Montreal Public Health is asking health care providers to be vigilant after two children died and two others tested positive for the contagious bacterial infection since mid-November.
The agency said in a notice to physicians on Friday that all four invasive group A streptococcus (IgAS) infections were in children two years of age and younger, and none had a chronic health condition or a recent case of chickenpox.
The notice encourages medical professionals to be on the lookout for concerning symptoms and to conduct appropriate tests.
“We are seeing an increase in the number of cases in children in Montreal,” said Dr. Geneviève Bergeron, Montreal Public Health’s chief of infectious diseases.
“We want to raise awareness for clinicians so they can appropriately diagnose and treat cases and then report to public health so we can continue to investigate the situation.”
Bergeron said the increase in cases in Montreal is primarily among children — above average for this time of year, and a trend seen globally.
The Government of Canada website states that strep A bacteria are usually associated with mild illnesses such as strep throat and sinus infections.
However, in rare cases, the infection can lead to more aggressive and life-threatening conditions, including pneumonia, flesh-eating disease, and toxic shock syndrome.
While strep A is more common, it is the severe forms of the infection that are reportable to public health, Bergeron said.
Such infections led to four deaths earlier this year in a private Montreal Seniors Home According to the World Health Organization (WHO), back in August, and iGAS is starting late in Europe, more than a dozen children under the age of 15 have died in the United Kingdom.
The WHO says the spike in cases may reflect an early start to the season for Group A streptococcus infections. This comes at a time when there has also been a rise in respiratory viruses and possible viral co-infections. This may increase the risk of IGAS, the WHO said in a statement on Thursday.
Bergeron said the recent spike in cases in Montreal could be related to the abandonment of pandemic health measures or an increase in flu-like viruses.
Montreal Public Health encourages physicians to offer appropriate care, including prescribing antibiotics.
“Practice routine exercise and extra precautions according to the patient’s condition,” the agency says.
The health agency offers several tips to avoid infection:
- Isolate at home for 24 hours after the start of antibiotic treatment.
- Cover the sores associated with strep A.
- If necessary consult a specialist such as a microbiologist.
- Report any case of Igas infection immediately.
The health agency also encourages physicians to promote vaccination against influenza and varicella because these infections predispose to iGAS infections.
