Japan is facing an unprecedented outbreak of the rare and potentially deadly bacterial infection Streptococcal Toxic Shock Syndrome (STSS), with over 1,000 cases already recorded so far this year – surpassing the total for all of last year.
The rapid rise in cases of the illness has authorities concerned to contain its spread, especially among older populations across the world.
Arabian Business reached out to UAE doctors to find out if residents should be concerned of the spread of STSS in the nation and here is what they had to say:
What is Streptococcal toxic shock syndrome (STSS)?
“STSS is an invasive infection caused by group A streptococcal infection associated with sudden onset of shock and multi-organ failure. These bacteria produce some kind of exotoxins that can spread to blood bloodstream, causing a massive immune response involving cytokines and chemokines,” Dr. Niyas Khalid, Specialist/HOD – Internal Medicine, Family Medicine & GPs at Burjeel Medical City told Arabian Business.
Even with treatment, STSS has a high mortality rate of around 30 percent, according to the US Centers for Disease Control and Prevention (CDC) website.
Complications can include need for surgery or limb amputation.
Symptoms of STSS
According to Dr. Khalid, STSS cause “super antigenic activity,” leading to severe multi-organ damage or death. Symptoms include:
- High fever, rashes;
- Hypotension;
- Skin desquamation;
- Severe body pain;
- Vomiting;
- Diarrhea;
- Headaches;
- Non-focal neurological symptoms;
- Necrotising fascitis (which can eat up the flesh);
- Multi-organ failure.
Echoing the sentiment, Dr Anil Grover, Specialist – Internal Medicine, Prime Hospital added that after the first symptoms begin, “it takes only about 24 to 48 hours for low blood pressure to develop.”
“It is treatable,” Dr. Grover told Arabian Business.
“Patients with STSS need immediate care in a hospital for treatment with antibiotics, IV fluids, etc. Hospital treatment focuses on managing infection, low blood pressure and multiple organ failure,” he added.
However, STSS is most common in adults who are 65 years or older, Dr. Grover explained, adding that individuals with an open would are at an “increased risk” for the infection.
“This can include people who recently had surgery or a viral infection that causes open sores. People with diabetes or alcohol use disorder are also at increased risk for STSS,” he said.
“STSS usually affects the elderly, those who are immunocompromised, people with diabetes, etc. Usually, minor trauma or viral infections like varicella and influenza provide the portal of entry to the bacteria,” Dr. Khalid added.
How does an STSS infection occur?
According to Dr. Khalid, though streptococcal infections can spread from one person to another, STSS does not spread from one person to another through direct contact.
“It doesn’t spread like a pandemic. So there is no need to worry about an extensive spread of the infection. Also, it’s not a new infection. It happens in most parts of the world and has been around for many years. The cause for the recent increase in cases in Japan is not known yet,” he said.
How is STSS treated?
It requires intensive care and treatment, Dr. Khalid said, adding that early identification and intensive treatment are crucial.
“It is usually treated with antibiotics, supportive therapy with fluid resuscitation, inotropic support, dialysis, etc. Necrotising fasciitis may need surgical debridement. The infection has a high mortality rate of up to 40 percent, so early identification and intensive treatment are key,” he said.
Should UAE residents travel to Japan right now?
“It is safe to travel to the country,” Dr. Grover said.
He also advised individuals to “follow standard infection control practices” such as hand hygiene, cough etiquette and cleaning wounds to reduce the spread of group A streptococcal infection. He said:
- Clean and care for wounds;
- Cover your mouth while coughing or sneezing;
- Wash glasses, utensils, and plates after someone who’s sick uses them;
- Wash hands often;
- There is no role of prophylactic antibiotics. For patients with a serious infection, doctors may prescribe antibiotics to caretakers/close contacts only if they are 65 years or older or have other factors that increase their risk of getting a serious group A streptococcal infection.
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