17/06/2024
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**Record Levels of Fatal Bacterial Infection Reported in Japan, Officials Say**
Japan is facing a record surge in cases of a highly fatal bacterial infection, with health experts struggling to determine the cause of the increase. Official figures from the Health Ministry reveal that as of June 2, there have been 977 reported cases of streptococcal toxic shock syndrome (STSS) this year, which has a mortality rate of up to 30%. Between January and March, 77 deaths were attributed to the infection, according to the latest available data.
The current outbreak has already surpassed last year's record of 941 preliminary infections, the highest since tracking began in 1999. In 2023, the National Institute of Infectious Diseases (NIID) reported 97 deaths due to STSS, marking the second-highest fatality count in the past six years.
STSS is a rare but severe condition that arises when bacteria invade deep tissues and the bloodstream. Early symptoms include fever, muscle pain, and vomiting, but the illness can rapidly become life-threatening, leading to low blood pressure, swelling, and multiple organ failure.
“Even with treatment, STSS can be deadly. Out of 10 people with STSS, as many as three people will die from the infection,” the US Centers for Disease Control and Prevention (CDC) states.
The majority of STSS cases are caused by group A streptococcus (GAS) bacteria, which typically cause mild infections like strep throat in children. However, in rare instances, these bacteria can become invasive and produce toxins that facilitate entry into the bloodstream, resulting in severe illnesses such as toxic shock. GAS can also lead to necrotizing fasciitis, a "flesh-eating" disease that may necessitate limb amputation, particularly in individuals with underlying health conditions like cancer or diabetes.
The spread of invasive GAS infections had been curtailed by COVID-19 preventive measures such as masking and social distancing. However, the relaxation of these measures has led to a rise in cases worldwide. In December 2022, five European countries reported an increase in invasive GAS infections, primarily affecting children under 10, prompting the World Health Organization and the CDC to investigate.
In March, Japanese authorities issued a warning about the spike in STSS cases. The NIID noted a significant increase in STSS cases caused by invasive GAS since July 2023, particularly among individuals under 50 years old.
The CDC highlights that older individuals with open wounds, including those who have recently undergone surgery, are at an elevated risk of contracting STSS. However, the route of bacterial entry remains unknown for nearly half of the STSS cases.
The reason for the recent surge in STSS cases in Japan remains unclear, as reported by NHK, Japan's public broadcaster. Professor Ken Kikuchi of Tokyo Women’s Medical University suggested that the increase might be linked to weakened immune systems post-COVID.
“We can boost immunity if we are constantly exposed to bacteria. But that mechanism was absent during the coronavirus pandemic,” Kikuchi explained. “So, more people are now susceptible to infection, and that may be one reason for the sharp rise in cases.”
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