A rare and deadly disease is surging in Japan and experts are stumped about the reason why. The deadly virus has infected a record-breaking number of 977 people in 2024, with over 30% of those cases ending in death.
Streptococcal toxic shock syndrome, or STSS, occurs when the common strep A bacteria cause an invasive infection and the body’s immune system reacts excessively with superantigens. Symptoms include pain, swelling of body parts, fatigue, and a high fever.
Rapid swelling and drowsiness should ring alarm bells and require immediate attention, doctors have warned. Some call STSS a “flesh-eating disease” since the life-threatening condition can destroy muscle tissue.
It causes severe symptoms such as sepsis and can rapidly progress to multiple organ failure.
Japanese health authorities note
First described by medicine in 1927, STSS is most common in developing nations. There are usually around 3 occurrences per 100,000 population per year in the USA. Though Japanese health authorities have pointed out that it is not the only region seeing an uptick in cases, Japan has seen record numbers of cases over the last two years. 2023’s record total was 941, while the first six months of 2024 have seen a surging infection rate nearly three times that, at an alarming 977 cases as of 2 June. Tokyo is the worst affected location, with 145 cases this year and a death toll of around 30%.
The disease most often strikes adults over 30, however children can be susceptible too, experts say, especially perhaps since their usual immunity may have failed to build up during Covid lockdowns and social distancing measures. Japan’s health authorities also say the unexplained increase could be related to “an increase in the number of patients with acute pharyngitis caused by group A hemolytic streptococcus since the summer of 2023”. Exposure to the disease occurs through coughing, sneezing, skin contact with an infected person, and – frequently – infection of an open wound.
Mysteriously many recent patients are unable to identify any wound and instead are developing symptoms after being bruised, according to Professor Kikuchi Ken of Tokyo Women’s Medical University.
Treatment may include administering antibiotics and performing emergency surgery to remove infected lesions. The good news is that actions as simple as regular handwashing and scrupulous hygiene around flesh wounds can help prevent infection in the first place.
The World Health Organisation says travel to regions where STSS is common or on the rise need not be avoided. No travel warnings for Japan related to STSS have been issued.
Nonetheless, travel agents are being urged to ensure potential visitors to Japan are informed about the apparent increased risk of STSS in the country and preventative measures they can take, including keeping track of advice from relevant official health authorities.
