Alberta health experts urge caution as Canada sees record number of invasive Strep A infections

Canada's public health agency (PHAC) has logged a record number of potentially deadly strep A infections across the country, sparking major concerns from Alberta infectious disease experts and pharmacists.

PHAC says the increase in these types of invasive cases is particularly noticed in children under the age of 15. Already, at least six children have died in Ontario.

As of Jan. 9, the National Microbiology Laboratory has logged more than 4,600 cases from 2023, which is the highest annual total ever recorded in Canada and a more than 40 per cent increase over a previous peak in 2019.

According to PHAC, invasive group A streptococcus is endemic in the country, with 2,000 to 3,000 cases reported annually in recent years.

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In Alberta, the province says there were 768 confirmed cases of invasive group A streptococcal (iGAS) in 2023, which makes it the highest year on record.

That’s a jump from 434 total cases in 2022 and 359 cases back in 2021.

The 2023 numbers include 98 cases in individuals nine years and younger, 32 in those aged 10-19 and 638 in the 20-plus age group.

“The majority of iGAS cases and deaths occur in adults, particularly those that are vulnerable, unstably housed and/or suffer from substance abuse-related issues,” Alberta Health said in an emailed statement Wednesday.

iGAS rates have been on the rise since 2017, with the largest increase in cases coming from September 2022 to August 2023.

“What we're seeing right now is not so much an increase in strep throat, but actually an increase in invasive disease (GAS) caused by these bacteria,” said Dr. Stephanie Smith, a University of Alberta infectious disease expert.

“So that would be things like where we find bacteria and this bacteria in the blood or deep in the soft tissues.”

Smith adds that this type of bacteria can also cause lung infections like pneumonia, debilitating flesh-eating disease, or even toxic shock syndrome, which is when bacteria produce toxins that cause organs in the body to stop functioning.

She notes that the increase in cases is potentially linked to a larger-than-normal amount of respiratory viral infections over the last two years.

“So yes, we've obviously just come through a pandemic, but in the last couple of years, we've also seen a lot of influenza RSV, and we know that group A strep can follow those respiratory viral infections.”

'HIGHEST NUMBER OF STREP CASES IN MY CAREER': CALGARY PHARMACIST

Jason Chan Remillard is the owner of the Northmount Pharmasave in Calgary and says the increase in strep throat and group A streptococcus cases has been evident from the spike in patients he’s seen experiencing symptoms.

“Overall in 2023, there were a lot more cases of strep. I've been a pharmacist since 2001 and this is the highest number of strep cases in my career,” he said.

“The (bacteria) is still 100 per cent treated by penicillin and even if someone is allergic to penicillin, alternatives are also effective.”

Chan Remillard also says that early treatment, which includes antibiotics for both invasive and non-invasive GAS diseases, can help make symptoms less severe or prevent more serious complications.

Proper handwashing, wiping down surfaces with sanitizer and staying away from others who are sick is also recommended to prevent transmission.

Visit your health-care provider for a diagnosis if you have become ill and think it is a Group A streptococcus (GAS) disease – either invasive or non-invasive.

Anyone diagnosed with a GAS infection should stay home for 24 hours after starting antibiotics, to help avoid making other people sick.