Nineesha Nigli still remembers how much she was shivering and shaking after giving birth.
The 37-year-old Pickering, Ont., resident contracted a community-acquired strep A infection in mid-November 2017, after giving birth to her son Evan at Markham Stouffville Hospital (MSH) in southern Ontario.
After a recent exclusive by Global News on 24-year-old Ayesha Riaz, who died of septic shock with the same infection at the same hospital, Nigli was reminded of her own experience.
Nineesha Nigli while she was pregnant with Evan.
Riaz’s husband Ahmad Saleem alleges the hospital dismissed and ignored some of his wife’s symptoms. But unlike Nigli’s infection, Riaz’s was hospital-acquired.
Speaking with Global News earlier in March, MSH said it was unable to comment on the allegations due to patient confidentiality, but the hospital instituted “enhanced cleaning measures and restricted visitors to the patient care unit” following Riaz’s death. There have been a total of three strep A infections at the hospital this year.
MSH also told Global News on Tuesday it could not comment on Nigli’s allegations, but confirmed her infection was community-acquired.
“Strep A is very active in the community so it is not unusual for someone to come into the hospital carrying the strep A bacteria but showing no symptoms. They could subsequently start showing symptoms, in which case the hospital would treat those symptoms if necessary,” says Lisa Joyce, vice-president of communications and affairs at MSH.
The symptoms of Strep A infections
For women postpartum, experts say strep A infections are still quite rare, and yet, these infections appear to be slightly higher for women post-childbirth.
“It might be some subtle changes that happen to the body around pregnancy. It might simply be that there might be open wounds and the normal skin barriers aren’t entirely closed so there is a greater opportunity for the bacteria to become invasive,” infectious diseases specialist Dr. Isaac Bogoch tells Global News.
Another theory is that hormonal changes, which might make some women more susceptible to getting strep A in the first place.
Symptoms also vary from patient to patient, but some symptoms are quite similar.
Besides shaking, Nigli says she started feeling feverish and had pain in her abdominal area.
“I had a baby before. It’s not my first one, and I know what I’m supposed to feel, and none of these things I’ve felt before,” she continues. “I was just scared that I would sleep and not wake up and not see my son, so there were a lot of emotions at that point.”
Tina Hamilton also contracted a strep A infection after giving birth in October 2017 at Grand River Hospital in Kitchener, Ont.
She remembers being discharged, going home and starting noticing symptoms of shakiness and a fever.
“I was a bit delirious,” she tells Global News. “After a while, my fever got really high and I had severe pain on the right side of my body. My husband convinced me to go back to the hospital.”
Hamilton says doctors were able to quickly tell it was strep A and give her the right antibiotics. But she was still unsure of how she contracted it.
Calgary-based new mom Jessica, whose name has been changed for privacy reasons, also remembers her fever after giving birth to her daughter in January.
The 21-year-old mom tells Global News that after being discharged from Kelowna General Hospital four days after birth, she went back to her doctor to describe her symptoms.
Jessica says her doctor told her she had an infection in her uterus (she was never specifically told strep A) and was put on antibiotics.
“I was getting better but I was having this pain on the left side of my body. I had given birth so I thought this probably feels normal,” she continues. “When it’s your first baby, you don’t know how you’re supposed to feel.”
Jessica continued with her medications after flying to Calgary to see her parents, but noticed her fever and pain on her left side weren’t going away. Going back to the doctors and having a swab test done, she was told she had contracted strep A from the community.
The single mom was sent to the emergency room, put in isolation and eventually had scans of her uterus. Scans revealed her left fallopian tube and ovaries were swollen and she had fluid in her uterus. She ended up getting a hysterectomy because of the infection.
Advocating for yourself
All three women said they did not know about the dangers of strep A before giving birth.
Although women are told to take a test for strep B, Jessica says she was unaware what the bacteria could actually do. In Riaz’s case, her husband says they, too, were not aware of what strep A was — or how deadly it could be.
“We need to educate people and not just brush off symptoms,” Jessica says, adding at a point, people around her, including health professionals and her family members, were telling her she was just experiencing normal or common side effects of giving birth.
“If people keep telling you, you are sleep deprived or tired [or] ‘you just had a baby’… you believe it. I wish I had advocated for myself.”
Nigli adds since November 2017, she still has unanswered questions as to how she could’ve contracted a community-acquired strep A infection within the hospital. And for any women who begin to feel these symptoms, they should speak up — they know their bodies the best.
“If you know it is not normal for your body, it is not normal.”
— With files from Caryn Lieberman