Public health officials with Manitoba Health, Seniors and Long-Term Care have identified a recent increase in the number of invasive meningococcal disease (IMD) and invasive group A streptococcal (iGAS) infections.
Invasive Meningococcal Disease
Eight cases of IMD have been identified in the last month including six adults and two children. Six people live in the Winnipeg Regional Health Authority, with one in Prairie Mountain Health and one in the Northern Regional Health Authority. Public health investigations are underway, at this time there are no known links between cases.
These infections most commonly present either as meningitis or an infection in the bloodstream (bacteremia). Symptoms include a dark purple rash, high fever, severe headache, stiff neck, upset stomach, severe aches or pains, weakness, drowsiness and sensitivity to light. It can result in serious outcomes including amputations and in about 10 per cent of cases, can result in death. Rapid treatment is necessary including antibiotics and other care, depending on the symptoms.
About 10 per cent of people can carry the bacteria that cause IMD in the back of their nose and throat without being ill. People spread the bacteria through respiratory droplets and saliva, generally through close or prolonged contact.
Many Manitobans have been immunized to protect against this disease, as part of the province’s routine immunization schedule. This includes immunizations to protect against specific types of bacteria for infants at 12 months of age and for children in Grade 6. Talk to a health-care provider about eligibility for immunization.
Invasive meningococcal disease is reportable to public health, as required under the Public Health Act. Typically, about six cases are reported annually. Public health will follow up with all close contacts of cases and offer antibiotics as well as immunization if the case is due to a vaccine-preventable type of the infection.
Invasive Group A Streptococcal Infections
Invasive Group A streptococci are bacteria commonly found in the throat and on the skin. The vast majority of group A strep infections are mild illnesses, such as strep throat and impetigo. However, iGAS infections are severe and sometimes life-threatening because the bacteria have invaded parts of the body where they are not usually found, such as the blood, deep muscle and fat tissue, or the lungs. It can cause severe disease such as necrotizing fasciitis, streptococcal toxic shock syndrome, or meningitis and requires immediate treatment including appropriate antibiotic therapy.
Only invasive infections are reportable to public health. Public health will follow up with close contacts of cases and recommend antibiotics for some people. While there is not a current cluster or outbreak of cases, Manitoba has seen an increase in reported iGAS cases post-pandemic, a trend that has been seen in other jurisdictions. In 2023, 200 confirmed cases were reported, compared to 150 in 2022.
iGAS can cause a range of different symptoms. As well as the signs of serious illness, there may be fever, muscle aches and pains. A bruise or skin infection may become red, warm or very painful, including pain beyond the area that is obviously affected. A rash may be present. Symptoms of meningitis include a headache, stiff neck, or vomiting, and some people present in shock with confusion and low blood pressure.
In early stages, invasive bacterial infections like IMD or iGAS sometimes mimic symptoms of viral infections like COVID-19 and influenza. They can occur at the same time or after these viral infections. While severe infections from IMD and iGAS are very rare, they are more commonly seen during periods where there is increased transmission of viral respiratory infections, like influenza. People should seek urgent medical care if symptoms worsen or if they or the people they care for become very unwell.
Immunization against influenza, COVID-19, and pneumococcal disease helps reduce the risk of having serious secondary bacterial infections that can occur after a respiratory infection, such as IMD and iGAS. It is also important for parents and caregivers to ensure their children are up to date on their routine immunizations, because this includes protection against some types of meningococcal disease.
Public health has provided an update to health-care providers about IMD and iGAS infections, asking them to remain vigilant for signs and symptoms among their patients. This update is available at: Updates to Health Care Providers – Communicable Disease Control | Health | Province of Manitoba
For more information about meningococcal disease, visit Meningococcal Disease (Neisseria meningitides) | Health | Province of Manitoba (gov.mb.ca)
For more information about iGAS infections, visit Group A streptococcus | Health | Province of Manitoba (gov.mb.ca)
