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One Child Died From Strep Infection In Mecklenburg County. Cases Are On The Rise.
One child died in Mecklenburg County and another was hospitalized after getting strep infections in May, according to North Carolina's Department of Health and Human Services.
Both had infections from the bacteria that causes strep throat, the state said. Infections can turn invasive and deadly when bacteria — specifically group A strep (GAS) bacteria — enters the bloodstream, the agency stated.
These invasive infections also are responsible for increased adult and children hospitalizations across the county, state and nation, according to state and U.S. Data.
Once infected, there's no consistent time frame for when — or if — infections turn deadly, said Dr. Amina Ahmed, chief of pediatric infectious diseases and immunology at Levine Children's Hospital. "Once it's in your throat, it's unfortunately just a matter of bad luck how it gets into your bloodstream or if it gets into your bloodstream," Ahmed said.
The child's death in May was the first pediatric death due to an invasive GAS infection in Mecklenburg County this year, county data provided by public information officer Suzette Nedrich showed. Neither the county nor the state would say how old the child was.
There have been a total of 33 invasive infections so far this year, including five pediatric cases. Two adults also died with infections this year in Mecklenburg, county data indicated.
Last year, there were 43 total cases in Mecklenburg County, and in 2021 there were 24.
Rising strep infections in NC and Mecklenburg CountyA spike in cases typically happens from October to April every year, Ahmed said.
Before last year, there were an average of 15 invasive pediatric GAS cases during that seven-month span, according to state data from the past seven years.
But since October 2022, North Carolina has seen 62 pediatric infections, state data indicated. Mecklenburg County had the most cases, accounting for nine of the state's infections.
Cases last peaked in Mecklenburg County in 2019, when 61 adults and children were infected, Nedrich said.
Statewide, there have been 468 invasive GAS cases to date, compared to 461 for all of last year, N.C. Health records show. And there have been 47 deaths from invasive GAS cases in the first five months of this year in North Carolina. That's more deaths than any other year in the state going back to at least 2016.
And through June 1, there have been 46 pediatric invasive GAS cases in the state, N.C. Data show. That total also is higher than any other year going back to at least 2016.
Officials don't know why cases are spiking again, Ahmed said. Some infections are preceded by chicken pox, COVID or the flu, Ahmed said, but not all are.
Experts originally thought the spike was due to decreased immunity from wearing masks throughout the pandemic and quarantine, but she said that doesn't align with historical findings.
Some experts thought it was a more powerful strain. Sometimes it is, Ahmed said, but tests in Mecklenburg County don't reflect the more intense type doctors found in other parts of the country.
From strep throat to an invasive infectionThe uncomfortable swab at the doctor's office doesn't just test for strep throat. It tests for the presence of GAS bacteria, Ahmed said.
When it spreads to the blood, heart or spinal fluid, the bacteria can cause dangerous infections and diseases. These include scarlet fever, rheumatic fever, necrotizing fasciitis — a flesh-eating disease — and strep throat, according to the Centers for Disease Control and Prevention.
The reason to treat strep throat is not just to prevent invasive infections, according to Ahmed, but mainly to prevent non-infectious complications like rheumatic fever.
Amoxicillin is the preferred treatment for strep infections. But a national shortage has created another hurdle for doctors, Ahmed said. The American Academy of Pediatrics issued a list of alternative treatments while the shortage is expected to continue for several months.
Ahmed said each month she sees 10 to 15 hospitalized strep patients at Levine Children's Hospital While some cases aren't considered invasive infections, their severity still lands them in the hospital.
Skin and soft tissue infections make up most of those cases, she said. They occur when GAS bacteria lands on and infects skin, not just the throat or mouth.
But invasive infections become most problematic and potentially fatal when it develops into streptococcal toxic shock syndrome, Ahmed said.
