Increase in streptococcus A infections: the appeal to French public health surveillance

Infections with streptococci A, bacteria in particular at the origin of scarlet fever, are registering an unusual increase among children in France, health authorities warned on Tuesday 6 December, citing several deaths but judging it unlikely that this outbreak was due to the emergence of a new strain. “Several pediatric cases of invasive group A streptococcal infections (…), in greater numbers than usual, have been reported in different regions – Occitanie, Auvergne-Rhône-Alpes, Nouvelle-Aquitaine – in the last 15 days”, he warned the General Directorate of Health (Dgs) in a message to caregivers.

Strep A are a class of bacteria that cause a variety of infections that often result in a sore throat. They are in particular the cause of scarlet fever, a major childhood disease. In recent days, two children and one adult have died in hospital from complications of these infections, according to the DGS. But the situation probably does not concern only these proven cases.

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Indeed, health professionals have traced a “recrudescence of severe forms and deaths (…) following a streptococcus A infection in several children, for a few weeks”, warned the Directorate General of Health. In the UK, at least six child deaths have been attributed to a strep A infection. The British and French authorities, however, consider it unlikely that this upsurge is due to the emergence of a new, more dangerous bacterial strain. In France, recent severe cases “have no link to each other” and appear to be caused by “different strains,” the DGS said.

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A major health crisis

This epidemic of bacterial infections also occurs against a backdrop of shortages of the main antibiotic used in children, amoxicillin. Several organizations of doctors – infectious disease specialists and pediatricians – have warned that this shortage risks causing a major public health crisis among children. However, unlike childhood viral illnesses such as bronchiolitis, which are currently in the midst of an epidemic, strep A infections can be treated with antibiotics, such as amoxicillin or penicillin. The DGS has, in this context, planned to “specify recommendations for the management of cases and contact persons, particularly in the current context of tensions over amoxicillin”.