The world is currently facing a respiratory virus outbreak that has led to substantial health concerns worldwide. Amidst these concerns, another serious threat has gone relatively unnoticed, and that is the rise of pediatric invasive group A Streptococcal infections. These infections have become more common among children, and the situation demands more attention from the healthcare community. This article will explore the reasons for the surge of these infections during the respiratory virus outbreak and discuss the importance of timely diagnosis and treatment.
A recent study published in the journal Open Forum Infectious Diseases explored the incidence of invasive Group A streptococcal (iGAS) infections among children before and after the COVID-19 pandemic. The study analyzed risk factors, clinical characteristics, and molecular data associated with iGAS infections, which can result in severe diseases, including osteoarticular or soft tissue infections, bacteremia, toxic shock syndrome (TSS), and pleural empyema. The research found an unexpected increase in iGAS infections in children since October 2022, particularly involving pleural empyema. The rise appeared to coincide with a respiratory virus outbreak, particularly the influenza virus. The researchers suggest that physicians should be aware of the increased risk of iGAS infections in settings with an intense circulation of respiratory viruses.
The study included pediatric patients under 18 years old who were hospitalized due to iGAS infections at a French tertiary care hospital between 2008 and 2022. The team performed genotyping, assessed virulence gene profiles, and counted respiratory pathogenic organisms. The study comprised three periods: the pre-COVID-19 associated non-pharmaceutical intervention (NPI) period, the NPI period, and the NPI relaxation period. The study found a significant reduction in the quarterly rate of iGAS infections among every 1,000 hospitalizations during the NPI period. However, there was a notable rise in the quarterly rate of iGAS infections during the NPI relaxation period, particularly between October and December 2022. During the final three months, 60% tested positive for respiratory viruses through nasopharyngeal viral swab-PCR, rising to 100% for pleural cavity empyema. Furthermore, there was a shift observed in the prime clinical manifestations, likely associated with an increased percentage of pleural cavity empyema from 15% to 33%.
According to the researchers, physicians must be aware of the elevated risk of pediatric iGAS infections, particularly in settings with an intense circulation of respiratory viruses. They suggest conducting further research, including randomized controlled trials, to evaluate pediatric susceptibility to iGAS and whole-genome sequencing (WGS) of iGAS strains. The study’s findings reinforce the importance of monitoring infections concurrently with respiratory viruses and may provide insight on developing measures to prevent and manage iGAS infections.
As we navigate through the ongoing respiratory virus outbreak, it is important to stay vigilant of other infections and their impact on vulnerable populations, such as young children. Pediatric invasive group A Streptococcal infections may not be as well-known as other illnesses, but they can have devastating outcomes. As cases continue to rise, it is crucial for healthcare professionals and caregivers alike to remain informed and take preventive measures to protect children from this dangerous infection. By following proper hygiene protocols, recognizing and addressing symptoms promptly, and staying up-to-date on vaccination recommendations, we can work together to keep our communities safe and healthy.
