Streptococcal Toxic Shock Syndrome (STSS) in Japan: Causes, Symptoms, Prevention, and Global Impact

 

Streptococcal toxic shock syndrome (STSS) is a very serious bacterial infection caused by Streptococcus pyogenes. Recently, cases of STSS have been reported increasingly from all over Japan. On the 13th of March, the National Institute of Infectious Diseases issued an alert on the sudden surge in STSS cases this year compared to the average count for the same period in the past few years. As of June 2, the ministry of health reported 977 cases in 2024, which was more than that of the previous year.

Symptoms and seriousness

Onset of STSS is rapid; even in a few hours, it can progress to a life-threatening emergency. The initial examination shows fever, chills, muscle aches, nausea, vomiting, and pain and swelling in the arms and legs. Within 24 to 48 hours, there is a decrease in blood pressure which can finally lead to organ failure, tachycardia, or tachypnoea. STSS remains lethal even with vigorous treatment; the mortality rate can be as high as 30%.

Causes and Risk Factors

This infection is caused by toxins that the bacterium Streptococcus pyogenes produces. According to Dr. Céline Gounder, serious infections, in rare cases, may be in the blood or lungs and are occasionally part of necrotizing fasciitis—"flesh-eating" infections. Among the contributing causes of the rise in serious infections are underlying conditions, including diabetes, alcohol use disorder, and immunosuppression, together with recent exposure to chickenpox or influenza.

Prevention and Treatment

Preventive measures include vaccination against the varicella zoster virus and influenza, which lower the risk for serious Streptococcus infections. In those patients with decreased immunity or who have recently been exposed to serious infections, antibiotic prophylaxis is recommended. Early recognition and early seeking of medical care are important in STSS management and can really improve its outcome.

Global Impact and Surveillance

This is not prevalent in Japan alone; several countries have reported cases, such as the United Kingdom and Sweden, with increasing incidence rates present. This thus stresses the importance of surveillance and control of infectious diseases globally to avert outbreaks and ensure that public health worldwide is protected.

While the medical fraternity continues to study the enhancing factors in the spread of STSS, awareness, prevention, and timely treatment remain very vital in this possible fight to death against infection.