Montreal public health keeping a close watch on Strep A outbreak in U.K. where 15 children have died

Montreal's public health department is keeping a close eye on the evolution of Strep A infections in the U.K. amid a spike in deaths of children from rare complications caused by the bacteria, a spokesperson told CTV News.

"Montreal public health is closely monitoring the situation (in the U.K.)...if our indicators would show anything of concern we would act," Jean Nicolas Aubé told CTV News.

The uncommon invasive strain of Strep A which, according to the BBC, has claimed the lives of 15 children across the U.K. since September, 9 of them in recent weeks, is a disease that laboratories here in Montreal are obligated to report to public health each time they detect a positive case.

According to Aubé, the numbers they have to date "resemble pretty much what it was last year and what it was before COVID."

He provided the case counts for each November in the last six years.

Cases of invasive group A streptococcal infections (iGAS) in Montreal, adults and children combined:

• 2022: 9
• 2021: 9
• 2020: 4
• 2019: 5
• 2018: 8
• 2017: 9

WHAT IS STREP A?

Strep-A is a common bacterium known as group A streptococcus. It's found around the world and affects all age groups.

The bacteria can cause a wide spectrum of illnesses such as scarlet fever, impetigo and strep throat and is usually a mild infection that is easily treated with antibiotics.

It can even be found in the throats of "about 15 per cent of school-age kids," said the Director of Infectious Diseases at the Montreal Children's Hospital (MCH).

"We call that colonization. It doesn't bother them. They're not symptomatic. It's not transmissible," Dr. Earl Rubin explained.

WHAT ABOUT INVASIVE STREP A?

It's the rare, invasive strain of Strep A that doctors worry about. It gets into the bloodstream, progresses rapidly and can cause the life-threatening illness sepsis, damaging "multiple organs."

This serious form of the infection can also cause necrotizing tissue (fasciitis), streptococcal toxic shock syndrome and pneumonia.

"(Patients) get very sick, often need intensive care treatment, and unfortunately, can die from it," said Rubin.

Any children treated at the MCH over the last few months have recovered, Rubin said in an interview.

"I think it's important to bring forward because it has hit the news of what's happened in the UK," he said. "People need to be aware, to kind of put things into perspective. There is a ton of strep and always has been, but it is the infinitesimally small percentage who suffer severe consequences."

HOW DOES STREP A SPREAD?

Strep A can be transmitted from one person to the next.

According to the Public Health Agency of Canada (PHAC) the bacteria can be spread "by direct contact with infected wounds on the skin and fluids from the nose or throat of infected persons," when that person coughs or sneezes.

WHEN TO SEEK HELP

Since Strep A causes such a wide range of illnesses, there are also a wide range of symptoms.

If the child has a fever and very sore throat for example but is otherwise alright, Rubin said they don't need to go to the emergency room. They can instead visit a clinic or family doctor where a health care provider might perform a strep test.

Scarlet fever is highly infectious. U.K. health officials are asking families there to look for the following symptoms in a child: "a sore throat, headache, and fever, along with a fine, pinkish or red body rash with a sandpapery feel," and to seek treatment quickly to prevent complications.

If the invasive strain has taken hold, Rubin said there will likely be no household debate about whether or not to head to the ER.

"It is very rapid onset. It is quite fulminant and they will be quite sick…non-functioning…I think most parents will not need to be told that they need to seek attention immediately," he said.

HOW ARE SERIOUS OUTBREAKS PREVENTED?

If a child is diagnosed with a strain that produces a toxin (invasive strain), members of the household are likely to be prescribed preventive antibiotics.

Rubin said if there's a similar outbreak in a daycare or school public health might decide to apply the same measure in those settings.