Hospitals seeing an increase in Step A infections
Researchers say Australia’s experiencing an intense surge in severe strep a cases after reduced social contact during the pandemic. The Murdoch Children's Research Institute analysed cases in children from 2018 to 2022, finding numbers quadrupled to 107.
Transcript
00:00 There are a number of reasons why we're seeing a surge and certainly more research is needed
00:06 to clearly define those reasons. But as you say, during the pandemic, we saw very low
00:12 numbers. And it's thought that because children aren't getting the usual exposures to this
00:17 common strep A bacteria, when we emerged from lockdowns and there was more social interactions,
00:24 that they didn't have that immunity. And then we saw this surge. But other potential reasons
00:29 are that we might be seeing more aggressive strains of this bacteria. And also another
00:35 contributing factor is potentially the change in increasing respiratory viruses that we've
00:40 seen here and overseas as well.
00:43 How severe are the symptoms?
00:45 Yes, so luckily, as you say, the strep A is a very common bacteria and most commonly causes
00:51 mild infections, superficial infections of the throat or skin. But if you do get these
00:57 more serious infections with invasive strep A, children can be very unwell and it can
01:06 be quite quick. So it's really important to be aware of the signs to look out for if a
01:12 child's not getting better in the time that you would expect them to, or if you think
01:17 something's not right to get your child checked.
01:20 And for mild cases, antibiotics usually do the trick. What about for more severe cases?
01:25 Does that sometimes require surgery?
01:27 Yes, so more severe cases, like the cases that we studied in our report, often require
01:34 much more intensive support. And one third of the children affected with invasive strep
01:40 A required paediatric intensive care unit admission. And it can be life threatening
01:45 and yes, treatment can involve surgery as well.
01:50 So this must be a really tricky situation for parents and children to navigate.
01:56 Yes, absolutely. It's tricky and I guess this research supports the need for a vaccine.
02:01 So there isn't currently a vaccine to prevent invasive strep A infections and the other
02:07 infections caused by strep A, such as long term health problems associated with rheumatic
02:12 heart disease, which affects Aboriginal and Torres Strait Islander populations. So we
02:18 really, yeah, we really need a vaccine. And that's what MCRI will be researching along
02:24 with other institutions in Australia.
02:28 Yeah, so tell us a little bit more about that. What more researchers need to understand about
02:34 severe strep A?
02:36 Yes, so we need to understand the burden of disease, which is what our study contributes
02:42 and what it's also become nationally notifiable now. So we will have that ongoing data on
02:48 the burden of disease. And we've also had initiatives to support vaccine research. So
02:54 the Australian Strep A Vaccine Initiative and here at MCRI, we'll be doing vaccine research
03:03 using what's called an adult human challenge model of strep A pharyngitis to hopefully
03:08 accelerate the development of vaccines.
03:11 How far off is a vaccine?
03:14 Yes, it's a very good question. We hope to be doing the human challenge trials of vaccines
03:20 next year. And yes, the idea will be that these human challenge trials will propel larger
03:26 field trials. But vaccine development is always very careful. And we'll, yeah, the human challenge
03:33 model will certainly aim to give us those early findings and propel the efforts forward
03:40 to get a vaccine as soon as we can.
03:44 What are the risks involved in exposing the trial participants to the bacteria?
03:49 Yeah, so we will be recruiting healthy adult participants. It's a very controlled environment
03:57 where they're informed and provide fully informed consent. And so they receive either the strep
04:03 A vaccine or a dummy or placebo vaccine. And then the strep A bacteria, which is a carefully
04:11 produced strain that we know everything about, that's applied to the throat of the volunteers
04:17 and they're monitored in a very carefully inpatient setting and given antibiotics to
04:23 treat the infection if they develop pharyngitis, depending on which vaccine they get and how
04:30 effective the vaccine is.
04:32 What can parents do to protect their children in lieu of a vaccine?
04:36 Yes, it's a great question. So we all need to be aware as parents of the signs of sepsis
04:44 and more serious infections. So if you think that your child is getting worse or not getting
04:50 better from what you think started off as a mild infection, then certainly take them
04:55 to see their doctor. Some of the signs of more serious infections include excessive
05:02 lethargy, limb pain, reluctance to walk, there can be a sunburn type rash, vomiting. So yes,
05:10 certainly if you think things aren't right, then go and get your child checked.
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