The National Department of Health reports on the epidemiology of Streptococcus pyogenes (also known as Group A Streptococcus), a Gram-positive bacterium responsible for acute pharyngitis and skin infections such as impetigo, cellulitis, and scarlet fever The most common bacterial cause.
The portfolio includes Streptococcus pyogenes as a mandatory inclusion at the national level following an alert in December 2022 due to an increase in cases of invasive disease caused by Group A Streptococcus in countries in the European region and the emergence of cases in different jurisdictions in Uruguay and Argentina. The Notified Events and Enhanced Surveillance Program is designed to help understand the reasons for changes in epidemiological patterns of event occurrence.
As of November 6, 2023, the National Health Surveillance System (SNVS 2.0) reported a total of 487 cases of invasive Streptococcus pyogenes infection, including 78 deaths. Almost half of the Streptococcus pyogenes cases were in children under 16 years of age (241 cases, equivalent to 49.5%), while 38.5% of deaths were in children under 16 years of age, with the remaining cases distributed across all age groups.
On the other hand, although scarlet fever is not a mandatory notifiable event, an outbreak of any cause is. Against this background, in October 2023, an outbreak of scarlet fever was reported in an educational institution in the province of Santa Fe, with 5 related cases, none of which required hospitalization, and all cases were progressing smoothly. Diagnosis is made from a sample of pharyngeal secretions.
Genomic surveillance
Health teams raised awareness through timely issuance of alerts, allowing cases to be detected and registered in the national health surveillance system during 2023. On the 26th and 31st of Epidemiological Week (SE), the National Epidemiological Bulletin (BEN) issued continuous reports, updated the national epidemiological situation, and issued an announcement on the discovery of M1UK clones and the discovery of 7 sublineage cases in Argentina. Warning M1 has acquired a mobile genetic element encoding the superantigenic toxin SpeC, distinct from the emerging strains M1UK (UK) and M1DK (Denmark).
The SE31 document emphasizes that these findings do not modify current recommendations for early diagnosis and prompt and adequate treatment of Streptococcus pyogenes infection and its re-transmission.
Based on these findings, a joint effort by the National Reference Laboratory, the Bureau of Epidemiology and jurisdictions is underway to implement supplementary surveillance of non-invasive disease caused by Streptococcus pyogenes with the aim of analyzing possible differences between emerging clones. relationship and the increase in cases this year. In July 2023, the Streptococcus pyogenes Notification Instructions and Other Invasive Infection Notification Forms in SNVS 2.0 (Monitoring Incidents of Group A Streptococcus Invasive Infections) were released and are available at:
https://bancos.salud.gob.ar/recurso/instructivo-para-la-notificacion-de-s-pyogenes-en-el-snvs-20
https://bancos.salud.gob.ar/recurso/otras-infecciones-invasivas-inmunoprevenibles-y-otras
Streptococcus pyogenes is included as a mandatory notification event within the framework of the PAHO alert-based surveillance awareness policy. Although the event could previously be notified in the national surveillance system, these actions aim to standardize the surveillance and notification of invasive diseases caused by Streptococcus pyogenes and increase awareness among health teams and in the epidemiological and laboratory fields, explains the systematic registration development across the country.
However, as a result of this effort, health teams are seeing higher rates of invasive disease caused by this pathogen, including fatal cases reflected in the notification. A highly virulent clone has been detected for the first time in Argentina, which has been registered in other countries, which may partly explain the higher morbidity and mortality, but for this more evidence is necessary, for which the national and provincial teams have interest.
Advice to the public
Symptoms of pharyngitis include sore throat, fever, headache, abdominal pain, nausea and vomiting, redness of the throat and tonsils, bad breath, and swollen lymph nodes in the neck.
The most common symptoms of scarlet fever are a red, sore throat; fever (38.3°C or higher); a red rash with a sandpaper texture; dark red skin in the armpits, elbows, and groin creases; white patches on the tongue or back of the throat Lichen; “raspberry” tongue; headache; nausea or vomiting; swollen glands; body aches.
When some of these symptoms occur, it’s important to avoid self-medicating with antibiotics and consult a doctor for prompt diagnosis. In case of medical indications for antibiotic treatment, it is necessary to complete the treatment regimen (adhere to the prescribed dosage and schedule, do not shorten or abandon treatment prematurely), since inappropriate use of antibiotics promotes bacterial resistance, which is a threat to its future effectiveness.
Sick people should avoid public places (work, school) and limit household contacts. It is also important to wash your hands frequently, not share personal items (cutlery, glasses, towels, etc.) and to adequately ventilate the environment regularly.