Photo: Tourists are crowded outside Sensoji Temple in Tokyo, Japan. \AFP

Japan has experienced an outbreak of Streptococcus A infection, commonly known as “man-eating bacteria” (or “flesh-eating bacteria”). Among them, nearly 1,000 cases of streptococcal toxic shock syndrome (STSS), a serious infection, were recorded in the first half of the year, setting a record high. The bacteria are mainly transmitted through droplets or contact, and streptococcal toxic shock syndrome develops rapidly, with a mortality rate of 30% to 50%, and patients may die within 48 hours. Infectious disease experts urge people to raise their awareness of prevention, especially the elderly who are susceptible to infection. If symptoms occur, they must seek medical attention as soon as possible.

NHK reported that the National Institute of Infectious Diseases of Japan stated that as of June 2 this year, there were 977 cases of streptococcal toxic shock syndrome (STSS) in Japan, about 2.8 times the same period last year, with the highest number of cases in Tokyo, reaching 145. Last year, there were 941 people infected in Japan, and the cumulative number of cases this year has exceeded this number, setting a record high.

Group A Streptococcus is a common bacterium, the full name of which is Streptococcus pyogenes. It is mainly transmitted through droplets or contact. Generally, the symptoms of infection are mild, including high fever, headache and rash. However, when Group A Streptococcus infects sterile parts (such as blood and muscles), serious infections such as necrotizing fasciitis (commonly known as “flesh-eating bacteria infection”), streptococcal toxic shock syndrome and meningitis may occasionally occur. Among them, streptococcal toxic shock syndrome is a rare and severe disease, and the disease progresses extremely quickly and violently. Elderly people or patients with chronic diseases (such as diabetic patients) may even experience a rapid drop in blood pressure, multiple organ failure, and shock within 48 hours, with a mortality rate of 30% to 50%.

The strain prevalent in Japan is highly toxic

Japanese media said that the current local prevalence of Group A Streptococcus in Japan is the highly toxic strain M1UK, which has been detected more frequently in areas including the Kanto region since the second half of last year. The health department is strengthening monitoring work.

Infectious disease expert and professor at Tokyo Women’s Medical University Ken Kikuchi said that most patients with streptococcal toxic shock syndrome are aged 65 and above. The bacteria usually enter the body through minor injuries, including rashes caused by athlete’s foot. Sometimes symptoms develop rapidly due to collisions such as falls. Since the disease is difficult to diagnose in the early stages, Kikuchi recommends that if there is rapid swelling of the wound, high fever or unconsciousness, medical treatment must be sought as soon as possible.

Japanese Chief Cabinet Secretary Yoshimasa Hayashi said on Tuesday that since the outbreak of the new coronavirus, cases of respiratory diseases have continued to increase, and the authorities have implemented basic infection prevention measures. Health, Labor and Welfare Minister Keizo Takemi said it is necessary to continue to pay attention to the development of the epidemic. Japanese authorities earlier called on people planning to travel to Japan not to cancel their trips because of this, as long as they maintain hand hygiene during the trip, cover their mouths and noses when coughing, and pay attention to basic epidemic prevention.

It is difficult to prevent transmission through droplets

According to reporter Yi Xiaotong, Hong Kong infection and infectious disease specialist Dr. Lam Wai-sun told Ta Kung Pao on Wednesday that the strain prevalent in Japan is highly pathogenic, but serious cases are still rare and the probability of encountering the bacteria infection is low. Hong Kong people do not need to worry too much when traveling to Japan. He said that as long as you pay attention to personal hygiene, do not touch your mouth and nose casually, and wash your hands frequently, you can greatly reduce the chance of serious infection.

Lin Weixun said that due to different bacterial strains, some bacterial strains are more pathogenic and thus can cause more serious diseases. The symptoms and conditions can vary, ranging from simple upper respiratory tract infections such as pharyngitis and tonsillitis to severe soft tissue inflammation, including necrotizing fasciitis, and may also cause unstable blood pressure and shock. He said that “man-eating bacteria” can be spread through droplets or through direct or indirect contact with wounds. The elderly or people with impaired immune systems are at higher risk of infection, but when the bacteria are more pathogenic, people in good health may also be infected.

Lam Wai-shun said that there have been occasional serious cases of streptococcal infection in Hong Kong recently. He believed that there have been cases of “man-eating bacteria” in Hong Kong, but it is not certain that a large-scale outbreak will occur. He reminded the public that if they have upper respiratory tract infections and find that their condition is unusual or there is severe soft tissue inflammation, they should seek medical attention as soon as possible. On April 3 this year, the Hong Kong Department of Health reported that a Hong Kong resident was infected with group A streptococci while traveling in Osaka, Japan, causing necrotizing fasciitis and died there. (Comprehensive report)