Strep A: an innocent bacterium that could be life-threatening

By Magda Panoutsopoulou

ATHENS (AA) - Several children have died in Europe and other parts of the world from the common bacterial infection Group A streptococcus bacteria, also known as Strep A.

"Strep A is a common type of bacteria that is called group A Streptococcus and is found in the nasopharynx and skin," Eleni Paximadi, a molecular biologist and virologist, told Anadolu.

Paximadi explained that about 5% of healthy people have this microbe in their throat without having an infection. In the winter months, these healthy carriers can reach 20%.

In Greece, three children have so far lost their lives from the bacterial Strep A since the beginning of the year, with the youngest victim 18 months old that died from a septic shock.

"For children, the Strep A bacteria is spread through coughing, sneezing, ... or even touching infected things from someone already infected or a carrier," Anna Pardali, the vice president of the Union of Self-Employed Pediatricians of Attica, told Anadolu.

In general, experts claim that the bacteria is not life-threatening if it is diagnosed early, however, some of its flu-like symptoms could lead to more serious complications, especially in children, like sepsis and eventually septic shock.

A very serious but rather rare complication of the bacteria could lead to sepsis which is life-threatening, Pardali underlined.

In children, there are various parameters that should be taken into consideration and could suggest the severity of the infection, like very high fever, bad skin color, anorexia, vomiting, and a general bad medical condition, she said.

An 18-month-old child died recently from Strep A bacterial infection that led to a septic shock, Pardali noted, saying: "At these ages, children usually find it difficult to describe what they feel and they cannot communicate their symptoms like a sore throat or high fever."

These symptoms could suggest typical flu, while it could also depict that a child is suffering from a Strep A infection.

Sepsis, however, "could rarely manifest itself rapidly though not only in streptococcus, but in all infections,’’ Gkikas Magiorkinis, a professor of hygiene and epidemiology at Athens University and the scientific coordinator of the National Reference Centre for Retroviruses, told Anadolu.

Magiorkinis stressed that to avoid complications of the infection, "it is important to have a correct diagnosis so that antibiotics can be taken."

"Septic shock is a serious medical condition that can occur when an infection in your body causes extremely low blood pressure and organ failure due to sepsis,’’ Paximadi also noted, adding that this condition is life-threatening and requires immediate medical treatment.

- Strep A in adults: transmission and diagnosis

According to experts, many of us carry the bacteria on our throats and skin without showing any symptoms of infection. However, this particular pathogen can in some cases cause an infection, mild or even more severe.

Although Strep A usually infects children, elderly people are also susceptible to it.

“Septic shock is reported even in adults from Group A beta-hemolytic streptococcus infection, while an age of over 65 is considered an aggravating factor,” Magiorkinis said.

He explained that for about half of the patients who will develop toxic shock syndrome, we do not know the portal of entry of the microbe. About three in 10 people who develop the syndrome will die, sometimes requiring amputations to remove tissue irreversibly infected by the microbe.

Magiorkinis also said the diagnosis of group A beta-hemolytic streptococcus is made by a rapid antigen detection test or by culture, usually of a pharyngeal sample, which has a higher diagnostic sensitivity.

After two days of treatment, transmission is very difficult, Paximadi explained, while after infection, protective antibodies are created. But because there are many types of microbes, in essence, there is no complete immunity to new infections, she added.

In comparison to other European countries, the death record in Greece is lower, but health experts still advise that any symptoms that could suggest Strep A infection should be reported to a pediatrician.