Health officials racing to identify cause of rise in streptococcal toxic shock syndrome, which has a 30% fatality rate

Experts warn that a rare but dangerous bacterial infection is spreading at a record rate in Japan, with officials struggling to identify the cause.

The number of cases in 2024 is expected to exceed last year’s record numbers, while concern is growing that the harshest and potentially deadly form of group A streptococcal disease – streptococcal toxic shock syndrome (STSS) – will continue to spread, after the presence of highly virulent and infectious strains were confirmed in Japan.

The National Institute of Infectious Diseases (NIID) said: “There are still many unknown factors regarding the mechanisms behind fulminant (severe and sudden) forms of streptococcus, and we are not at the stage where we can explain them.”

Provisional figures released by the NIID recorded 941 cases of STSS were reported last year. In the first two months of 2024, 378 cases have already been recorded, with infections identified in all but two of Japan’s 47 prefectures.

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    Experts warn that a rare but dangerous bacterial infection is spreading at a record rate in Japan, with officials struggling to identify the cause.

    The National Institute of Infectious Diseases (NIID) said: “There are still many unknown factors regarding the mechanisms behind fulminant (severe and sudden) forms of streptococcus, and we are not at the stage where we can explain them.”

    The move also prompted people to lower their guard, in a country where widespread mask wearing, hand sanitising and avoiding the “three Cs” were credited with keeping Covid-19 deaths comparatively low.

    Ken Kikuchi, a professor of infectious diseases at Tokyo Women’s Medical University, says he is “very concerned” about the dramatic rise this year in the number of patients with severe invasive streptococcal infections.

    Japan’s health ministry recommends that people take the same basic hygiene precautions against strep A that became a part of everyday life during the coronavirus pandemic.

    “We want people to take preventive steps such as keeping your fingers and hands clean, and exercising cough etiquette,” the health minister, Keizo Takemi, told reporters earlier this year, according to the Japan Times.


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