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Cases of invasive Strep A are 4.5 times higher than expected so far this year

There have been 394 cases of invasive Group A Streptococcus notified in Ireland to date.

CASES OF invasive Step A are 4.5 times higher than expected so far this year, according to a new report by the Health Protection Surveillance Centre (HPSC). 

The HPSC said in a new report that since October 2022, Ireland has experienced an “unusual upsurge” in invasive Group A Streptococcus (iGAS), particularly in those under 18. 

Similar increases in iGAS activity have been reported in other European countries, including Denmark, France, the Netherlands and the UK. 

“iGAS infections in Ireland typically peak during the first six months of the year,” the HPSC said. 

“The increase observed towards the end of 2022 is the first time a peak has been reported outside this usual period of seasonal increase. This may, in part, be explained as being as a consequence of the COVD-19 pandemic when normal social mixing patterns were interrupted leading to changes in transmission of diseases such as iGAS,” it said. 

Between 2 October 2022 and 26 August 2023, there were 480 cases of iGAS were notified to the HPSC in Ireland. Of these, 189 (39%) were in children aged under 18, of whom 166 were aged nine or below. 

The HPSC says this contrasts to pre-pandemic years when around 25% of Step A cases were in children under 18. 

The HPSC noted that the iGAS case definition was updated at the end of December 2022 in order to ensure that all potential cases were captured by routine iGAS surveillance. 

“As a consequence, the overall numbers of cases would be expected to be higher than with the previous case definition,” the HPSC said. 

“Analysis of the cases notified so far in 2023 has revealed that the new case definition has resulted in an additional 19% of cases being reported that would not have classified as iGAS by the previous case definition.” 

Looking at 2023 to date, there have been 394 cases of iGAS notified. The HPSC said the numbers are “significantly higher” than recorded for the same period last year, where just 32 cases were notified. 

So far this year, 17 deaths have been reported where iGAS infection was determined to be the main or contributory cause of deaths. Eight of the deaths were in those aged under 18. 

The HPSC’s report is based on data available as of 28 August 2023 and presents data up to 26 August 2023.

The report outlines that iGAS activity started to “ease off” in late May but still remains at a slightly higher level than would be expected for this time of year. 

Group A Streptococcus bacteria can cause many different infections.

The bacteria are commonly found in the throat and on the skin, and some people have no symptoms.

Infections caused by Strep A range from minor illnesses to serious and deadly diseases.

They include the skin infection impetigo, scarlet fever and strep throat.

While the vast majority of infections are relatively mild, sometimes the bacteria cause life-threatening illness called invasive Group A Streptococcal disease.

Invasive Group A Strep disease is sometimes a life-threatening infection in which the bacteria have invaded parts of the body, such as the blood, deep muscle or lungs. 

Hospitals 

592 patients are being treated on trolleys, chairs and other inappropriate bed spaces across Irish hospitals today according to the Irish Nurses and Midwives Organisation (INMO).

“We are seeing trolley figures today that we would usually see at the height of winter. The fact that 592 patients have been admitted to hospital today, 3 October, without a bed is a high risk event,” INMO General Secretary Phil Ní Sheaghdha said.

“Our members are concerned about the spread of infections such as Strep A, Norovirus and indeed Covid-19,” she said.

“It is clear that the spread of viruses is going to have a detrimental impact on patient flow throughout our hospitals over the coming weeks.”

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