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Streptococcal Toxic Shock Syndrome Outbreak in Japan Raises Alarm: Cases Surpass Previous Year's Total

A deadly bacterial infection known as streptococcal toxic shock syndrome (STSS) is spreading across Japan, according to officials in the country.

In March, Japan's National Institute of Infectious Diseases issued its first warning about the rising cases of STSS. As of June 2, the health ministry has reported 977 cases for 2024, surpassing last year's total of 941 cases.

This year's count in Japan is nearly two and a half times higher than that reported in the United States, where 395 cases have been reported so far, close to the 390 cases seen at the same time last year.

STSS is a severe condition that can rapidly escalate into a life-threatening emergency, as described by the U.S. Centers for Disease Control and Prevention (CDC). Initial symptoms often include fever, chills, muscle aches, nausea, and vomiting. Within 24 to 48 hours, low blood pressure can develop, leading to more serious complications such as organ failure, increased heart rate, and rapid breathing.

"Even with treatment, STSS can be deadly. Out of 10 people with STSS, as many as 3 people will die from the infection," the CDC warned.

STSS is caused by toxins released by Streptococcus pyogenes, also known as Group A Streptococcus (GAS), which commonly cause sore throat and skin infections. Dr. Céline Gounder, an infectious diseases expert and CBS News medical contributor, noted that GAS can also lead to infections in the blood, lungs, and severe "flesh-eating" infections.

The reasons behind the increase in severe GAS infections are not fully understood, but preventive measures can help reduce the risk of illness, experts emphasized. Vaccination against varicella zoster virus (chickenpox) and influenza can lower the risk of severe GAS infections, especially for those in close contact with infected individuals who are immunocompromised, pregnant, or have open wounds.

Certain risk factors heighten susceptibility to STSS, including advanced age (most common in adults aged 65 and older), skin injuries or infections that breach the skin barrier, and underlying health conditions like diabetes and alcohol use disorder.

Since late 2022, several countries, including the United Kingdom, Ireland, France, the Netherlands, and Sweden, have reported increases in GAS cases, underscoring the need for ongoing global infectious disease surveillance and control efforts.

"Outbreaks like these highlight the importance of continuous monitoring and management of infectious diseases, not only in the United States but worldwide," Dr. Gounder emphasised.


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