Infection
‘Rare’ strep A infections have jumped in Queensland, with a childcare worker currently in hospital
Sep
A childcare centre worker is in intensive care with a severe Group A Streptococcus infection after a toddler, who attended the same facility, died last month.
Key points:
- A toddler who was infected with strep A attended the same childcare facility as a now-hospitalised worker
- Close contacts have been offered preventative antibiotics and the public should be alert, not alarmed
- Queensland’s Chief Health Officer John Gerrard said an outbreak of strep A is rare
The 20-month-old died on August 6 and is understood to have later tested positive to strep A in her bloodstream.
Both the toddler and the now-hospitalised worker attended the same south-east Queensland childcare facility.
While the two cases at the centre are considered a small cluster of invasive Group A Streptococcal disease, Queensland’s Chief Health Officer John Gerrard described the outbreak as rare.
“It may well be that there are some strains of Group A strep that are more virulent, and more prone to cause invasive disease than others,” Dr Gerrard said.
He said close contacts of the two cases had been offered preventative antibiotics, adding the greater public should be “alert but not alarmed”.
The outbreak comes amid a surge of invasive strep A infections across Australia and internationally.
“This … is likely to be as a result of the disruption caused by COVID-19 and the fact that the pattern of infectious disease during the course of the last two years has been quite aberrant, quite abnormal,” Dr Gerrard said.
In Queensland, health data shows invasive strep A infections have more than doubled from 176 reported cases at this stage of the year in 2021, to 435 so far in 2023. The state’s five-year average up to September 11 is 227 cases.
Dr Gerrard, an infectious diseases physician, said 25 Queenslanders had died from invasive Group A strep infections so far this year – more than double the nine cases for the whole of 2022.
What is strep A and how do I know if my child is infected?
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Group A Streptococcus is a common bacterium spread from person to person through unwashed hands or via coughing, sneezing, or kissing, according to Dr Gerrard.
While most people exposed to the germ do not become unwell, it can cause skin and throat infections and occasionally invades into the bloodstream, muscle, or lungs, resulting in serious illness.
Dr Gerrard said invasive Group A strep disease was one of the causes of sepsis; an abnormal, potentially life-threatening response to infection.
“Distinguishing sepsis from common viral infections, particularly in children, can be very difficult for both a parent and for a doctor,” he said.
“It’s not easy, particularly early on.”
Tell-tale symptoms can include fast breathing or long pauses in breathing; blotchy, pale or blue skin; a rash that fails to fade when pressed; or the patient may feel abnormally cold, seem confused, drowsy or be difficult to wake up.
“I don’t want to frighten people because these events are rare,” Dr Gerrard said.
“Most children get viral infections all the time and simply get better.”
Dr Gerrard said bacterial infections, such as those caused by Group A strep, could be a complication of influenza.
“Influenza, whether it be A or B, is known to predispose people to secondary bacterial infection and sepsis,” he said.
“It’s a well-recognised phenomenon.
“The typical story is someone gets classical influenza with a sore throat, runny nose, cough, fever, seems to be getting better, then about a week or two later suddenly becomes unwell and much worse again.
“If you look at the 1918-19 influenza pandemic, the Spanish flu, the commonest cause of death was actually bacterial sepsis rather than a direct effect of the virus itself.”
Dr Gerrard said all Queenslanders could play a role in limiting the spread of infectious diseases by practising good hand hygiene, covering coughs and sneezes with a tissue or the inside of their arm, and staying home when sick.
