What is STSS? Bacterial infection may cause organ failure, require surgery

• Cases of streptococcal toxic shock syndrome (STSS) have risen suddenly in Japan this year.
• The rare and deadly bacterial infection affects blood and tissue.
• STSS is treated with antibiotics and sometimes surgery. There is no vaccine for the infection.

In Japan, cases of an uncommon but deadly bacterial infection have spiked in recent months, concerning health officials, the Washington Post reported.

Since January 2024, officials from Japan’s Health Ministry have reported 1,019 cases of streptococcal toxic shock syndrome (STSS), a bacterial infection without a vaccine and treated with antibiotics. At least 77 deaths have been reported due to these STSS infections, with most fatal cases occurring in people over 50.

Officials from Japan’s Health Ministry said they are unsure what has caused the sudden increase in cases. But they find the surge alarming, considering that fewer than 1,000 cases of STSS were reported in the country in 2023.

STSS causes and symptoms

STSS is caused by bacteria called group-A Streptococcus (GAS), according to the CDC.

This particular bacteria also causes mild infections like strep throat since it is commonly found in the throat and on the skin.

But if GAS gets into a person’s bloodstream or tissue through open wounds or sores, their organs may start to fail within 24 to 48 hours, as per the CDC website. GAS has also been linked to necrotizing fasciitis, an infection that causes a “flesh-eating” disease.

According to the CDC, three in 10 people who develop STSS are likely to die.

Flu-like symptoms such as chills, fever, and muscle aches are often the first signs someone has STSS. More severe symptoms that signal organ failure due to STSS include:

• Low blood pressure signs include dizziness, blurred vision, weakness, nausea, and headaches.
• An abnormally rapid heart rate
• Abnormally rapid breathing

If someone has these symptoms, they should go to the hospital right away, according to the CDC.

Treatment typically involves replacing bodily fluids and antibiotics. According to the CDC, surgery may be needed to remove tissue infected by the GAS bacteria in some cases.

Infections like STSS are on the rise globally

Steer told the Washington Post that “we’ve had streptococcal toxic shock syndrome and invasive strep A infection in the US for decades and decades and decades, hundreds of years.”

However, it’s an uncommon infection, and healthcare providers should take the sudden uptick in STSS cases in Japan as a cue to increase their awareness of potential symptoms among their patients, said Andrew Steer, director of infection, immunity, and global health at Murdoch Children’s Research Institute in Melbourne, Australia.

Since the coronavirus pandemic, health officials worldwide have expressed concern about increasing bacterial and viral infection rates.

In 2022, UK health officials reported 19 child deaths due to group-A streptococcal infections, the same bacteria that causes STSS.

Vaccines could help prevent the spread of these rare but potentially deadly bacterial infections, health experts said. However, creating one has proven to be a decadeslong process that is still in progress due to financial and scientific hurdles.