Serious bacterial infections causing pneumonia and meningitis are on the rise in Alberta

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Experts are closely monitoring the increase in cases of invasive pneumococcal disease in Alberta.

This potentially fatal illness is caused by a bacteria known as Streptococcus pneumoniae, which often occurs after a viral illness.

These bacteria – including 100 different variants – can live in the respiratory tract, in many cases triggering no symptoms. In their mildest form, they can cause problems such as middle ear infections.

But when they invade normally germ-free parts of the body and become invasive, people can develop pneumonia, meningitis and sepsis.

“Across all age groups, there has been an increase in cases and an increase in the case rate to the highest levels I have ever seen,” said infectious disease specialist Dr. Jim Kellner at the University of Calgary studying invasive pneumococcal disease. disease trends in Calgary since 1998.

“It’s concerning to see the kind of numbers we’ve seen. We expected to see high numbers last year. The sustained high numbers this year are a concern.”

Provincial data shows cases of invasive pneumococcal disease rose to 812 last year, up from 481 in 2018, with declines in 2020 and 2021 that doctors attribute to pandemic restrictions.

The trend arrives at the same time as rates of invasive group A streptococci are also increasing in Canada.

Hospitalizations for invasive pneumococcal disease increased from 398 to 681 during the same five-year period and the number of deaths increased from 42 to 62.

Hospitalization and death rates per population are also increasing, according to figures provided by Alberta Health.

While the vast majority of serious cases reported last year involved adults, 44 of the 681 people hospitalized in 2023 were under the age of 18, and two children died.

A bald man in a suit poses for a photo.
Dr. Jim Kellner is an infectious disease specialist at Alberta Children’s Hospital. He has studied trends in invasive pneumococcal disease in Calgary since 1998. (Submitted by the COVID-19 Immunity Task Force)

“It’s concerning any time we see an increase in infectious diseases,” said Dr. Sam Wong, a pediatrician at Edmonton’s Stollery Children’s Hospital and chair of the pediatrics section of the Alberta Medical Association .

Wong has treated several children in recent weeks who ended up in intensive care after developing pneumonia with large collections of fluid around their lungs requiring a chest tube.

“To evacuate more than a liter of fluid from a five-year-old child is a significant volume. Then they decompensate and end up having to be intubated and require respiratory assistance as well as blood pressure support.”

According to Kellner, the mortality rates from invasive pneumococcal disease in the Calgary zone are as follows:

  • children (under 18): 3 percent
  • adults over 18: 10 percent
  • people aged 65 and over: 15 percent
  • over 85: 25 percent

“Although it is a perfectly treatable disease with antibiotics, in the most severe cases, in these invasive cases, there is still a notable mortality rate,” he said.

Connection to virus outbreaks

The reasons for the increase in invasive pneumococcal infections are complex, according to Kellner.

Given that pneumococcal disease often manifests as a secondary infection, there is no doubt that recent viral outbreaks play a key role.

A smiling pediatrician in a blue coat is seen in an unoccupied patient's room, adorned with colorful stickers on the walls.
Dr. Sam Wong is Chair of the Pediatric Section of the Alberta Medical Association. He works at Stollery Children’s Hospital in Edmonton. (Submitted by Sam Wong)

Viral infections cause inflammation of the airways, he said, making it easier for bacteria to invade.

Secondary infections are often limited to the ears and sinuses. But bacteria can also make their way into the bloodstream and travel to organs such as the lungs and brain.

“With these giant jumps last year with RSV and flu, and this current year being another huge, early year for flu, then you would expect to see an increase in secondary bacterial infections,” he said. he declares.

“This had a huge influence on the increase and the very large number of infections.”

Kellner said secondary pneumococcal infections can also occur after COVID-19, but it seems to happen less frequently.

“It’s a question of numbers… When the number of infections is higher, these rare complications become much more common,” Wong added.

“It’s been pretty bad this year with the high number of flu cases we’ve seen.”

Pneumococcal vaccines are provided as part of routine childhood immunizations and are publicly funded for Albertans aged 65 and older.

Provincial data shows childhood vaccination rates are declining. In 2008, 90.5 percent of Alberta children were fully immunized with three doses of the pneumococcal vaccine by the age of two. By 2022, this figure had fallen to 80.8 percent.

According to Kellner, vaccines are evolving and new formulations have recently been developed. approved for use in Canada.

“The uptick we are seeing now is linked to factors of increasing viral infections and emerging from the pandemic that may subside over time,” said Kellner, who over the past few decades has received funding from several organizations. public granting agencies and pharmaceutical companies for research projects and clinical trials of vaccines.

“There is hope that the new vaccines will have an impact and contribute to better control. But we are far from being able to truly control pneumococcal disease in the community, locally and globally.”

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