Reacción a "Reactions to the increase in 'Streptococcus pyogenes' infections in the UK and the situation in Spain"

At the moment we do not know why the increase in the UK is due to this. A priori, the simplest explanation would be an increase in bacterial infections proportional to the increase that is now occurring in viral respiratory infections in children, mainly due to the lack of exposure in previous years due to the non-circulation of seasonal viruses such as influenza or RSV, both because of the measures taken against covid-19, which may have had a non-specific impact on the epidemiology of these infections, and because of viral competition itself. 

In any case, it is early days. There are no published data yet on whether this is a specific strain with special characteristics. 

In general, and not surprisingly, there is a perceived increase in severe bacterial infections, related to the increase in respiratory infections in general and the usual collaboration between viruses and bacteria. Pyogenes is not a new or unusual pathogen, we paediatricians know how to recognise and treat it and, in fact, it is the most frequent cause of acute pharyngotonsillitis in children; but it is true that in some cases it can lead to serious infectious complications and even to non-suppurative complications involving the heart, kidney, rheumatic fever....  

What is now being reported is an increase in pyogenes infections which may be normal - they often occur in outbreaks with specific forms, such as scarlet fever - but more severe forms have also been seen and it is impossible to know if they are normal in proportion to viral infections without knowing the differences with previous seasons and years. 

In the case of the United Kingdom, the increase in the number of cases compared to the median of previous years is striking. In Spain, for the moment we do not have official or specific data and, although cases of deaths have been reported, they could be within normal numbers. I insist that this is not a new pathology that we do not know about. 

Is it possible that something similar is happening in Spain? It is possible, but I don't know. What is an objective and clear fact is that the numbers of respiratory infections in children have increased significantly and that we are seeing significant numbers of primary care and hospitalisation for viral respiratory infections in general and RSV in particular for the reasons given: less previous circulation and more susceptible population not previously exposed. When this occurs, it is normal to expect an increase in complications related to this type of infection. One of them is bacterial superinfection and one of the most common bacteria that can be found is pyogenes. 

I think it is important not to alarm the population. These are alerts that have to affect the authorities and health professionals to be more vigilant, but for the moment it does not condition any specific attitude in parents. If cases of pyogenes infection occur, paediatricians know exactly what to do. Now the authorities have to give us objective data to know if the cases being reported in our country are really more or less than those we usually have.  

I insist: the population does not have to do anything specifically. The best thing they can do is to get vaccinated with all the recommended vaccines, specifically the flu vaccine, because these are pathogens that take advantage of other infections to harm us, and so, to the extent that we avoid these viral infections for which vaccines exist, we will be reducing the likelihood of another complication occurring. 

I want to convey peace of mind: paediatricians are perfectly capable of recognising and treating it, and at present, with the information we have, it is not necessary to take any specific measures. We have spoken out from the Spanish Society of Paediatric Infectious Diseases, but with the idea of alerting professionals, not alarming the population.