London, ON - The Middlesex-London Health Unit has noted an increase in the number of reported local cases of invasive Group A Streptococcal (GAS) infection in 2012. So far this year, the Health Unit has received reports of 27 people diagnosed with invasive Group A Streptococcal infection, two of whom have died. In the previous five years, totals for cases of invasive Group A Streptococcal infection have ranged from 10 to 28 per year.

“The increase in the number of cases we’ve seen have been in three of the groups known to be at higher risk for GAS infections: those who use injection drugs, the elderly and those with underlying medical conditions,” says Bryna Warshawsky, Associate Medical Officer of Health for the Middlesex-London Health Unit. “Further testing is being done to determine if the infections are being caused by one common strain or several strains.”

A higher than usual number of invasive Group A Streptococcus cases was also reported in 2008, which resulted from several different strains circulating at the same time. At that time several of the cases occurred among people who used injection drugs. To-date in 2012, eight of the cases have been in those who use injection drugs.

Group A Streptococcus is a bacterium that is found in the throat and on the skin. People may carry Group A Streptococcus and have no symptoms of illness. Most infections are relatively mild, presenting as "strep throat" or impetigo, an infection of the skin. Occasionally these bacteria can cause severe and even life-threatening illness referred to as “invasive Group A Streptococcal infection”. Invasive Group A Streptococcal infection occurs when bacteria get into parts of the body where they are not usually found, including the blood, muscle, cerebrospinal fluid, or lungs, resulting in conditions such as streptococcal toxic shock syndrome, necrotizing fasciitis (flesh-eating disease), meningitis, and pneumonia.

The symptoms of invasive GAS disease may include the following:

• necrotizing fasciitis or myositis: fever, pain, swelling or redness of the affected area;
• meningitis: fever, severe neck pain, nausea and/or vomiting;
• pneumonia: fever, cough and/or chest pain;
• streptococcal toxic shock syndrome: fever, malaise, dizziness, confusion and/or a red rash on the body.

The Middlesex-London Health Unit is working with its partners to provide educational materials on safe injection techniques for individuals who use injection drugs. A poster and three pocket pamphlets about invasive Group A Streptococcal infection, wound care, and skin abscesses are being distributed to community partners. Health care providers have been informed of the increase in invasive Group A Streptococcus and the available services for patients who use injection drugs.

Media Contact:
Dan Flaherty, Communications Manager, Middlesex-London Health Unit, 519-663-5317 ext. 2469 or 519-617-0570 (cell)

Spokesperson:
Bryna Warshawsky, Associate Medical Officer of Health, Middlesex-London Health Unit