A steep rise in dangerous strep infections among children has emerged post-COVID, prompting calls for urgent public health action.
At a Glance
- Invasive Group A strep infections surged in children post-pandemic
- 25% of pediatric cases involved severe viral co-infections
- Genetic profile of strep strains remained stable despite rise
- Experts urge expanded surveillance and vaccination strategies
Surge in Infections Sparks Concern
Following the relaxation of pandemic-era precautions, health experts are sounding alarms over a significant resurgence of invasive Group A Streptococcus (iGAS) infections in children. These infections—ranging from skin conditions to life-threatening pneumonia and bloodstream infections—have spiked dramatically since 2023.
According to Contagion Live, the post-pandemic period has seen a disproportionate rise in pediatric iGAS cases, often requiring intensive care. Analysts attribute the surge to reduced immunity after years of isolation, masking, and school closures, which had also temporarily suppressed common infections like strep.
Watch Medscape’s report on the incident at Pediatric Invasive Group Streptococcal Infections Show Post-Pandemic Surge.
Genetic Stability Amid Epidemiological Shifts
Despite the uptick in infections, there is no evidence that the genetic structure of the bacteria has changed. The dominant strain, emm1/ST28, remains consistent with pre-pandemic findings, as confirmed in a study published in The Journal of Pediatric Infectious Diseases. This suggests the increased spread is due more to environmental and social changes than to bacterial evolution.
Anthony Flores, MD, MPH, PhD, explained in Contagion Live that “transmission bottlenecks play a critical role in shaping pathogen genetic diversity and evolutionary trajectories,” underlining the need to understand how such disruptions impact disease patterns.
Viral Co-Infections Intensify Severity
The interaction between strep and respiratory viruses has been particularly concerning. About one in four iGAS cases in children involved a concurrent viral infection, which intensified symptoms and often led to hospitalization. This trend has renewed interest in dual-vaccine strategies to prevent both viral and bacterial infections.
Dr. Halima Dabaja-Younis emphasized in Contagion Live that “the postpandemic resurgence of viral respiratory infections, which are known to predispose to IGAS, also likely contributed to increased disease incidence.”
Rethinking Prevention and Policy
The rise in iGAS infections has underscored critical gaps in disease preparedness. As noted in a Medscape report, this outbreak is a “clarion call” for ramped-up pathogen surveillance and studies into transmission dynamics. Their commentary stresses the urgency of understanding how viruses and bacteria co-evolve and impact human health in the aftermath of global disruptions.
Experts also advocate for targeted vaccination campaigns. The potential for strep and respiratory virus vaccines to reduce the burden of iGAS is significant, particularly in low- and middle-income countries where strain diversity is broader. Age-specific factors, including varicella history, may influence the likelihood of severe iGAS and should inform immunization strategies.
Looking Ahead
As health systems adapt to post-pandemic realities, the iGAS surge serves as a stark reminder of the importance of resilience in pediatric infectious disease control. With careful monitoring, strategic vaccinations, and improved public health responses, experts hope to reverse these worrying trends and better safeguard children’s health in the years to come.