For nearly half of people suffering from the toxic shock syndrome, according to the CDC, doctors do not know how the bacteria got into the body. Once in deep tissues or bloodstreams, bacteria causes low blood pressure, rapid breathing and increased heart rate, the CDC said.
How to prevent and detect strep infectionsGAS bacteria typically causes mild symptoms, like strep throat, impetigo — a skin infection — or pneumonia, according to the CDC. Many people, and 10% to 15% of children, carry GAS bacteria in their throat without getting sick, Ahmed said.
Invasive infections can happen when the original infection goes untreated or the bacteria gets into wounds or sores on the skin, according to Ahmed and the CDC.
The spread of all GAS infections can be reduced by washing your hands, especially after coughing and sneezing or before touching foods.
If people test positive for strep throat, they should stay home for at least 24 hours after taking an antibiotic, the CDC said.
©2023 The Charlotte Observer. Visit charlotteobserver.Com. Distributed by Tribune Content Agency, LLC.
Need Medication To Treat Strep But Can't Find It? A Charlotte Pharmacist Explains Why
As strep cases in North Carolina rise, medications used to treat it are in short supply.
Pediatric amoxicillin, which comes in liquid form so it's easier for children to take, was added to the Food and Drug Administration's list of drug shortages in October, NPR reported.
Jennifer Keller, a pharmacist who owns Pike's Pharmacy in Charlotte, said strep and other medications are scarce, too.
"There's a shortage of medications across the board, and it's painful," said Keller. "I receive an order every weekday, and on any given night, there are at least five items I cannot get."
Though demand for certain medications has spiked, Keller said the shortage can be attributed to drug manufacturers not being able to access chemicals necessary for production.
"Companies that produce the medication or that manufacture the medication are having issues getting the components they need," Keller said. "This is a mess. An absolute mess. I've never seen anything like it."
Strep cases in NCA spike in cases typically happens from October to April every year, Dr. Amina Ahmed, chief of pediatric infectious diseases and immunology at Levine Children's Hospital, told The Charlotte Observer.
But data show that infections are spreading more rapidly than usual.
One child died from strep infection in Mecklenburg County. Cases are on the rise.
Since October 2022, North Carolina has seen 62 pediatric infections, state data indicated. Mecklenburg County had the most cases, accounting for nine of the state's infections. For comparison, before last year, there were an average of 15 invasive pediatric strep throat cases between October and April, according to state data from the past seven years.
How to get strep medicationSince strep throat medications are not controlled substances, patients with prescriptions can call pharmacies to see if they have them in stock, Keller said.
Patients can also consider asking their doctors to write a prescription for an alternative drug used to treat strep that is more likely to be in stock.
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"For almost any condition we treat, there's a first line drug option, but there's also a second line drug option," said Keller. "It would be nice if doctors could consider writing for their second line option and saving parents some of the frustration and stress."
Other options to treat strepAntibiotics are the best way to treat strep throat, but over-the-counter pain relievers, including Advil, Motrin and Tylenol, can help reduce pain and fever, according to Mayo Clinic.
Aspirin should not be given to children under three since it has been linked to Reye's syndrome, a life-threatening condition that involves swelling in the liver and brain.
Here are some other ways to treat strep throat symptoms, according to Mayo Clinic:
Get plenty of rest
Drink plenty of water
Eat soothing foods, such as broths, soups and applesauce
Gargle with warm salt water
Use a humidifier
Stay away from irritants, such as cigarette smoke and paint fumes
Strep infections have impacted Mecklenburg County kids. Here's how to keep them healthy
How to prevent strep infectionsWashing your hands with soap and water is the best way to prevent strep throat infections, according to Mayo Clinic.
Teaching your children to cover their mouths when they cough or sneeze, and not sharing personal items, such as drinking glasses and eating utensils, can also reduce your risk of infection.
