By D.W.G. Kalani Tharanga, JadeTimes News
Japan is grappling with unprecedented cases of streptococcal toxic shock syndrome (STSS), a highly fatal bacterial infection. As of June 2, the Health Ministry reported 977 STSS cases, surpassing last year’s record of 941, marking the highest incidence since records began in 1999. Between January and March alone, 77 deaths were attributed to the infection, which has a mortality rate of up to 30%. In 2023, the National Institute of Infectious Diseases documented 97 fatalities due to STSS, the second highest in the past six years.
STSS, although rare, is a severe bacterial infection that occurs when bacteria infiltrate deep tissues and the bloodstream. Initial symptoms include fever, muscle pain, and vomiting, but the condition can swiftly become life threatening, leading to low blood pressure, swelling, and multiple organ failure as the body goes into shock. The US Centers for Disease Control and Prevention (CDC) emphasizes the high fatality rate, noting that even with treatment, up to three out of ten people with STSS may die.
Causes and Contributing Factors
The majority of STSS cases are caused by group A streptococcus (GAS) bacteria, which typically induce fever and throat infections in children. In rare instances, strep A becomes invasive, producing a toxin that allows it to enter the bloodstream, causing severe illnesses like toxic shock. Strep A can also lead to necrotizing fasciitis, a “flesh eating” disease that may result in limb loss. Individuals with weakened immune systems, such as those with cancer or diabetes, are more susceptible to severe outcomes.
The rise in invasive group A strep infections has been noted globally. After the relaxation of Covid 19 restrictions, such as masking and social distancing, many countries, including the UK and several European nations, reported an increase in these infections. Japan observed a significant increase in STSS cases from July 2023, particularly among those under 50. Factors such as recent surgery and open wounds elevate the risk of contracting STSS. However, the CDC acknowledges that the infection pathway remains unknown for nearly half of the cases.
Possible Explanations for the Surge
The precise reason for the surge in STSS cases in Japan remains unclear. Professor Ken Kikuchi of Tokyo Women’s Medical University suggests that weakened immune systems post Covid might be a contributing factor. “Regular exposure to bacteria helps boost immunity, but this mechanism was disrupted during the coronavirus pandemic,” Kikuchi explained. “As a result, more people are now vulnerable to infections, potentially explaining the sharp increase in STSS cases.” Japanese authorities continue to monitor the situation closely, seeking to understand and mitigate the factors driving this alarming trend.