All about STSS – the deadly flesh-eating bacteria on the rise in Japan

Over 1,000 cases of Streptococcal Toxic Shock Syndrome (STSS) were recorded in Japan in the first six months of the year. Photo: National Institute of Allergy and Infectious Diseases

SHAH ALAM - A rare, deadly, flesh-eating bacteria is on the rise in Japan, with over 1,000 cases of Streptococcal Toxic Shock Syndrome (STSS) recorded in the first six months of the year.

The number of STSS cases recorded in the land of the rising sun so far had surpassed the total cases recorded last year, and it is expected to reach 2,500 cases this year with a 30 per cent mortality rate.

STSS can be fatal in some cases, with 77 deaths from the illness recorded by Japan’s National Institute of Infectious Diseases in March.

The institute has warned that the disease can kill in a matter of days.

What is STSS?

Streptococcal toxic shock syndrome is a severe illness caused when Group A Streptococcus (GAS) bacteria spreads into the blood and deep tissues, according to the US Centres for Disease Control and Prevention (CDC).

Open wounds or sores, diabetes and alcohol usage are all factors that can increase the risk of contracting STSS. The disease is most common in those over 65 years old.

The disease can be more serious when it occurs with necrotizing fasciitis, a flesh-eating form of Group A Strep bacteria that STSS is ‘highly associated with,’ which destroys muscles, skin and underlying tissues, according to Penn Medicine.

Symptoms

Though rare, such infections would usually disguise themselves as common fever, muscle aches, and nausea.

Untreated for between 24 and 48 hours, this could lead to low blood pressure, observable through physical symptoms such as a heart rate faster than normal and rapid breathing.

By this time, patients would expect some organ failure, which could be observed by the inability to urinate (kidney failure), bleeding, and bruising with yellow eyes (liver failure), as part of the STSS condition.

How it spreads

GAS bacteria spreads through respiratory droplets or direct contact with infected people.

Individuals can carry the bacteria without showing symptoms of infection. Open sores and wounds, weakened immune systems and being pregnant might increase the chance of infection from GAS, while alcohol and drug use are additional risk factors.

Treatment

Treatment usually involves removing the infected tissues to control the infection but not get rid of it completely, making prevention important.

Preventative measures include maintaining good hygiene by washing hands regularly, covering the mouth while coughing or sneezing and treating any open wounds immediately.

What does this mean for Malaysia?

While Malaysia has not recorded any cases of STSS, Health Minister Datuk Seri Dr Dzulkefly Ahmad said that the country is currently seeking guidance from the World Health Organisation regarding the infection and implementing preventive measures.