Strep A Infections On The Rise Nationally, UMMC Experts Say
JACKSON, Miss. (PRESS RELEASE) – Streptococcus A infections can cause more than a simple sore throat, experts at the University of Mississippi Medical Center and Children's of Mississippi say. Cases of Group A strep infections are rising in the U.S. And in countries including Canada and Great Britain.
Group A strep bacteria is extremely contagious and can cause everything from strep throat to severe infection. Infection from these common bacteria can cause rare invasive infections of areas of the body that are usually germ-free, resulting in serious and life-threatening conditions such as necrotizing fasciitis, a rare but rapidly progressing infection that destroys deep soft tissues, and streptococcal toxic shock syndrome, which can cause organ failure and death.
Strep A can also cause skin infections including cellulitis and impetigo in children and adults.
U.S. Centers for Disease Control and Prevention statistics show that there are about 500 to 1,500 cases of necrotizing fasciitis and about 2,000 to 3,000 cases of streptococcal toxic shock syndrome each year in the United States. In comparison, there are several million cases of strep throat each year in the U.S.
HOBBS
While severe illness from strep infections is rare, "I think it is vital that pediatricians maintain a high level of suspicion for acute Group A strep disease, simply because there is the chance of reducing serious complications with the oldest antibiotic in the book, penicillin," said Dr. Charlotte Hobbs, professor of pediatric infectious diseases.
Spotting early signs of invasive disease, such as persistent fevers and change in behavior for children or development of rash is important as more aggressive treatment and antimicrobial therapy may be needed, she said. "Toxic shock syndrome or necrotizing fasciitis must be treated early and may even require surgical intervention to address the source of infection."
Even a mild strep throat infection can become serious if it develops into rheumatic fever, which can result in permanent cardiac damage.
MOSKOWITZ
Rheumatic fever can result in fluid around the heart, an enlarged heart, heart failure from valve leakage, or a heart murmur because of valve damage, said Dr. William Moskowitz, chief of UMMC's Division of Pediatric Cardiology and co-director of the Children's Heart Center.
A World Pediatric Project (WPP) volunteer for more than 20 years, Moskowitz developed a program during his WPP missions to screen children in the Eastern Caribbean for rheumatic heart disease as well as a public education program for rheumatic fever prevention.
"Timely and complete treatment for strep throat can keep a child's healthy heart from the risk of becoming damaged," Moskowitz said.
The rise in Group A strep infections mirrors the surges in respiratory viruses earlier in 2023, Hobbs said. "There is still a higher number of invasive Group A strep cases overall, although the respiratory viruses are abating. This increase is thought to be partly because, during peak COVID periods, people were being more careful in washing their hands and practicing good hygiene. Indeed, this is the best way to reduce GAS transmission."
NAVALKELE
Though strep throat is often viewed as a childhood malady, anyone can catch it, so Dr. Bhagyashri Navalkele, associate professor and medical director of infectious diseases at the University of Mississippi Medical Center, recommends anyone with symptoms of strep to get medical care.
"A sore throat without respiratory symptoms such as congestion after close contact with an infected person is a strong indicator for getting a strep test," she said. "A throat swab for strep is a rapid test, and if the result is negative, a culture is done to make sure the result is correct."
Hobbs and Navalkele say the best ways to stem the spread of strep include simple health habits such as washing hands, covering the nose and mouth when coughing or sneezing, and staying home when sick.
"Practicing good hygiene and seeing medical care early for signs of strep infections reduce the chances for the infection to spread or become more serious," Hobbs said.
"Fever and rash along with any signs of abnormal mental status should be taken very seriously in a child as they may be signs of serious invasive Group A strep infection, which can progress to fulminant disease very quickly," she said.
Other ways to reduce the risk of Group A strep infections include keeping any injuries clean and disinfected and making sure adults and children are current with vaccinations for influenza and varicella, or chicken pox. Influenza and the lesions from chicken pox can make infection with Strep A more likely.
Children's of Mississippi appointments can be made online or by calling (888) 815-2005.
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