Spread of flesh-eating bacteria causes frenzy in Japan: Here’s all about STSS, the deadly disease that can kill in 2 days

Japan is experiencing an increase in cases of a rare and deadly disease caused by flesh-eating bacteria, specifically streptococcal toxic shock syndrome (STSS). As of June 2, 2024, the country has already registered 977 reported cases, surpassing last year's record of 941 incidents. If the current rate of infections continues, experts worry that Japan could see up to 2,500 cases of STSS this year.

Here’s all you need to know about this rare and deadly illness.
What is STSS?
STSS is a severe illness caused by Group A Streptococcus (GAS) bacteria. While GAS often causes mild infections like a sore or scratchy throat, it can sometimes lead to more severe conditions like STSS.

This syndrome is mainly characterised by sudden symptom progression, including limb pain and swelling, fever, low blood pressure, necrosis, breathing difficulties and organ failure, finally leading to death.
Why are STSS cases increasing in Japan?
The rise in STSS cases in Japan has been linked to the relaxation of COVID-19 restrictions in the country. Similar trends have been observed in other countries, including several European nations that reported increases in invasive group A streptococcus diseases following the end of pandemic measures.
How quickly can STSS become fatal?
According to Ken Kikuchi, a professor of infectious diseases at Tokyo Women’s Medical University, most deaths occur within 48 hours of symptom onset. Swelling can progress rapidly, with a noticeable increase from the foot to the knee within hours.

The disease has a frightening mortality rate exceeding 30%, making it a significant public health concern. However, it is substantially lower in children than adults.
Who is most at risk of contracting STSS?
According to the Centers for Disease Control and Prevention (CDC), people over the age of 65 are more susceptible to STSS. The disease can spread quickly, leading to severe complications and a high mortality rate if not treated promptly.

In India, GAS mostly affects children between 5 and 15 years of age, with prevalence varying depending on the region. The associated disease has a higher rate of incidence in lesser developed nations, as per a study.
How can individuals protect themselves from STSS?
Medical bodies recommend the practice of good hand hygiene, promptly treating any open wounds, and following respiratory etiquette. Since patients may carry GAS in their intestines, which can contaminate hands through faeces, thorough hand washing is crucial to prevent the spread of the bacteria.