Invasive Group A strep is quick and merciless, N.B. mother warns as deaths climb to 6
Carolle de Ste-Croix, who almost lost her daughter Madeleine in 2007, wants people to be aware of symptoms
A New Brunswick mother who almost lost her child to invasive Group A strep about 16 years ago says she's still haunted by the experience and is sharing her family's ordeal in the hopes of helping others.
Carolle de Ste-Croix, who lives in Port Elgin, says her daughter Madeleine developed three infections within about seven weeks in 2007 when she was five years old.
Her immune system was so weakened by the repeated infections that she became septic and her organs started to shut down, said de Ste-Croix, a former Liberal MLA for Dalhousie-Restigouche East, where they lived at the time.
She describes her daughter's survival as "nothing short of miraculous."
With cases of invasive Group A strep on the rise in the province and across the country, de Ste-Croix wants to make sure other people are aware of the symptoms and the risks.
"Invasive strep A is quick, it's dangerous and it's merciless," she said.
"You know, we hear these stories of folks who have had flesh-eating disease, or scarlet fever, or who went septic like Madeleine, but the cases are so elevated right now, it's so worrisome."
New Brunswick has now recorded a sixth death from invasive Group A streptococcal infections in January and 30 confirmed cases, the Department of Health confirmed on Thursday.
That's double the national fatality rate of roughly one in 10 infected people.
It's also more than half New Brunswick's annual death toll for 2023, when 10 of 107 confirmed cases died.
Group A Streptococcal bacteria are commonly found on the skin or in the throat and typically cause mild illnesses, such as strep throat, scarlet fever and skin infections.
But when these bacteria spread into sterile parts of the body, such as the bloodstream, the fluids around the brain, lungs, or spine, or into soft tissue, they become "invasive" Group A strep infections, such as necrotizing fasciitis, more commonly known as flesh-eating disease, and toxic shock syndrome, which occurs when the bacteria produce toxins that can cause various organs to stop functioning.
'My God we were lucky'
De Ste-Croix said she felt compelled to post about her family's story on Facebook to remind people how serious strep A can be.
She dedicated the post to the daughter of a childhood friend who died in 2020 because of invasive Strep A that shut down her organs, and she publicly thanked Madeleine's doctors for saving her life.
"My God we were lucky," she wrote, noting invasive Group A strep was so rare at the time that the doctors requested permission to document Madeleine's case as a case study, aiming to learn and improve future treatments.
Madeleine's first infection, which was non-invasive, started with a very sore throat and a fever, said de Ste-Croix.
She was treated with antibiotics. "We thought, 'This is good, all good.'"
A week later, she was sick again with another non-invasive infection.
After a second round of antibiotics, she was better for a week or two. Then she got "very sick" with invasive Group A strep.
"The first real symptom that we knew that something was really not going well was that she wasn't breathing properly. She was experiencing sleep apnea because her throat was closing up on her," said de Ste-Croix.
After that, "everything is a bit of a blur."
Madeleine's father took her to the Dalhousie hospital's emergency department, where a doctor "immediately looked in her throat and said, 'Oh, goodness.'"
He called an ear, nose, throat specialist at the Bathurst hospital, who met Madeleine at the door and admitted her to intensive care.
He started her on a very intense course of two different antibiotics and an anti-inflammatory, said de Ste-Croix. "I remember them saying her blood is at 65 per cent oxygen. Usually, we're all up to about 96 [per cent]."
They couldn't intubate her because her throat was too swollen and she was too unstable to transfer to a children's hospital.
"It was a very harrowing 12 hours," as Madeleine battled for her life.
The 'what-ifs' have always haunted me- Carolle de Ste-Croix, mother
The image that stands out for de Ste-Croix is when she arrived at the ICU, "in Mama bear mode," and a registered nurse in the hallway looked up at her.
"I didn't really know, because I had just kind of gotten there, but she knew how bad things were, and she was afraid of what might happen," she said.
"The look on her face has always haunted me. The 'what-ifs' have always haunted me. We were so, so lucky."
The medications worked and Madeleine was stable enough for doctors to operate. They took out her tonsils and adenoids — "anything where that [bacteria] could have been hiding," said de Ste-Croix.
About a week later, Madeleine was back home, running around outside. "It was pretty miraculous."
The aftermath
She did not escape unscathed, however. The aftermath of septicemia has left her with health issues, said de Ste-Croix.
Because her immune system was so depleted, three weeks later, she contracted hand-foot-and-mouth disease, a viral infection common in young children.
Within four or five years, she developed pancreatitis twice and had to be hospitalized.
She has had multiple issues with her thyroid and underwent heart surgery. "It hits all the organs, right?"
Still, Madeleine is doing "incredibly well," said de Ste-Croix. She's graduating this year from Mount Allison University and is "excelling at everything she's doing.
"From what we know right now, her future is bright — health wise, physically. But it is difficult," she said. "It always stays with you."
Seek immediate care
De Ste-Croix said she doesn't want to create panic, but urges anyone with symptoms to immediately seek medical attention and to request a swab test.
"I know it's hard and frustrating to access care in New Brunswick. But it's worth the wait," she wrote, noting early treatment is crucial to avoid the many complications of invasive strep.
"The thought of any family enduring what we have is unbearable."
According to the Department of Health, the signs and symptoms of invasive disease include severe pain, swelling and redness of the affected area, dizziness and confusion, widespread red rash, nausea, vomiting and abdominal pain.
The development of symptoms can be rapid in invasive disease, the department's website says.
The bacteria can be spread by direct contact with infected wounds on the skin, or fluids from the nose or throat of an infected person, such as through coughing or sneezing.
Six New Brunswick pharmacies are offering point-of-care testing and prescribing for Group A strep as part of a pilot project announced in July.
With files from Information Morning Moncton