Even compared to the pre-pandemic level, Strep infection is still high in the U.S.

Strep rates are still higher than usual, a challenge that has been compounded by an antibiotic shortage. But doctors are optimistic the trend will abate soon.

Even though the pandemic is over, Strep infections are still high this spring.

The Centers for Disease Control and Prevention (CDC) said that unpublished data from their national surveillance program shows that emergency department visits for regular infections reached a five-year peak in February and march.

Epic Research’s report, which analyses electronic health records and analyzes strep rates, indicates that the rate of strep in February was nearly 30% higher than in February 2017, when it peaked.

The group informed NBC News that preliminary data indicates the upward trend continued into March.

The CDC could not confirm Epic’s stats because it did not have any data for regular strep infection dating back to 2017.

But Dr. Michael Cappello said, “we’re seeing more streps throats than ever before, and without doubt, compared to the pre-pandemic level.”

In general, the highest rates of Strep are seen between December and April. However, doctors began seeing cases last year as early as September.

Invasive group A strep infection rates have also been higher. Invasive cases of strep are more severe and can be life-threatening than ordinary strep. They occur when bacteria spreads to parts of the body normally free from germs, like the bloodstream or lungs.

According to a spokesperson for the CDC, “many states continue to experience higher than normal numbers of invasive Group A strep infections in children and adults ages 17 and under and 65 and older.”

In December, the CDC released a health alert about an increase in cases of invasive Group A strep infections in children.

The rise of invasive strep A is unprecedented

Dr. Maureen Ahmann is a pediatrician with Cleveland Clinic Children’s. She said that her practice has seen an increase in cases of invasive strep A.

Ahmann stated that “it’s still rare in comparison to other childhood illnesses but we are now seeing an increase.”

The U.S. records several million cases of noninvasive group A strep per year, but just around 14,000 to 25,000 invasive infections, according to the CDC. The invasive cases kill between 1,500 and 2,300 individuals every year.

Dr. Sam Dominguez is an infectious disease expert at Children’s Hospital Colorado, and professor at the University of Colorado School of Medicine. He said that his hospital had seen about 80 cases of invasive streptococcal strep between October and March. He said that in the past, there had been between five and ten cases per year during pandemics, but only about 20 to 25 years ago.

Dominguez stated that “we have seen a really unprecedented rise in Group A strep – more than we’ve seen here looking back at least ten years ago, and probably even longer,”

Invasive strep may cause skin infections such as flesh-eating diseases, lower airway infection like pneumonia or streptococcaltoxic shock syndrome, a severe immune reaction which can lead to organ failure. The CDC has 117 streptococcal cases this year compared to 45 last year.

Why hasn’t the number of strep infections decreased?

Epic Research’s findings are not peer-reviewed. They were based upon data collected from more than 1,100 clinics and hospitals in the U.S. as well as a health organization in Lebanon where they also collect data.

The report states that strep was the most common among children aged 4-13, but it has increased in all age groups.

The doctors have several theories about why the strep infection rate is so high.

The second factor is the respiratory virus that has been sweeping through hospitals and causing severe illness in babies. Another possible factor could be the respiratory viruses surge that the U.S. experienced this winter. Cappello explained that viral infections could weaken the immune system or cause irritation of the protective lining in the nose, throat and mouth, which would make it easier for strep to develop.

Cappello suggested that the other possibility was that this strain of group A streptococcus is one we’ve never seen before.

Doctors are hopeful that the cases will decline soon. Dominguez said that Cappello’s hospitals had seen fewer cases in April than they did in previous months.

Cappello stated, “I hope that this means we are on the downswing.”

The shortage of antibiotics is a serious problem

A shortage of amoxicillin has made it difficult to treat strep throat infections. In October, the Food and Drug Administration announced a shortage for a powder form of the drug. This problem has yet to be resolved.

Ahmann stated that some Ohio parents struggled with filling their children’s liquid amoxicillin medications.

Ahmann explained that a few months ago it got to a point where, when we needed liquid antibiotic, we would print out the prescription and hand it to a parent, saying, “Last I heard, this was available at the pharmacy down the street, but if not, you can try here.” Parents would literally search from pharmacy to pharmacy for it.

She added that anecdotally the shortage seems to finally be improving.

Children with a red or sore neck that makes it difficult to swallow, fever, swollen nodes, or rashes should be tested for strep.

Cappello advised that if your child suddenly stops communicating, is difficult to awaken, incoherent or working hard to breath, you should take them to the ER immediately.

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