Invasive Group A strep deaths and infections continue to climb in N.B.

New Brunswick recorded another 20 confirmed cases of invasive group A streptococcal infections in February and of these, two more people died, figures obtained from the Department of Health show.

The latest deaths include a person aged 10 to 59 and a person aged 60 or older.

The province's 2024 total now stands at 50 cases and nine deaths, including a seventh death added to the January total.

That's almost the same number of deaths New Brunswick saw all of last year, when 10 of 107 confirmed cases died.

Between 2018 to 2022, New Brunswick saw an average of six invasive Group A strep (iGAS) deaths per year, and 51 cases.

"This [2024] data is still under review and is subject to change," said department spokesperson Sean Hatchard.

Group A streptococcus is a common, often-harmless bacteria found on the skin or in the nose and throat. It can cause a variety of common illnesses, such as strep throat, scarlet fever and skin infections.

But when these bacteria spread into sterile parts of the body, such as the bloodstream, the fluids around the brain, lungs, or spine, or into soft tissue, they become "invasive" Group A strep infections, such as necrotizing fasciitis, more commonly known as flesh-eating disease, and toxic shock syndrome, which occurs when the bacteria produce toxins that can cause various organs to stop functioning.

Canada is seeing a record number of invasive Group A strep (iGAS) infections. The exact cause is unclear.

Updates only monthly and upon request

New Brunswick will only be releasing iGAS data monthly — and only upon request, Hatchard told CBC News in mid-February, when he denied a request for an update.

"While Public Health is monitoring the situation, the Department of Health will be updating the number of cases and deaths, upon request, on a monthly basis going forward. This is to ensure time for the numbers to be reviewed and validated," he said in an emailed statement.

"However, should the situation change, and Public Health determines more timely communication is needed, the department will act quickly."

The department has no plans to add invasive Group A to the monthly Respiratory Watch report, said Hatchard.

"These reports are intended for respiratory viruses, such as influenza and COVID-19, and many other jurisdictions do not include iGAS in their respiratory reports," he said.

Breakdown of cases by age

Invasive Group A strep is reportable in New Brunswick. This means that these more severe infections are tracked, and contacts are managed by Public Health staff to reduce the risk of ongoing spread.

Hatchard said he could not provide a breakdown of which types of invasive Group A strep infections New Brunswick is seeing the most of, or discuss whether any particularly concerning trends are emerging.

He could not provide a regional breakdown of infections either, but the breakdown by ages for February includes:

• 0-9 years old: 0 cases, 0 deaths.

• 10-59: 15 cases, one death.

• 60 and older: Five cases, one death.

The age breakdowns for 2024, as of Feb. 29, include:

• 0-9 years old: One case, one death.

• 10-59: 31 cases, five deaths.

• 60 and older: 18 cases, three deaths.

Review of pharmacy testing pilot not until fall

The Opposition has called on the Department of Health to work with pharmacists to expand a pilot that's currently providing strep A testing at six pharmacies.

"Parents are worried about their kids and are looking to our healthcare system to help ensure they are safe and healthy," Opposition Leader Susan Holt said in a recent statement.

"I understand that there are lots of details to be worked out in order to make it happen, but we must give people across the province accessible and timely service to what could be a life saving test."

Rob McKee, health critic for the Liberals, said sick New Brunswickers don't have many places to turn "with our primary-care system crumbling and growing shortage of family doctors.

"The pilot was a good idea that we need to expedite to deal with a health-care issue that people are facing right now," he said.

Invasive Group A strep diagnosis is based on assessment of clinical symptoms by a health-care provider and laboratory testing, according to Public Health. (istock)

Hatchard said the Pharmacist Care Clinic pilot project won't be reviewed until the early fall, after all six pharmacies have been participating for a year.

The department is working with the New Brunswick Institute for Research, Data and Training to conduct a comprehensive, independent evaluation.

"It should be noted that … New Brunswick, Nova Scotia (both in pilot projects) and Alberta are the only provinces at this time where pharmacists offer Group A strep assessment, point-of-care testing and prescription," said Hatchard.

"If you do not have symptoms, you do not need to be assessed or tested," he added.

Horizon Health Network acknowledged in a recent public service announcement that there are "limited appointments" available at the six participating pharmacies, and urged people to be patient.

Nurse practitioners are supporting the participating pharmacies in Moncton and Fredericton by temporarily providing assessments a few days a week, during the evenings, it said. "A participating pharmacy may refer you to a Horizon [nurse practitioner] for an assessment."

People can also visit their primary care provider, an after-hours clinic, or eVisitNB, or call Tele-Care 811 and speak to a registered nurse, who can refer patients to a primary care provider for assessment and treatment.

New Group A strep website

In response to the increased number of iGAS infections, the province recently created a Group A strep website and updated its factsheet to ensure New Brunswickers have access to useful information.

In January, Dr. Yves Léger, the province's acting chief medical officer of health, asked the Department of Education and Early Childhood Development to share a memo about an increase in invasive Group A strep infections and other respiratory viruses, such as influenza, RSV, COVID-19, with parents and guardians of children in schools and  across the province.

In December, the department advised physicians about the anticipated increase in cases, said Hatchard.

Symptoms to watch for

Public Health recommends New Brunswickers get assessed if they have any of the following symptoms: a sore throat that continues to worsen over the course of a few days and is accompanied by fever but without any the other typical viral infection symptoms, such as cough, runny nose, or hoarseness; signs of skin infection, such as red, painful or swollen skin, or fluid draining; a fever that lasts more than three days, or a fever that has passed and then returns; difficulty breathing; white or blue lips; difficulty waking up or confusion.

Anyone who is very ill and deteriorating quickly should also get assessed, said Hatchard

"In addition, if a parent looking after a sick child feels that something is not right with their child, they should follow their instincts and contact a health-care provider," he said.

A microscopic view of Group A streptococcus bacteria (orange), which can cause a spectrum of disease, ranging from milder infections like strep throat to life-threatening illness. (National Institute of Allergy and Infectious Diseases/The Associated Press)

While there is no vaccine available for invasive Group A strep, Public Health says respiratory virus vaccinations, such as those for COVID-19, influenza and chickenpox, can help limit the likelihood of serious infection.

Other protective measures people can take include wearing a well-fitting mask when in crowded places, frequent handwashing and staying home when sick.

In addition, avoid contact with saliva or respiratory secretions by not sharing straws, cups and utensils, etc., and keep cuts and wounds clean and covered.