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Prof. Dr. Siegbert Richard Rieg, head of the Department of Infectious Diseases at the Medical Center - University of Freiburg, discusses the causes of outbreaks of streptococcal toxic shock syndrome and prevention strategies.

In the last two years several European countries including Sweden, the UK, France and the Netherlands as well as Australia, the USA and Japan have reported higher number of invasive Group A Streptococcus infections particularly in children. Possible explanations include waning immunity due to reduced exposure with the causative bacteria as a consequence of COVID-19-related protection measures such as wearing masks and social distancing. Another reason may be an epidemiological shift with occurrence of new Streptococcus strains with more invasive characteristics and higher toxin production.

Streptococcal Toxic Shock Syndrome (STSS) is a severe illness caused by Group A Streptococcus (GAS) bacteria entering deeper tissues or the bloodstream and producing toxins, leading to organ failure and shock. Symptoms include sudden high fever, low blood pressure, rash, redness of eyes, mouth, and throat, confusion, and severe pain or swelling at infection sites.

STSS can arise from various streptococcal infections like skin or respiratory infections and post-surgical wounds. High-risk groups include individuals with chronic illnesses, those who are immunocompromised, and those recently undergoing surgery or childbirth.

Treatment requires immediate intravenous antibiotics, intensive care management, and surgery to remove infection sources. The mortality rate can be as high as 30%, therefore early diagnosis is of paramount importance, and immediate contact to large referral centers (such as the University Medical Center Freiburg) is recommended.

Preventive measures include good hygiene practices, prompt treatment of streptococcal infections, and seeking early medical help if symptoms such as severe redness, pain and fever at the skin or soft tissues or at surgical sites appear.

In conclusion, STSS is a life-threatening condition that requires immediate medical attention. Understanding symptoms and preventive measures can reduce its incidence and improve outcomes. Public health measures in Europe aim to control outbreaks through rapid response and treatment protocols. Maintaining good hygiene and timely medical care are essential for protection against STSS.