Experts warned that even though officials are having difficulty determining the cause, an uncommon but severe bacterial illness is spreading at a record rate throughout Japan.

As more highly dangerous and infectious strains of group A streptococcal disease were confirmed in Japan, there is growing worry that the most severe and possibly deadly form of the disease, Streptococcal Toxic Shock Syndrome (STSS), will continue to spread. In 2024, the number of cases is predicted to surpass the record numbers from the previous year.

Japan Faces Alarming Streptococcal Surge

Experts Sound Alarm as Dangerous Bacterial Infection Spreads Rapidly in Japan

Concerns mount over surge in cases of Streptococcal Toxic Shock Syndrome and possible links to Covid-19 restrictions easing in Japan. (not the actual photo)
(Photo : CHRISTOPHE ARCHAMBAULT/AFP via Getty Images)

Last year, the NIID released provisional data indicating that an amount of 941 STSS cases were reported. In an unexpected course of circumstances, an alarming 378 new cases have been reported in Japan within the first two months of 2024. These cases have been detected in almost all of Japan's 47 regions, with only two staying unharmed.

According to recent statistics from NIID, there has been a shift in the demographics of those at higher risk. Previously, it was considered that older individuals were more susceptible, but now it appears that patients under 50 are experiencing more fatalities, particularly from the group A strain.

Following reports from the Asahi Shimbun newspaper, a concerning number of individuals under 50 were diagnosed with STSS between July and December 2023. Tragically, a significant portion of these patients, specifically 21 out of 65, did not survive the illness.

STSS, predominantly caused by the bacterium Streptococcus pyogenes, commonly known as strep A, typically manifests as sore throats, particularly among children. However, the highly contagious nature of the bacteria can result in severe health complications and even death, particularly among adults over 30, with approximately 30% of STSS cases proving fatal.

The symptoms associated with STSS can escalate from mild cold-like symptoms to severe conditions such as strep throat, tonsillitis, pneumonia, and meningitis. In the most severe cases, the infection can progress to multiple organ failure and tissue necrosis, according to The Guardian.

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STSS Surge Linked to COVID-19 Easing

There is speculation among experts that the recent rise in cases of STSS could be connected to the easing of COVID-19 restrictions that were put in place during the pandemic. In May 2023, the Japanese government made a significant decision around the status of COVID-19. They decided to downgrade its severity, treating it more like seasonal flu. 

As a result, certain containment measures were lifted. There was an apparent reduction in the population's vigilance following the change in policy, even though measures such as mask-wearing, hand sanitizing, and social distancing had proven effective in keeping COVID19 fatalities relatively low compared to other countries.

Ken Kikuchi, a professor specializing in infectious diseases at Tokyo Women's Medical University, has voiced serious concerns about the substantial spike in severe streptococcal infections. He believes that this increase can be primarily attributed to the changed public perception towards COVID-19.

Kikuchi emphasized the impact of changing attitudes towards the pandemic on the neglect of essential infection prevention practices, such as regular hand disinfection. In addition, the health ministry illustrates the significance of implementing crucial infection control measures, including good hand hygiene and following cough etiquette.

This is because streptococcal infections can be transmitted through respiratory droplets and physical contact. In light of the ongoing concerns regarding the increase in infections, health authorities insist on the importance of maintaining reservations and following preventive measures to limit the spread of the disease.

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