Dangerous bacteria circulate among young children

Group A streptococciImage BSIP / Universal Images Group via

About seventy cases in young children have been reported in academic hospitals in recent months. We know this always peaks in the spring. But I cautiously estimate that we’re now seeing a threefold increase compared to previous years, says Michael van der Vlaer (UMC Utrecht), a pediatrician and infectious disease/immunologist. “Here in Utrecht alone, we had ten cases, and group A streptococcal infection was identified as the cause of death for two deceased young children who came to hospital for examination.”

His colleague, medical microbiologist Elske Sieswerda, agrees that there is a “scary high”. I have already seen some very serious cases. Remarkably, we also see necrotizing fasciitis, where the bacteria affect the skin and muscles. We don’t actually see it in children. Official records confirm that image. Before Corona, an average of seven serious infections were reported annually in young children. The counter is now at 11, and the year isn’t over yet.

flesh-eating bacteria

GAS bacteria (for short: group A streptococcus) usually cause fairly harmless conditions, ranging from scarlet fever to strep throat and impetigo. But in rare cases, the bacteria can lead to septicemia, arthritis and bone inflammation, meningitis, and thus also necrotizing fasciitis, to which the bacilli owe the name “flesh-eating bacteria.” Usually the infection can be treated with antibiotics, but sometimes a surgeon must remove infected tissue or proceed with amputation. Sometimes the result is fatal.

It’s “my guess,” van der Vlaer asserts, but there may be a catch-up effect after the Corona years. After all, bacteria often infect after chickenpox, probably because the bacteria take their chance through the infected skin. And with school closures and other anti-coronavirus measures like keeping a distance in recent years, we’ve also seen fewer chickenpox. This may lead to an increased incidence of chickenpox for the time being.”

Inquiries with research institute Nivel confirm this picture. In recent years, GPs have seen very few cases of chickenpox – and hospitals have not reported any serious cases of GAD. But at the end of last year, chickenpox started spreading again. In infants and young children, but also in children aged 5 to 15 years: this group currently has twice the number of chickenpox than in the years before the pandemic.

Springback effect

Research has shown that in any case, there is no new and dangerous strain of bacteria involved. So Siswerda is also considering the rebound effect. “I suspect this is related to the fact that children have been colonized less in the past two years.”

Pediatricians, RIVM and NHG GPs sent a warning to GPs: Beware if children who have had chickenpox get infected again, it could be this bacteria. “General practitioners know this, of course,” says van der Vlier. “But we hope everyone will be extra alert again.”

More or less the same advice applies to parents, he says: If a child with chickenpox develops a fever again and becomes drowsy, call the doctor. It is recommended to give a child with chickenpox paracetamol, not the strongest anti-inflammatories such as ibuprofen or diclofenac. “This may increase the risk of developing a gas infection.” By the way, there is no reason to panic, as van der Vlaer asserts: “The incidence is again so low that we don’t have to take all kinds of general measures right away.”

weak resistance

Gas strep is not the only infectious disease that behaves unusually after corona. For example, there was a major outbreak of RS last year, in the middle of summer of course. And in the UK, among other countries, people are concerned about sudden outbreaks of hepatitis (hepatitis), as well as among children.

Van der Flier appears less likely that children’s resistance has been weakened by sitting at home during lockdowns, alternative circuits claim. “Personally, I don’t think that’s the case. Then we should also see a lower response from children to vaccination, and that doesn’t seem to be the case.

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