Public Health Alert – Increase in cases of iGAS
Situation
There has been an increase in invasive Group A Streptococcal (iGAS) Disease cases in other parts of Ontario and in the US. Cases include a larger proportion of children under 18 than in the past and the highest rates are in those aged 0-4 and 65 and over.
Increased risk of iGAS exists in: infants and children under 4 years old: people who are pregnant or postpartum: older adults: immunocompromised people: those with chickenpox infections: and people experiencing homelessness or using injection drugs.
Currently in the Northwestern Health Unit (NWHU) region the number of cases and age distribution have remained consistent with our normal trends over time. The emm types (for typable isolates for samples taken from those with iGAS have included only one of the 12 most commonly reported emm types. Emm type 77 has been present in our area for some time and is consistent with 3.4% of typable samples in Ontario in the past six months.
Actions requested
- Read and follow the memorandum from the Office of the Chief Medical Officer of Health including prompt assessment and treatment of non-invasive GAS and remain alert to complications of GAS, particularly in those at highest risk of severe illness.
- NWHU’s catchment area is currently not seeing the same age shift or increase, however that may indicate a possible threat in the near future. It is very important to follow the guidance on prompt assessment and treatment and to remain alert to iGAS in children, pregnant and postpartum people, and other groups who more frequently have iGAS.
- Promote routine vaccinations including varicella and influenza for eligible patients. Severe illness from GAS in other areas has often followed respiratory infections and iGAS is known to correlate with recent chickenpox infection.
More information about iGAS in Ontario can be found on Public Health Ontario’s Invasive Group A Streptococcal (iGAS) Disease in Ontario: October 1, 2022 to April 30, 2023 report.
Contact:
Dr Kit Young Hoon
Medical Officer of Health
Northwestern Health Unit