Published On: Mon, Nov 27th, 2017

Canada: Group A Streptococcus alert issued in London

An invasive group A streptococcus (iGAS) outbreak, that has been ongoing since April last year, has prompted an alert issued to local healthcare providers, hospitals and community partners in London, Ontario.

Streptococcus pyogenes on Sheep blood agar
Image/ CDC

Since April 1st, 2016 more than 132 cases of iGAS infection have been reported to the  Middlesex-London Health Unit. Of the cases, 22% required treatment in intensive care, 15% had Streptococcal Toxic Shock Syndrome, 15% had Necrotizing Fasciitis (aka “flesh-eating” disease), and nine people have died.

“Two distinct realities have emerged during our investigation,” says Dr. Hovhannisyan, Associate Medical Officer of Health at the Middlesex-London Health Unit. “We’ve found about half of the cases are among injection drug users and/or those without access to stable housing. Yet there has also been an increase in iGAS infections among people who have no connection, and are not related, to the outbreak in people who inject drugs or who are under-housed. We need a better understanding of what’s happening, which is why we’ve issued this alert.”

LISTEN: The story behind the Toxic Shock Syndrome outbreak investigation of the late 70s-early 80s

Group A streptococcus (GAS) are common bacteria which can cause skin and throat infections, including strep throat and cellulitis; however some people may carry GAS in their throat or on their skin without becoming sick. While the majority of GAS infections cause relatively mild illnesses like strep throat and impetigo, sometimes the bacteria can become invasive and can cause more serious and potentially life-threatening infections when they get into muscles, blood and other organs. Symptoms of an iGAS infection depend on the site of the infection and may include fever, chills, sore throat, dizziness, confusion, severe pain, redness or swelling around a wound or injured area.

GAS bacteria are spread by direct contact with nose and throat secretions from an infected person, or by direct contact with infected wounds or sores on the skin. While GAS infections can occur year-round, the number of infections tends to increase during winter months.

The dark side of strep throat: What is necrotizing faciitis?

Health officials offer the following preventive measures for the public:

  • Wash your hands regularly, especially after coughing or sneezing and before handling or eating food;
  • Cover the mouth and nose when you cough or sneeze; use a tissue or your sleeve, not your hands;
  • Avoid sharing drinking glasses, cups, water bottles and eating utensils,
  • Do not share drugs, needles, filters and other drug paraphernalia;
  • Keep all wounds clean, and watch for possible signs of infection such as a rapid increase in redness, swelling, drainage, and pain at the wound site. Seek medical care if infection does not clear up, or if it spreads rapidly.
  • If you’ve been in close contact with a person who has recently had iGAS disease, see your health care provider immediately, as you may need to begin preventative antibiotics.



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  1. Toronto officials report 10 deaths due to a group A streptococcus in 2017 - Outbreak News Today says:

    […] days after Middlesex-London Health officials reported an invasive group A streptococcus (iGAS) outbreak that has resulted in nine fatalities in 2017, Toronto health officials have confirmed 10 group A […]

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