During the second half of November 2022, pediatric clinicians and resuscitators reported to Public Health France and the Regional Health Agencies (ARS) a higher number of pediatric cases of invasive Group A Streptococcal (IISGA) infections. than usually seen in their services, some of which have been fatal. These reports came from different regions (Occitanie, Auvergne-Rhône-Alpes, Nouvelle-Aquitaine) and mainly concerned children under 10 years old.
In order to objectivize an increase in cases at the end of 2022, an initial assessment was carried out on December 8 from the data available at the national level on Group A Streptococcal infections.
Invasive group A streptococcal infections in France and prevention advice
GAS is a strictly human pathogen that is transmitted by respiratory droplets and direct contact (nasal secretions, skin lesions, etc.). It is most often responsible for mild non-invasive infections, such as angina, impetigo and scarlet fever. More rarely, it is responsible for serious invasive infections (necrotizing skin infections, puerperal infections, pneumopathies and pleuropneumopathies and meningitis) which may be associated with streptococcal toxic shock syndrome (STSS).
To limit the risk of transmission, it is advisable to adopt the same barrier gestures used against winter viruses:
- hand washing,
- wearing a mask for people with respiratory infections,
- sneeze or cough into the bend of the elbow.
As a reminder, the High Council of Public Health recommends the eviction from school or from a community (up to 2 days after the start of antibiotic therapy) of a child suffering from scarlet fever or angina with SGA [8]. A suspicion of non-invasive GAS infection (eg angina, scarlet fever) should lead to consultation for confirmation of the etiology without delay for the implementation of the appropriate treatment.
Implementation of enhanced monitoring
Active surveillance is set up by Public Health France and the GFRUP (Francophone Group for Resuscitation and Pediatric Emergencies) in order to complete the already existing surveillance system, to better assess the situation on the epidemiological level and to characterize the severe forms admitted. in intensive care. The protocol for this monitoring is available on our website.
This collection of data complements the microbiological monitoring of streptococci A which is carried out by the National Reference Center for Streptococci, as well as that of the EPIBAC network. GAS strains transmitted to the CNR by bacteriology laboratories are characterized in particular on the genotypic level.