March 27, 2017 2:56 pm
Updated: March 28, 2017 9:41 am

Why strep throat is causing serious complications, from amputations to death

A Michigan man will have both his hands and his feet removed after what started as strep throat turned into a near-death experience.

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You’ve seen the headlines over the past week: A Winnipeg mom lost both legs and her right arm after contracting strep throat, and a Pitt Meadows, B.C. mom lost her hands and feet for the same reason.

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Meanwhile an 11-year-old Mississauga girl suffered the same fate after doctors sent her home with the flu. Other instances of amputation or death from a rare form of strep throat were reported across Canada and into the U.S.

“We’re all familiar with strep throat. It’s caused by a bacteria called Streptococcus, and most of the time it goes in and it’s run of the mill,” Jason Tetro, a Canadian microbiologist and bestselling author of The Germ Files, told Global News.

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But it can also cause a “whole spectrum” of illnesses, according to Dr. Michael Gardam, chief of infectious disease control and prevention at the University Health Network.

“While strep is benign, it can cause much more serious infections from pneumonia and meningitis to toxic shock syndrome,” Gardam said. “These reports you’re hearing, they may sound unusual to you but they’re not unusual to someone like me.”

So why is strep throat, a common illness many Canadians encounter over their lifetime, tied to such grisly complications? We asked the experts.

What is strep throat?

Strep throat is a bacterial infection in the throat and the tonsils. Your throat gets irritated and inflamed, causing a sudden, severe sore throat.

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It incubates for about two to three days and by days three to 10 you’re encountering symptoms like a sore throat, pain when you swallow, a fever and those telltale white or yellow spots on the back of a bright red throat. Sound familiar? This is how strep throat conventionally presents.

Within a week, it should run its course, especially with the help of antibiotics.

Why do things go wrong?

It takes a handful of factors to create the perfect storm that turns ordinary strep germs into something deadly, according to Dr. Isaac Bogoch, tropical infectious disease specialist at Toronto General Hospital and the University of Toronto.

“It’s not an uncommon bacteria and the range of symptoms when people are carrying it can be anywhere from completely asymptomatic – and thankfully, that represents the vast, vast, vast majority of cases, but the spectrum can go all the way to the other end where you have a severe life-threatening disease that requires surgery on an urgent basis, antibiotics and intensive care unit care,” Bogoch warned.

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In about 3.5 in 100,000 cases, symptoms from a rare Group A Streptococcus infection could lead to serious complications, Gardam said citing U.S. Centers for Disease Control and Prevention numbers. He said the statistics are similar in Canada.

There are a handful of conditions: for starters, the group A strep germs that colonize your body need to be “invasive.” Not all germs are created equally, the experts note.

Secondly, the host — your body’s immune system — needs to react in a way that could cause a bad outcome. In the majority of cases, the germs run their course, you get sick for a week as your body fights back, and you recover.

In incredibly rare instances, your immune system goes wild, Gardam warned. 

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“Superantigens (T-cells in your body) could turn on your whole body’s immune system and indiscriminately attack everything,” he said.

Still, in about 90 per cent of invasive cases, people still aren’t in grave danger. They’ll recover with antibiotics and medical intervention.

What are the repercussions of “invasive” Strep bacteria?

Necrotizing fasciitis, nicknamed “flesh-eating disease” is what’s behind all of the reports of amputation. Its clinical name, in short, means “causing the death of tissues,” according to the CDC.

It can be brought on by a number of bacteria, including group A Strep. The germs create a toxin that can get into your skin or blood, causing irreparable damage. Antibiotics, at this point, can’t help because they don’t work on the toxin. Amputation is the next option.

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But in other cases, especially if they’re left unattended, complications set in.

This is how the Winnipeg mom lost her limbs, and it’s also how a Pitt Meadows woman lost her hands and feet.

A 44-year-old Michigan man also lost his hands and feet after he contracted the bacteria from his son who had strep throat.

“That strep organism, that is really common, somehow that went from his pharynx in his throat and made its way into his abdominal cavity,” his doctor, Elizabeth Steensma, told CNN.

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“As [strep] travels through the body, it can set up housekeeping, if you will, in various locations in the body and cause damage at those locations,” Dr. William Schaffner, an infectious disease expert, told CNN.

Toxic shock syndrome is another concern. It’s a life-threatening complication that stems from certain bacterial infections. In this case, symptoms include a sudden high fever, low blood pressure, vomiting or diarrhea, a rash, confusion and muscle aches, according to the Mayo Clinic.

Gardam said CDC stats peg about 3.5 people per 100,000 encountering TSS when they’re grappling with Strep A germs.

Are cases of flesh-eating disease tied to Strep bacteria increasing?

They’re not, the experts say. This is still an incredibly rare incident that won’t affect the majority of Canadians who get infected with Strep germs.

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“I wouldn’t say this is a new epidemic going on. This has been going on in the background but because it’s so dramatic, people pick up on it,” Gardam said.

He conceded that cases of flesh-eating disease, on its own, have escalated over the past few years, though. It’s hard to tell why.

Either way, the experts say Canadians shouldn’t worry.

“These are extremely rare events,” Bogoch said.

How do I protect myself and my family?

For starters, try to maintain good hand hygiene by washing your hands to cut the risk of spreading germs to others.

If you or your family member has already contracted strep throat, pay attention to the symptoms. It’s hard to diagnose flesh-eating disease because your skin doesn’t give away any telltale signs, such as swelling or redness, until it’s too late.

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But if you feel severe pain or discomfort in some parts of your body while you’re sick with Strep throat, it could be a warning sign.

“You will feel very weak, you’re going to have a fever and certain areas of your body are going to be really tender to the point where if you touch it you’re going to be screaming,” Tetro warned.

If your loved one who’s sick is young, old, or has a compromised immune system, you should also consider getting them medical attention sooner, too.

carmen.chai@globalnews.ca

© 2017 Global News, a division of Corus Entertainment Inc.

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