MSGID: 1:317/3 642f9c63   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Physicians should be on alert for group A strep as cases experience   
   historic rise, study finds    
      
     Date:   
         April 6, 2023   
     Source:   
         University of Texas Health Science Center at Houston   
     Summary:   
         The U.S. experienced an unprecedented number of group A   
         streptococcal infections in children from October to December of   
         2022, which should alert physicians to check for the potentially   
         deadly infectious disease as the country moves out of the pandemic.   
      
      
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   FULL STORY   
   ==========================================================================   
   The U.S. experienced an unprecedented number of group A streptococcal   
   infections in children from October to December of 2022, which should   
   alert physicians to check for the potentially deadly infectious disease   
   as the country moves out of the pandemic, according to research published   
   by UTHealth Houston.   
      
      
   ==========================================================================   
   The study, led by senior author Anthony R. Flores, MD, PhD, MPH,   
   associate professor and chief of pediatric infectious diseases at McGovern   
   Medical School at UTHealth Houston, was published this month in Clinical   
   Infectious Diseases.   
      
   During the COVID-19 pandemic, the rate of other infectious diseases   
   dropped due to safety measures such as social distancing and mask-wearing,   
   according to researchers. But as those safety measures began to lift,   
   diseases such as respiratory syncytial virus, the flu, and group A strep   
   all experienced a resurgence in cases.   
      
   Infectious disease experts first noticed the rise in cases in the UK,   
   now with 355 deaths of which 40 were children dying from severe group   
   A strep infections. Researchers such as Flores then turned to what was   
   occurring in the U.S.   
      
   "In 2020 and 2021, the overall number of infections that we saw due to   
   group A strep were far lower than what we had seen before the pandemic,"   
   Flores said.   
      
   "When we look at the number of infections by quarter, historically, pre-   
   pandemic cases of group A strep were pretty consistent from quarter   
   to quarter with a little variation and more infections in the winter   
   months. But during the last quarter of 2022, the number of infections   
   we saw, including invasive infections, were far greater than what we'd   
   ever seen before."  In 2022, a total of 318 individual group A strep   
   cases were identified in young children in Houston. Researchers looked   
   at three group A strep disease types: invasive group A strep (iGAS),   
   skin and soft tissue infections (SSTI), and pharyngeal, or throat,   
   infections (PHG). The study found that group A strep strains derived   
   from iGAS accounted for 31.4%, SSTI for 17.6%, and pharyngeal for 50.9%.   
      
   "Proportionately speaking, if we just looked at the percentage of all   
   infections that were invasive, it was the same as we had seen in the   
   past," Flores said. "It wasn't like, all of a sudden, 75% of our cases are   
   invasive diseases. What we're seeing is an increase in the total number   
   of infections."  The study also found that emm12 group A strep strains   
   were disproportionately represented, compared to emm1group A strep,   
   which was the dominant emm type pre-pandemic. Emm type is a marker that   
   differentiates different strains of group A strep.   
      
   "By looking at the molecular epidemiology, we can look at specific things   
   about the bacteria that give us clues as to whether or not something is   
   changing," Flores said. "What we will be observing as we go forward is   
   whether it will shift back to what it was pre-pandemic, and if it doesn't,   
   then we hope to have some work underway that is going to tell us why."   
   As cases of group A strep continued to be high in the first quarter of   
   2023 in Houston, the disease is a cause for concern for pediatricians   
   who see children with symptoms of group A strep.   
      
   "The reason why this is important is we're seeing group A strep   
   more frequently than what we have seen in the past, and therefore,   
   if a physician has a child coming in with a sore throat or with a skin   
   infection, we should have a high index of suspicion for group A strep,"   
   Flores said.   
      
   Co-authors on the paper from McGovern Medical Schools department of   
   pediatrics infectious diseases division included Aya Aboulhosn, MD;   
   Misu A. Sanson- Iglesias, MD, PhD; Luis Alberto Vega, PhD; and Maria   
   G. Segura, MD.   
      
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             o Health_&_Medicine   
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                   # Lung_Disease # Eye_Care   
       * RELATED_TERMS   
             o Scarlet_fever o Spanish_flu o Pandemic o H5N1 o Bubonic_plague   
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   ==========================================================================   
   Story Source: Materials provided by   
   University_of_Texas_Health_Science_Center_at_Houston.   
      
   Original written by Halle Jones. Note: Content may be edited for style   
   and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Aya Aboulhosn, Misu A Sanson, Luis Alberto Vega, Maria G Segura,   
      Lauren M   
         Summer, Marritta Joseph, J Chase McNeil, Anthony R Flores. Increases   
         in group A streptococcal infections in the pediatric population   
         in Houston, TX, 2022. Clinical Infectious Diseases, 2023; DOI:   
         10.1093/cid/ciad197   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2023/04/230406190358.htm   
      
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