Spike in invasive meningococcal disease prompts warning from Manitoba health officials: What you need to know

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A recent rise in cases of invasive meningococcal disease (IMD) and invasive group A streptococcal (iGAS) infections have prompted a statement from Manitoba public health officials.

In a Jan. 11 media bulletin, officials with Manitoba Health, Seniors and Long-Term Care reported eight cases of IMD were identified within the last month (six adults and two children). There are no known links between the cases. According to the province, there are on average six cases of IMD reported annually.

What is invasive meningococcal disease?

Invasive meningococcal disease (IMD) is a serious infection caused by bacteria called Neisseria meningitidis. While the bacteria can exist in the back of your throat or nose without causing harm or symptoms, it can can invade other areas of the body and cause meningitis or bloodstream infections.

Meningitis occurs when the Neisseria meningitidis bacteria infects the fluid membranes surrounding the brain and spinal cord. Symptoms of meningitis include headache, fever, stiff neck, sensitivity to light, nausea, vomiting and, in some cases, confusion.

In cases where bacteria causes bloodstream infections, symptoms include:

• Fever

• Vomiting

• Severe body aches, muscle and joint pain

• Diarrhea

• Fatigue

• Dark purplish rash (for late stage infection)

What is invasive group A streptococcal (iGAS)?

Like IMD, invasive group A streptococcal (iGAS) occurs when group A streptococcus bacteria invades parts of the body where it usually isn't found.

Canada is currently experiencing a spike in cases of iGAS. According to the Public Health Agency of Canada (PHAC), there were more than 4,600 iGAS cases confirmed at the National Microbiology Laboratory in Winnipeg last year. That's a 40 per cent increase compared to a previous record high in 2019.

In Ontario, 48 people died from iGAS between October and December 2023 — six were children under the age of nine. New Brunswick has already reported two iGAS-related deaths in 2024.

Dr. Isaac Bogoch, an infectious diseases specialist at the University of Toronto, said streptococcus infections can range in severity.

"Sometimes streptococcus can cause infections that are more of a nuisance but need to be treated like strep throat. But there are invasive forms of group A streptococcus in which it gets deeper into the body, causing a bloodstream infection — it can go anywhere," Bogoch told Yahoo Canada. "It can go to the brain, it can go to the skin and soft tissue and cause significant problems."

Bogoch said people can develop necrotizing fasciitis, a severe skin and soft tissue infection that can lead to surgery to remove damaged tissue and prevent the infection from spreading. It could also potentially lead to amputation "if the damage to the tissues is irreparable."

What are the symptoms of invasive group A streptococcal?

Symtpoms of iGAS can include:

• Fever

• Dizziness

• Confusion

• Muscle tenderness

• Severe muscle aches and pain

• Redness at the site of a wound

"With both of these infections, you tend to see them in more crowded settings," said Bogoch. "Shelter populations, barracks, university dorms. The infections tends to be more common in unhoused populations, as well."

How can you protect yourself from invasive meningococcal disease and invasive group A streptococcal?

Bogoch noted severity of these infections cannot be emphasized enough.

"People are sick," he explained. "It's not like you're wondering, 'Should I go to the hospital or not?' If you have bacterial meningitis you are very, very unwell. So this isn't, 'Oh, my throat hurts.' They will feel extremely unwell and it's obvious they need medical care."

While there is no vaccine for strep A, Bogoch said it's important for people to remember that IMD is a "preventable illness" thanks to meningococcus vaccines being a part of routine vaccination programs in Canada.

If you're unsure whether or not you've been immunized, or if you need a booster, Bogoch recommended checking your vaccination card or bringing it to a medical professional to advise you.

"A lot of people don't have a family physician or some people do have one, but they don't have easy access to their family physician," he said. "I think it's important to recognize there are other people who can help with this in the health care field."

Public health clinics and pharmacists can help ensure Canadians remain up to date on their vaccines.

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