After the COVID pandemic, several European countries reported an increased number of invasive group A streptococcus cases compared to previous years.

EODY started recording all iGAS incidents in the country at the beginning of 2023.

In total, in 2023, 90 cases of iGAS (48 children and 42 adults) were reported to EODY, among them 23 (26%), 9 children and 14 adults died. Since the beginning of 2024, 48 cases (21 children and 27 adults) have been reported, including 12 deaths (25%), 3 children and 9 adults.

On Monday 12/08/2024, the EODY sent a team to the General Hospital of Ilia in order to investigate an incident following information that in samples from a deceased patient in Ilia for whom a brown spider bite was initially reported as the cause of death, S. Pyogenes group A was isolated.

At the same time, there was information about a second case that ended up with similar symptoms (necrotic cellulitis / myositis in the lower limbs) in whose samples S. pyogenes was also isolated.

The isolation was done in both cases in autopsy material.

The EODY negotiated so that the executives were sent to a specialized laboratory and further laboratory investigation was carried out.

From the detailed history taken from the relatives of the two cases, as well as from 3 more patients with cellulitis / myositis who visited the GN Pyrgos during the same period, no common exposure or risk factor was found.

Despite the timing of the two deaths, the investigation showed that they were visitors to the area who lived in different parts of the country, with symptoms that probably started before their move to Ilia or immediately after it.

In order to determine whether there is an increased rate of carriage in the community, strep-tests are carried out in collaboration with the GN Pyrgos on those they come to TEP.

So far, 80 people who came to the hospital have been examined, of which one had a positive strep test which is being further tested in the laboratory. The stretcher check continues and will continue next week.

This specific infection is not common but has increased morbidity and mortality.

For this reason, we remind you that the basic personal protection measures and the timely visit to the doctor in case of symptoms (fever, pharyngotonsillitis, cellulitis, etc.) recognition of iGAS infection and prompt initiation of antimicrobial and supportive therapy are extremely important for a favorable disease outcome.

Also, close contacts of iGAS cases should be identified by public health authorities, their condition assessed and treated according to the guidelines posted on the EODY website: https://eody.gov.gr/disease /streptokokkos-omadas-a/.

The vigilance of healthcare professionals and timely laboratory testing are extremely important for the management of iGAS cases.

EODY will continue the enhanced surveillance of cases of invasive streptococcal group A (iGAS) throughout the country as well as in Ilia where the latest cases appeared.