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Explained: What is STSS, deadly 'flesh-eating bacteria' spreading in Japan; will it affect rest of the world?

In recent weeks, Japan has been grappling with a significant health crisis as cases of Streptococcal Toxic Shock Syndrome (STSS), commonly known as 'flesh-eating bacteria', have surged to alarming levels.

Explained What is STSS, deadly 'flesh-eating bacteria' spreading in Japan; will it affect rest of the world symptoms treatment snt
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First Published Jun 18, 2024, 10:51 AM IST

Japan is witnessing a disturbing increase in cases of a rare yet deadly human flesh-eating bacterial infection following the relaxation of COVID-19 restrictions. This disease, known as Streptococcal Toxic Shock Syndrome (STSS), has the terrifying capability of causing death within a mere 48 hours of infection.

As of June 2 this year, STSS cases in Japan have totaled 977, exceeding last year's total of 941 cases, as reported by the National Institute of Infectious Diseases. Due to its capacity for tissue destruction and rapid organ failure, the unchecked spread of this "flesh-eating bacteria" is alarming medical communities in Japan and around the globe.

Here’s what you need to know about this rare but severe bacterial infection, its symptoms, prevention, diagnosis, and treatment.

What is Streptococcal Toxic Shock Syndrome?

STSS is caused by the group A Streptococcus bacteria, typically known for causing strep throat among other infections. However, in rare cases, these bacteria can invade deeper tissues and the bloodstream, releasing toxins that trigger a rapid and severe response in the body. This can lead to life-threatening complications such as organ failure and tissue damage.

“STSS is a severe infection caused by Group A Streptococcus (GAS) bacteria. It progresses rapidly, leading to high fever, severe pain, low blood pressure, and potential organ failure.” Dr Jagadish Hiremath, public health intellectual, was quoted as saying in an Indian Express report.

What are the symptoms of STSS?

The onset of STSS is characterized by flu-like symptoms including fever, chills, muscle aches, nausea, and vomiting. Within a short period—usually 24 to 48 hours—the infection can progress rapidly, causing low blood pressure, rapid heart rate, breathing difficulties, and multiple organ failure. Prompt medical attention is crucial to manage these severe symptoms effectively.

“These toxins lead to widespread tissue damage and severe inflammation, resulting in rapid tissue necrosis (flesh-eating), extreme pain, and shock," Dr Hiremath said.

He further stated, “The bacteria can swiftly enter the bloodstream and organs, causing multi-organ failure in a short period. This rapid progression explains why STSS can be fatal within 48 hours, if not treated promptly. The toxins disrupt the immune system, leading to severe symptoms that require immediate medical intervention to prevent death.”

Who is at Risk?

While anyone can potentially develop STSS, certain factors may increase the risk, such as:

  • Age: Adults over 50 are more vulnerable.
  • Weakened Immune System: Individuals with compromised immunity.
  • Recent Surgery or Injury: Especially if wounds are not properly cared for.
  • Chronic Illnesses: Such as diabetes or heart disease.

What are some of the prevention measures?

Preventing STSS primarily involves practicing good hygiene habits such as regular handwashing and covering the mouth when coughing or sneezing. Proper wound care is also essential to prevent infections that could potentially lead to STSS. Seeking medical attention promptly for any signs of infection can help in early detection and treatment, thereby reducing the risk of complications.

How is STSS diagnosed and what treatment is carried out?

Diagnosing STSS typically involves blood tests to detect the presence of group A Streptococcus bacteria and to assess organ function. A confirmed diagnosis is made when there is evidence of a group A strep infection along with low blood pressure and signs of organ failure.

Treatment involves aggressive antibiotic therapy administered intravenously to eliminate the bacteria. Supportive care such as fluid replacement and, in severe cases, surgical intervention to remove infected tissue may also be necessary.

Why is it important to detect STSS early?

Early medical intervention significantly improves the chances of recovery from STSS and reduces the risk of long-term complications or fatalities. Timely recognition of symptoms and prompt initiation of treatment are critical in managing this rapidly progressing infection.

Will STSS affect rest of the world?

Dr. Hiremath reports that Japanese health authorities are actively overseeing the situation and implementing measures to contain the spread of STSS. Public awareness campaigns are educating individuals about the symptoms and gravity of STSS, stressing the importance of seeking immediate medical attention upon symptom onset.

“Hospitals are on alert to identify and treat STSS cases swiftly, and enhanced hygiene practices are being promoted. There’s a push for better wound care and timely treatment of infections. These measures aim to reduce the transmission and mortality associated with STSS," he said.

While the current outbreak is centered in Japan, Dr. Hiremath warns of its potential for global dissemination through international travel. Dr. Hiremath suggests that other countries can benefit from Japan's comprehensive approach to enhance their preparedness and response strategies. "Educating healthcare providers and the public about recognizing early symptoms and seeking timely medical care is very important," he emphasized.

While STSS remains rare, its rapid progression and severe consequences underscore the importance of vigilance, early detection, and immediate medical intervention. By understanding the symptoms, risk factors, and preventive measures outlined here, individuals can take proactive steps to safeguard their health against this serious bacterial infection.

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