One day after health officials alerted the public to a spate of recent deaths involving an aggressive form of strep infection, hundreds of concerned patients flowed into area hospitals and doctors’ offices to see whether their own winter illnesses were possible cases.
The most intense response Monday came in Kane County, where four men died in February from invasive infections brought about by the bacteria that cause strep throat. Some emergency rooms said up to three-fourths of new patients since Sunday wanted tests for strep, which can have symptoms similar to many common–and less dangerous–sicknesses.
Some caregivers, such as Dr. Daniel Sikic of the Fox Valley Family Practice Center in Aurora, said they were practically overwhelmed by the influx.
“We’ve been double- and triple-booked all day long,” said Sikic, estimating he and his two partners saw nearly 100 patients who wanted to be tested for strep Monday. “Our phone lines were so jammed that people with other problems had to physically come here to tell me what their symptoms were.”
While infectious-disease experts said Monday that anyone with a high fever, sore throat, chills or other unusual symptoms should call a physician, health officials stressed there is no evidence that seven recent strep-related deaths in the Chicago area were connected or signal a looming threat to the public.
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Thomas Schafer, a spokesman for the state Department of Health, said the deaths from invasive strep do not represent an upswing in the region from this time last year. For reasons researchers do not fully understand, February and March always bring a relatively high rate of Group A strep.
With the season of flu and sniffles at its height, many health professionals worried that the risk of strep could be causing undue alarm among people with nothing more serious than common colds.
“We’re getting all the people with the flu symptoms that everyone seems to have right now,” said Pat Rogers, team leader for the emergency department at Delnor-Community Hospital in Geneva, where 40 nervous patients went to the emergency room Sunday complaining of sore throat or fever. “They’re concerned that what they have might not be flu.”
“Strep is generally a fever and sore throat without cold symptoms,” said Dr. Stanford Shulman, head of infectious diseases at Children’s Memorial Hospital in Chicago. “If you just have a runny nose and a cough, you don’t have strep and probably don’t need to worry about this.”
The recent deaths were caused by Group A streptococcal bacteria, which normally infect the throat. In a very small number of cases– about 11,000 each year nationwide–the bacteria enter the bloodstream, releasing toxins that cause toxic shock or a frightening flesh-eating condition called necrotizing fasciitis.
Among the first to describe the flesh-eating disease was Florence Nightingale, the famous nurse and humanitarian who observed it 140 years ago in soldiers she treated during the Crimean War.
Five official cases of the invasive variety have been recorded in DuPage and Cook Counties this year–not an unusual figure considering 100 such cases were recorded during all of last year.
Five Chicago-area deaths had been reported as of Sunday, and McHenry and DuPage Counties on Monday each reported one strep-related fatality since the beginning of the year.
The more serious forms of strep sometimes occur when a person is infected directly through an open cut or sore, or when the bacteria enter the bloodstream of someone who has strep throat. The second route is common in children who have had chicken pox; most pediatric cases of strep-related toxic shock or flesh-eating disease happen in patients who have had chickenpox, experts said.
That is what happened to Jim Trinh’s 18-month-old son last week. Trinh flew to Chicago from California on Saturday morning when he learned that his child, who lives here with Trinh’s former wife, developed an invasive strep infection after the chickenpox he contracted from a 7-year-old cousin.
The previous day, the boy’s temperature had soared to 105 degrees, and a lobster-colored rash spread across his body. Family members took the child to St. Alexius Medical Center in Hoffman Estates, where doctors explained to Trinh on Saturday that his son’s condition was potentially deadly.
“When I came (into the hospital room), I burst into tears,” Trinh said. “He had puffiness of his hand and could not move, (and he was having trouble) breathing.”
The condition of Jim Trinh’s son has been upgraded to fair. Trinh said his son has been taken off a respirator, his fever is down and he is eating and watching TV.
“He’s well on the road to recovery,” said Dr. Bob Tiballi, a Kane County private practitioner who specializes in infectious diseases.
Almost exactly one year ago, a similar situation confronted Eric Vates of Chicago’s Southwest Side. Vates’ 4-year-old daughter, Erica, contracted Group A strep that reached her lungs and developed into pneumonia.
“You really don’t see it coming,” said Vates, whose daughter’s lungs became 75 percent filled with fluid over the course of an afternoon. “If we had waited another 12 hours to take her to the hospital, she would have died.”
Although Erica required surgery to cleanse her lungs of fluid, the fact that she recovered is not unusual; about 13 percent of patients with invasive strep infections die. Most can be treated with penicillin or other antibiotics.
Tiballi is working with a team of doctors assigned the invasive strep cases in the Kane County and Fox Valley areas. He advised parents to take children to the doctor if they complain of sore throats. Signs of toxic shock include a red rash, high fever, muscle aches, chills and swelling of the arms or legs.
Children and the elderly are most at risk for invasive strep infections, though the disease can strike healthy adults, experts say.
One of the most difficult messages to communicate to patients since health officials made the strep announcement, doctors said, is that not everyone with mild symptoms needs to be screened for the bacteria.
“We have people coming in who are insisting on work-ups that aren’t appropriate or are disappointed if they don’t get antibiotics,” said Dr. Mark Rosenbloom, an emergency physician at Northwestern Memorial Hospital. “We get inundated, and it makes it hard to treat truly sick patients.”