[News Terms] Japan Spread '30% Fatality Rate' 'Streptococcal Toxic Shock Syndrome'

KDCA Evaluates "Low Possibility of Domestic Outbreak"
Visit Medical Institutions for Early Treatment if Suspected

'Streptococcal Toxic Shock Syndrome (STSS)' is an infectious disease caused by bacteria called pyogenic bacteria (pyogenic streptococcus, Group A streptococcus) spreading into deep tissues or the bloodstream.

According to the Korea Disease Control and Prevention Agency (KDCA), STSS occurs when infected by the causative pathogen called 'Group A streptococcus.' When infected with this bacterium, mild respiratory symptoms such as sore throat appear initially, but as the infection progresses, high fever and rash occur. In severe cases, it can worsen to conditions such as STSS and necrotizing fasciitis.

Tourists visiting Japan. The photo is not directly related to the article content.
Photo by AP/ Yonhap News

The infection route is mainly through mucous membranes or wounds, and respiratory transmission through droplets is also known to be possible. Therefore, if a wound occurs, it is helpful to prevent infection by thoroughly disinfecting it, minimizing exposure of the affected area, and strictly following basic hygiene rules such as hand washing and cough etiquette.

Those aged 65 or older with diabetes or chickenpox are considered high-risk groups and should be observed more carefully. If suspicious symptoms appear, they should immediately visit a medical institution. Since there is currently no developed vaccine, early diagnosis and prompt treatment with antibiotics before the disease worsens into a severe condition are important. According to the U.S. Centers for Disease Control and Prevention (CDC), the fatality rate of STSS is known to be over 30%.

On the 22nd, the KDCA announced that it is monitoring the domestic and international occurrence trends of STSS, which is showing a spreading trend recently in Japan. The KDCA also assessed that the possibility of an outbreak in Korea is low. However, it recommended that those with suspicious symptoms visit medical institutions for early diagnosis.

According to the 'STSS Patient Occurrence Status' by the National Institute of Infectious Diseases (NIID) of Japan, the number of STSS patients in Japan was 684 in 2018, 894 in 2019, 718 in 2020, 622 in 2021, and 732 in 2022. Last year, it increased to 941. This year, as of the end of last month, 414 cases have been reported, which is a high level compared to previous years. Among the 414 reported cases, 90 died (fatality rate 21.7%). The fatality rate was higher at 24% among patients aged 50 and older.

As concerns about spread in Korea grow, the KDCA explained that STSS is rarely transmitted through human contact, and the incidence of scarlet fever, which can be caused by the same causative bacterium Group A streptococcus, is also very low domestically.

Jiyoungmi, Commissioner of the Korea Disease Control and Prevention Agency.
[Photo by Yonhap News]

For this reason, STSS is not classified as a separate legally notifiable infectious disease in Korea. However, 'scarlet fever,' which can occur from infection by Group A streptococcus, the same causative pathogen as STSS, is designated and monitored as a 'Class 2 legally notifiable infectious disease' requiring reporting and isolation within 24 hours. All scarlet fever patients occurring domestically are reported by medical institutions and monitored, and epidemiological investigations are conducted in cases of severe complications or deaths due to scarlet fever.

Jiyoungmi, Director of the KDCA, said, "Although the possibility of a domestic outbreak of STSS is expected to be low, it is important to promptly visit medical institutions for early diagnosis and rapid treatment if suspicious symptoms appear." She added, "Considering the recent situation in Japan, we will closely monitor domestic and international occurrence trends and respond quickly by providing patient care guidance to frontline medical staff."