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Disease linked to death of teen on rise in B.C.; officials don’t know why

An invasive disease linked to the death of a 13-year-old Esquimalt girl has been on the rise in B.C. over the past two years, and public health officials have yet to determine what’s causing a spike in cases.

An invasive disease linked to the death of a 13-year-old Esquimalt girl has been on the rise in B.C. over the past two years, and public health officials have yet to determine what’s causing a spike in cases.

The incidence rate of invasive Group A streptococcal disease jumped to 8.4 cases per 100,000 people last year — the highest rate since reporting began two decades ago, according to the B.C. Centre for Disease Control.

There were a total of 406 cases in 2017 and 303 in 2016.

In the previous nine years, the number of annual cases ranged from a low of 145 to a high of 259.

Provincial health officer Dr. Bonnie Henry said investigators are trying to figure out what’s behind the increase, which is occurring in other parts of Canada as well.

“We do have some theories about whether it’s related to things like influenza — a couple of bad influenza seasons,” she said.

“Some of it may be related to our ability to test for it a little better and watching for it.

“But much of it’s not clear. It may be related to our use of antibiotics and how that is changing the milieu of the bacteria both on our skin and in our gut, how that affects our ability to fight off infection, and whether that means this group A form of the bacteria is more common.

“Those are questions we don’t have answers to. We’re looking.”

Henry said the disease mostly affects older people or those with an underlying illness such as diabetes or lung disease.

Intravenous drug use and homelessness are also risk factors, Henry said, noting that there have been outbreaks in homeless shelters in other parts of Canada.

The disease is caused by bacteria that people carry on their skin or in their noses and throats, often without experiencing any symptoms or illness.

When infections do occur, they are usually mild illnesses such as strep throat or impetigo, the B.C. Centre for Disease Control states.

In more serious cases, the bacteria “invade” the lungs, blood or layers of tissue around muscle resulting in toxic shock syndrome, flesh-eating disease, pneumonia, meningitis or, in rare cases, death.

Island Health confirmed Wednesday that Rockheights Middle School student Robin Carey was suffering from an invasive streptococcal infection at the time of her death on March 23.

A rising softball star, she fell ill with flu-like symptoms while attending a high-performance camp in Parksville last week.

Henry stressed that it’s unusual for a teenager to die from an invasive streptococcal infection.

Of the more than 400 cases in B.C. last year, only 12 involved young people from 10- to 19-years-old, and none of them died.

The 16 deaths linked to the disease in 2017 included two children under the age of five and 14 adults over 39.

“It is tragic,” Henry said of Robin’s death. “I think it’s important for people to know that it is rare to have severe disease in young people.”

There’s no vaccine for the disease, but Henry said people can take preventative measures to avoid infections by keeping cuts and scrapes clean, washing hands frequently and never sharing drinks or other personal items that come into contact with saliva.

It’s also important to be careful when you’re sick, Henry said.

“Most people who have strep throat, which is a bacterial infection in their throat, don’t go on to have severe illness, but some people do. So if the pain is not going away, if your fever is high and you’re not getting better, make sure you get it checked out.

“This is a bacteria that is in our environment, on our skin and in our throats and so we just need to be aware that if it causes infections, it still can be treated with antibiotics.”

Island Health has advised parents and players who attended the Parksville camp with Robin to watch for signs of infection, such as sore throat, fever or respiratory symptoms and seek treatment if they are feeling ill.

“The likelihood of spread of infection from routine social or sports contact with an ill person is low, and antibiotic treatment for people who have had this kind of exposure is not recommended,” Dr. Dee Hoyano, a medical health officer, said in a statement.

Officials are recommending preventative antibiotic treatment only for those who were in close contact with Robin, sharing sleeping quarters, living in the same house or coming into contact with saliva or vomit.

lkines@timescolonist.com t