New Brunswick

Strep A deaths spike in N.B., include young children, data shows

Invasive Group A strep infections have already claimed the lives of two New Brunswickers this year, compared to 10 all of last year and an annual average of six over the previous five years, data from the Department of Health reveals. This spike in deaths includes young children.

A child under 9 has already died in 2024, compared to 2 last year and average of 0.4 over previous 5 years

An electron microscope image shows group A streptococcus during phagocytic interaction with a human neutrophil.
A microscopic view of Group A streptococcus bacteria (orange), which can cause a spectrum of disease, ranging from milder infections like strep throat to life-threatening illness. (National Institute of Allergy and Infectious Diseases/The Associated Press)

Deaths from invasive Group A strep infections have spiked in New Brunswick, data from the Department of Health reveals.

Two people have already died this year, including a child under the age of nine and a person aged 10 to 59.

"It's important to note that this data is still under review and is subject to change," department spokesperson Sean Hatchard said in an emailed statement.

Last year, there were 10 deaths in total, which represented a nearly 67 per cent jump. At least two of these were children, the data shows.

Group A streptococcus is a common, often-harmless bacteria found on the skin or in the nose and throat. It can cause a variety of common infections, such as strep throat, scarlet fever and skin infections, such as impetigo, which are typically treated with antibiotics.

But when the bacteria get into areas of the body where bacteria are not usually found, such as the blood, muscles, or lungs, they cause more severe infections called "invasive" Group A streptococcal infections, or iGAS.

These are reportable diseases in New Brunswick and can include life-threatening conditions such as necrotizing fasciitis, where soft tissue below the skin starts to die, and toxic shock syndrome, the rapidly worsening symptoms from failure of many different organs.

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Of the 10 deaths due to iGAS reported between January and December 2023, two were children nine years old or younger, said Hatchard, and they represented 20 per cent of the deaths.

The other iGAS deaths included three people aged 10 to 59, and five people aged 60 or older.

Hatchard did not respond to questions about why such large age groupings are used.

Between 2018 to 2022, New Brunswick saw an average of six iGAS deaths per year, he said.

Children under nine represented fewer than seven per cent of these, at an average of 0.4 deaths per year.

'Concerning trend'

On Tuesday, Dr. Yves Léger, the province's acting chief medical officer of health, warned about the high number of severe Group A strep infections in the province — "at least double" the usual rates, and some of them fatal.

He described it as a "concerning trend," one being seen across Canada and in other countries. 

New Brunswick recorded 107 confirmed cases of invasive Group A streptococcal infections between January and December 2023, Hatchard confirmed Wednesday.

Children up to nine years old represented 15 of these, he said, or 14 per cent.

In the previous five years the annual provincial average of iGAS cases was 51, said Hatchard.

Among children nine or under, the average over those five years was three cases. That's fewer than six per cent of infections between 2018 and 2022.

'No obvious explanation'

Asked what might account for the increase, Léger told CBC "no obvious explanation has been identified yet."

"We're seeing it in most age groups. So it's not limited to a specific group or a specific age group."

It's not related to a specific strain of bacteria either, he said.

"At times we've seen increases related to what we call an emerging strain or a new strain that's making its way across the population, but that doesn't seem to be the case at this point in time.

"Again, the main message, we don't quite know why at this point, but certainly thought it prudent to share that with the public."

Watch for symptoms, seek treatment

Léger urged people to take measures to protect themselves and others against severe Group A streptococcal infections and other respiratory illnesses, such as COVID-19, the flu and respiratory syncytial virus, commonly known as RSV.

These can include staying home when sick, masking in public places, washing your hands, and keeping up to date with vaccines, he said.

People should also watch for symptoms and seek medical treatment to avoid spread, said Léger.

With non-invasive Group A streptococcal infections, symptoms may include sore throat, fever, rash or a skin infection that is red, swollen, warm and tender to the touch, according to the province's website.

The early signs and symptoms of invasive disease are high fever; severe pain, swelling and redness of the affected area; dizziness and confusion; widespread red rash; nausea, vomiting and abdominal pain, it says. "The development of symptoms is rapid in invasive disease."

"Public Health is continually monitoring the spread of various communicable diseases within the province, including invasive Group A streptococcal (iGAS) infections," Hatchard said in an emailed statement.

These severe infections are "tracked, and individual cases and contacts are managed by Public Health staff to reduce the risk of ongoing spread," he said.

With files from Mariam Mesbah