.
The Australian Pathogenic Genomic Program is currently building a Strep A surveillance system nationally with epidemiological data essential to guide future vaccine roll out and treatment measures.
The journal article Getting to grips with iGAS surveillance in Australia: are we experiencing an epidemic? can be viewed here.