What is STSS? Bacterial infection can lead to organ failure, requiring surgery


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  • This year, there has been a sudden increase in cases of streptococcal toxic shock syndrome (STSS) in Japan.
  • This rare and fatal bacterial infection affects the blood and tissues.
  • STSS is treated with antibiotics and sometimes surgery. There is no vaccine for this infection.

Cases of an unusual but deadly bacterial infection have surged in Japan in recent months, worrying health officials, the Washington Post reports.

Since January 2024, Japan's health ministry officials have reported 1,019 cases of streptococcal toxic shock syndrome (STSS), a bacterial infection for which there is no vaccine and which is treated with antibiotics. These STSS infections have caused at least 77 deaths, with most fatal cases occurring in people over 50.

Japan's health ministry officials said they don't know what's causing the sudden surge in cases. But they find the increase worrying, as the country had reported fewer than 1,000 cases of STSS in 2023.

Causes and Symptoms of STSS

According to the CDC, STSS is caused by bacteria called group A streptococcus (GAS).

This particular bacteria also causes mild infections like strep throat, as it is commonly found in the throat and on the skin.

But if GAS enters a person's bloodstream or tissue through open wounds or sores, his or her organs can stop working within 24 to 48 hours, according to the CDC website. GAS has also been linked to necrotizing fasciitis, an infection that causes a “flesh-eating” disease.

According to the CDC, three out of 10 people with STSS are likely to die.

Flu-like symptoms such as chills, fever, and muscle aches are often the first signs of STSS. More severe symptoms that indicate organ failure due to STSS include:

  • Symptoms of low blood pressure include dizziness, blurred vision, weakness, nausea, and headache.
  • abnormally fast heart rate
  • Abnormally fast breathing

According to the CDC, if a person experiences these symptoms, they should go to the hospital immediately.

Treatment typically involves replacing bodily fluids and antibiotics. Some cases may require surgery to remove tissue infected with GAS bacteria, according to the CDC.

STSS-like infections are on the rise globally

Steere told the Washington Post that “streptococcal toxic shock syndrome and invasive strep A infections have been around in the United States for decades, decades, decades, hundreds of years.”

However, it is an uncommon infection, and health care providers should take the sudden increase in STSS cases in Japan as a signal to increase awareness of potential symptoms among their patients, said Andrew Steer, director of infection, immunity and global health at the Murdoch Children's Research Institute in Melbourne, Australia.

Since the coronavirus pandemic, health officials around the world have expressed concern about rising rates of bacterial and viral infections.

In 2022, UK health officials reported 19 child deaths due to group-A streptococcal infection, the same bacteria that causes STSS.

Health experts say vaccines could help stop the spread of these rare but potentially deadly bacterial infections. However, it has taken decades to create a vaccine that is still ongoing due to financial and scientific hurdles.

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