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Lethal “flesh-eating” bacteria with a two-day fatality rate spreads in Japan

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A rare and potentially lethal disease known as Streptococcal toxic shock syndrome (STSS), often referred to as “flesh-eating bacteria,” is rapidly spreading in Japan following the easing of Covid-era restrictions. According to the National Institute of Infectious Diseases, Japan has reported 977 cases of STSS as of June 2 this year, surpassing last year’s total of 941 cases.

STSS is caused by certain strains of Group A Streptococcus (GAS), which typically cause mild symptoms such as swelling and sore throat in children. However, more virulent strains associated with STSS can lead to severe complications including limb pain, swelling, fever, low blood pressure, tissue necrosis, respiratory distress, organ failure, and death, particularly among individuals over 50.

Professor Ken Kikuchi from Tokyo Women’s Medical University emphasized the rapid progression and high mortality rate of the disease, noting that “most deaths occur within 48 hours” of symptom onset, with swelling spreading rapidly from the foot to the knee in mere hours.

The resurgence of STSS cases is not limited to Japan; several European countries have also reported increases in invasive Group A streptococcus (iGAS) cases to the World Health Organization in late 2022.

With cases potentially reaching 2,500 by year’s end, Kikuchi warned of a “terrifying” mortality rate of around 30%. He stressed the critical importance of maintaining rigorous hand hygiene and proper care of wounds, highlighting the risk of infection from GAS bacteria found in the intestines.

In response to the outbreak, Hong Kong authorities have issued travel advisories for visitors to Japan, urging strict adherence to personal hygiene practices and heightened vigilance regarding wounds. Medical professionals worldwide are emphasizing the significance of good hygiene habits, especially with the resumption of international travel, advising prompt medical attention for any sudden onset of fever or pain, and thorough cleaning and protection of wounds or cuts.

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