Brian McDonald
A potentially deadly bacterial infection called streptococcal toxic shock syndrome, or STSS, is spreading in Japan, raising questions about its causes and how to prevent it.
National Institute of Infectious Diseases of Japan issued a statement in March warning that STSS was increasing in the country. On June 2, Japan’s Ministry of Health reports 977 cases since the beginning of 2024 – surpassing 941 cases from last year.
That’s nearly two and a half times the number reported in the U.S. so far this year.
The STSS is a ‘rare but serious’ bacterial infection which can “evolve very quickly into a life-threatening emergency,” according to the Centers for Disease Control and Prevention.
Early symptoms of STSS often include fever, chills, muscle aches, nausea and vomiting, the CDC states. Japan’s health ministry adds that people also experience pain and swelling in their arms and legs.
After 24 to 48 hours, low blood pressure typically develops and can cause more serious problems, including organ failure, increased heart rate, and rapid breathing.
“Even with treatment, STSS can be deadly. Out of every 10 people with STSS, up to 3 people will die from the infection,” the CDC states.
In the US, the CDC counted 395 cases reported so far this year, not far from the 390 reported this time last year.
What causes streptococcal toxic shock syndrome?
STSS is caused by toxins released by Streptococcus pyogenes, also known as Group A Streptococcus, or GAS, which commonly causes sore throats and skin infections, explains Dr. Céline Gounder, a CBS News medical contributor who specializes in infectious diseases and general editor for public health at KFF Health News.
“Less commonly, GAS causes blood and lung infections, as well as ‘flesh-eating’ infections,” explained Gounder. “Approximately 30 to 60% of people who suffer from these more serious infections will die from them.”
It’s not yet known why these serious infections are becoming more common, experts say, but there are ways to help prevent infection.
“Because chickenpox and influenza are risk factors for serious GAS infection, vaccination against varicella zoster virus and influenza may reduce the risk of serious GAS infection,” Gounder said. “People who have been in close contact with someone with serious GAS infections and who are immunocompromised, pregnant, or have open wounds should receive antibiotics to prevent infection.”
Where is SSTS found?
Anyone can get STSS, says the CDC, but certain risk factors can increase your risk, including:
- Age – is more common in adults aged 65 and over
- Infections or injuries that break the skin
- Other health factors, including diabetes and alcohol use disorder
Risk factors for serious Group A Streptococcus infections, Gounder said, include trauma, surgery, burns, immunosuppression, pregnancy, diabetes, injection drug use, homelessness and chickenpox or flu infection.
Since the end of 2022Several countries have recorded rising rates of GAS, including the United Kingdom, Ireland, France, the Netherlands and Sweden.
“Outbreaks like these demonstrate the need for continued surveillance and control of infectious diseases, not just in the United States, but around the world,” said Gounder.
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