Sharp rise in number of serious infections caused by flesh-eating bacteria

The group A streptococcus, also known as the flesh-eating bacteria, is spreading. The number of patients with subcutaneous infection, caused by the group A streptococcus, increased sharply since last March: from an average of four to fifteen per month. In this article Nina van Sorge, Professor of Translational Microbiology at Amsterdam UMC and member of the Amsterdam institute for Infection and Immunity, shares her knowledge about the group A streptococcus (strep A).

The consequences of strep A infection are far-reaching. A subcutaneous infection can lead to the death of limbs and-if vital organs are affected-to the death of the patient. Other pathologies caused by the group A streptococcus are also occurring more frequently than before. For example, between March 2022 and April 2023, an average of 21 women per month suffered from maternal fever. By comparison, before the corona pandemic, the average was 10 women per month.

A third disease caused by the streptococcus bacteria is meningitis. Statistics on this condition also paint a disturbing picture. Normally, there are an average of five cases of meningitis caused by this bacteria per year. Last year, however, there were as many as 19 cases and this year already 14, according to figures from the Dutch Reference Laboratory for Bacterial Meningitis (NRLBM), part of Amsterdam UMC.

Washing your hands

The Rijksinstituut voor Volksgezondheid en Milieu (National Institute for Public Health and the Environment, RIVM) is in the dark about the cause of the increase. "Possibly the increase has to do with COVID-19, but we do not know that for sure," says spokesman Coen Berends. "Before we come up with any conclusions, we want to follow the trends for a longer period of time."

During the COVID-19 pandemic, there were actually fewer serious infections with group A streptococci than before. "Through measures such as hand washing, keeping distance and wearing mouth masks, less transmission of the bacteria took place," Prof. van Sorge, head of the NRLBM, explains.

Are we currently talking about a catch-up effect? "Yes, but there seems to be more going on," says the microbiologist, who has been researching diseases caused by group A streptococci for years. "We now see that a certain variant, the M1UK, is very dominant. We used to see a more varied picture. Possibly this variant has properties that increases the risk of meningitis."

Streptococcus bacteria strike primarily in three different age groups, Prof. van Sorge knows: young children, the elderly and a group in between. About 10 percent of patients involve children ages 0 to 5. A third involve people over 65. And 20 to 25 percent involve people between the ages of 30 and 40. ''That in-between group is something particular. These are people who are in the prime of their lives and suddenly become seriously ill."

We cannot always explain why someone becomes seriously ill

Nina van Sorge

Professor of Translational Microbiology and head of the Dutch Reference Laboratory for Bacterial Meningitis (NRLBM) at Amsterdam UMC

Insidious

Group A streptococcus occurs in 10 to 15 percent of people and usually does no harm. Things go wrong when the bacteria manage to enter the body through a wound. Often this happens to someone with weakened immune systems. But this is not necessary. "We cannot always explain why someone becomes seriously ill," Prof. van Sorge says. "That is what makes this bacteria so insidious."

Scientists have tried for years to develop an effective vaccine against group A streptococcus, says the microbiologist. But because the bacterium easily mutates, changes properties, they have not succeeded so far. However, there are antibiotics to which the bacterium is sensitive.

Source: read the original (Dutch) article by Maarten Costerus in reformatorisch dagblad here.