4 dead in streptococcus A outbreak at seniors' home in Montreal's west end

Montreal health authorities are confirming that four people have died from a streptococcus A outbreak at a private seniors' residence.

A spokesman for the regional health authority says six cases of invasive group A streptococcal infections had been detected in the residence in Montreal's west end as of Monday, including the four fatal cases.

Jean-Nicolas Aubé says the disease appears to have spread to a second seniors' home, where one case has been detected.

The health authority for the west of Montreal — the CIUSSS de l'Ouest-de-l'Île-de-Montréal — confirmed the outbreaks are at Les résidences floralies locations in the Lachine and LaSalle boroughs.

Ramona Rodrigues, the CIUSSS's director of prevention and infection control, said teams have mobilized at the two residences to try to limit the spread.

An evaluation revealed that compliance with regular handwashing, glove-wearing and other hygiene measures was low and that needed to be corrected, she said. The teams will make sure masks and COVID protocols are respected, she said.

The bacteria is spread through droplets and touch, Rodrigues said, and that's why COVID protocols will be effective. 

Specialists are now onsite to give constant feedback to employees on their compliance with hygiene and safety protocols, she said.

"Also to make sure gloves are used appropriately so there is no cross-transmission of this bacteria," she said.

Every resident has been screened for the bacteria, as have staff and regular visitors, she said. Antibiotics are offered to all residents, positive or negative, and further screening is encouraged for all families who have a positive case at home.

She said cases started back in June at the Lachine location, where there were five in total. Then another case popped up in LaSalle, she said. There are nearly 500 residents between the two locations, she noted.

It's highly likely an employee of the residence, moving between the two facilities, spread the bacteria, she said.

Rodrigues said some residents will be moved to curb the spread, with strict testing and prevention measures followed.

The government of Canada's website says strep A bacteria is usually associated with mild illnesses such as strep throat and sinus infections.

However, in rare cases, infection can cause more invasive and life-threatening conditions including pneumonia, flesh-eating disease and toxic shock syndrome.

Dr. Matthew Oughton, an infectious diseases specialist at Montreal's Jewish General Hospital and an assistant professor at McGill University, said the bacteria is easily spread but also easy to detect.

It's common in long-term care facilities and can show up in medical facilities, military barracks and other places where people are living in close quarters, he said.

It can be invasive and cause serious illness, he said, and that's why aggressive measures are taken to stop the spread. Once an outbreak is recognized, promptly implementing those measures can get the situation under control, he said.

"Thankfully, although group A streptococcus is a very aggressive organism, it has never been one to be terribly antibiotic resistant," said Oughton.