2 Montreal children die from Strep A infections as public health urges doctors to be vigilant

Two children in Montreal have died due to complications with Strep A infection as cases of the illness are on the rise, the city's public health department said Friday.

Public health has recorded four cases of group A streptococcal infections (iGAS) among young children since mid-November.

"In comparison, during this same period in 2017-2021, there were 0 to 1 cases of invasive infections among Montreal children," Montreal public health said in a news release.

Public health said earlier this month it was keeping a close eye on the progression of cases in the city following a spike in deaths in Europe. The BBC reported in December that the infection had claimed the lives of 15 children in the U.K. since Sept. 9.

The number has risen to 19, U.K. media reported Thursday.

The rise in cases is becoming a global phenomenon, with the World Health Organization reporting at least five countries — France, Ireland, the Netherlands, Sweden and the U. K. — reporting an increase in infections of Strep A and scarlet fever among children in recent weeks.

With the deaths in Montreal involving two children aged two and younger, public health is urging health professionals to be vigilant for any signs of symptoms in children.

Strep A is a common bacterium found around the world, but it's the invasive strain of Strep A that has doctors on alert because once it gets into the bloodstream it can progress rapidly and cause life-threatening sepsis and damage multiple organs.

Severe symptoms can include fever, significant discomfort, severe pain in the infected area with redness or blueness that spreads, pneumonia, and blood infection.

The infection can be treated with antibiotics, such as penicillin or amoxicillin. Patients with a recent respiratory infection, such as RSV, are considered to be among the people more at risk for Strep A. 

WAYS TO PREVENT INFECTION

Dr. Geneviève Bergeron, the medical officer for health emergencies and infectious diseases at Montreal public health, said it's unclear why the increase in cases is happening now, but there are some theories that can help explain it.

"Some hypotheses at this point have to do with the fact that there was less social mixing over the last few years with the pandemic and now we're seeing cohorts of children that have had less exposure to a bacteria that is relatively common," she said in an interview Friday.

Another possible reason could be related to the earlier-than-usual influenza season hitting the community since the flu increases your risk of having bacterial infections as a complication, including group Strep A.

The notice issued Friday from public health officials was intended for clinicians to be on the lookout, but parents can also take certain steps to protect their children.

Two key measures to follow are staying home when feeling ill and keeping routine vaccinations updated, especially ones for the flu and chickenpox, Bergeron said. In the case of chickenpox, skin lesions can be an entry point for bacteria to cause an infection.

"Being up-to-date with vaccination is really the best thing that people can do to be in the best shape possible and prevent disease," she said.

If parents notice fever, severe muscle aches, redness or pain related to wound or skin infection, or severe sore throat in their children, those are symptoms that should be evaluated by a health-care professional who can take samples and prescribe antibiotics, if needed.

Parents seeking health-care options can call the 811 Info-Santé hotline. 

People who are over 65, have a chronic disease, or are in close contact with an infected person are at risk.

With files from CTV News Montreal's Max Harrold