What is Streptococcal Toxic Shock Syndrome or STSS?

Close to 1,000 cases of a potentially fatal 'flesh-eating' disease have been reported in Japan this year.

In the first half of 2024, Japan experienced a surge in cases of streptococcal toxic shock syndrome (STSS), a potentially fatal disease caused by a rare and aggressive strain of flesh-eating bacteria.

According to Japan Times, Cases of STSS reached 977 by June 2 this year, surpassing the previous record of 941 cases reported for all of last year, according to the National Institute of Infectious Diseases, which has tracked the disease since 1999.

Experts believe the number of cases in Japan could escalate to 2,500 by year's end. Here is a look at the disease:

What is STSS?

STSS is a rare but severe bacterial infection caused by group A Streptococcus (GAS). It occurs when these bacteria enter deep tissues and the bloodstream, releasing toxins that cause a rapid and dangerous response in the body.

The bacterium responsible for STSS, Streptococcus pyogenes, can claim lives within a mere 48 hours of symptom onset, making swift diagnosis and treatment essential.

Symptoms

The Japanese Ministry of Health, Labor, and Welfare has issued a warning to the public, urging them to be vigilant for symptoms such as fever, chills, nausea, vomiting, diarrhea, and a rash or bruises, which may indicate the presence of STSS.

How it spreads

The bacteria is transmitted through respiratory droplets, direct contact, and contaminated food.

People who carry the bacteria in their intestines can spread it by not washing their hands properly, contaminating surfaces and infecting others. The bacteria can also enter the body through open wounds, cuts, or skin infections.

Who is at risk?

"People with an open wound are at increased risk for STSS," according to the US CDC. This includes individuals who recently had surgery or a viral infection that causes open sores.

However, experts don't know how the bacteria enter the body for nearly half of people who get STSS.

Health experts stress the importance of preventing STSS through good hygiene practices, such as regular hand washing and covering the mouth while coughing or sneezing. Proper wound care is essential, and medical attention should be sought for any signs of infection.

Potential factors under investigation include changes in bacterial strains, environmental conditions, and human behaviour.

The public in Japan is being encouraged to practice good hygiene, including regular hand washing and proper food handling, to minimise the risk of infection.

What about outside Japan?

The World Health Organization (WHO) has been informed of the situation in Japan and is closely monitoring the situation.

The WHO has advised that STSS is rare outside of specific risk groups, such as those with weakened immune systems, menstruating women, and individuals with wounds or burns.

However, the organization emphasizes the importance of maintaining good hygiene practices to prevent the spread of the bacteria that cause STSS.