Kitchener mom warns parents about Group A strep infection rise after daughter dies
Public Health Ontario says it is concerned about the increased spread
A Kitchener mom whose daughter died of complications from invasive Group A streptococcus is warning about the rare consequences of the bacterial infection, which has been circulating in Ontario at rates not seen in nearly a decade.
Quin Henderson, 5, was home from school with a cough and a fever in the days before her death March 25.
Christina Hecktus says no one seemed to pick up on the fact her daughter's symptoms might be something more than a bad cold.
"I did everything that I was told to do. I called the doctor, I called 811. I did all those things that a mother or a parent would do in this situation and was told multiple times: it's not necessarily needed [to take her to the doctor]," said Hecktus.
Earlier on the day Quin died, her parents had decided to take her to an emergency department in Kitchener. The family says she was admitted "in less than 15 minutes," put on oxygen, and given intravenous (IV) fluids and antibiotics while blood was drawn and X-rays were done.
Quin was diagnosed with pneumonia. That afternoon, she was transferred to McMaster Children's Hospital in Hamilton, where she was found to be septic — meaning the infection from harmful bacteria had become serious — from invasive Group A strep in her blood.
Quin died just 12 hours after they had taken her to the ER in Kitchener.
Now, Hecktus says she wants to shield others from the pain her family has endured.
"I don't ever want somebody to feel like they didn't do enough for their child, like I did. I don't blame anybody — because blame doesn't do anything for anybody — but I want to inform."
What makes this strep 'invasive'?
In Group A streptococcus, common bacteria live on the nose and skin, and in the throat. It can cause minor infections like strep throat and affect the skin in the form of cellulitis.
It becomes "invasive" when the bacteria gets into a sterile bacteria-free area, explains David Aoki, director of infectious disease at Region of Waterloo Public Health.
"Invasive means it's gotten beyond that first line of defence and it ends up somewhere it shouldn't; so either a blood infection or something else that can be more serious. It's a very rare complication, but it does occur."
Although rare, invasive Group A streptococcus infections are on the rise: globally, across Canada and in Waterloo region, specifically.
In the region, there have been 21 infections between January and the end of April; there were 25 infections in all of 2022.
Five of the 21 people diagnosed with invasive Group A strep in 2023 died — the highest number since 2014.
In Ontario, pre-pandemic, the five-year average was about 550 cases over the course of a cold and flu season, according to numbers from Public Health Ontario. For the 2022/2023 flu season, there have been about 900 cases — a spike of 63 per cent.
In Quebec, infections increased 56 per cent over a similar period, according to data collected by the province's Ministry of Health and Social Services.
Doctors alerted, not public
Public Health Ontario is concerned about the increased spread, said Dr. Liane Macdonald, one of the agency's public health physicians. Catching the infection early can be tricky, but health-care providers do know what to look for, Macdonald said.
"This is one of the really difficult challenges with invasive Group A streptococcal disease, because it's caused by a really common bacteria that has milder forms of illness that can mimic viral infections certainly," she said.
"But there are certain characteristics that trained health-care providers are aware of and can help them to think about a potential bacterial infection with Group A streptococcal disease."
Region of Waterloo Public Health issued an advisory to local doctors about spread in the community three days after Quin's death, confirmed Aoki. But while a public alert was made after just two deaths in Montreal, a public alert has not yet been made in Waterloo region.
Aoki said public health weighs a variety of factors before making a public alert. Those factors include how an infection is spreading, if cases are linked and how local rates compare to provincial numbers.
"There's no, 'Oh, you hit X number of cases and it means we're sending out an advisory,'" said Aoki. "We're constantly looking for those trends to see where we should be alerting. That's an ongoing process for us."
Hecktus said she can't help but wonder if her daughter's death led to the alert.
"That is their scope. That is their domain. If public health had said something, I feel like it should be the doctor's responsibility to be aware."
But she remains focused on educating other parents about the risks.
"I'm not the kind of person to do 'shoulda coulda woulda.' That's not the kind of person I am. But I don't want anyone else to deal with this if I can help prevent it," said Hecktus. "I want to inform and give people the knowledge so that they can make those decisions themselves and they don't feel like they never had the choice or the options."
Group A streptococcus has been in the headlines recently after 15 kids died in the U.K. Dr. Joanne Langley, a Halifax pediatrician specializing in infectious diseases, discussed what guardians and adults should know about this bacteria that can cause a range of illnesses.
At McMaster Children's Hospital, Dr. Jeffrey Pernica said he has seen more cases of invasive Group A strep this year and his colleagues across Canada are noticing it as well.
"I don't think there's anything special that parents need to do," he told CBC News. "I think a lot of parents are worried that they're going to miss things and I do not think that they will.
"The reasons to go to the emergency department now are the same as that they always were: difficulty breathing, not being able to keep liquids down, severe pain, not being responsive. Those are the reasons to go now — but those have always been the reasons. And so I am confident that parents in our region are going to continue to do the same good job they've always done."
Public health says the people who are most at risk are kids under four and adults over 65 and people who are pregnant or have recently given birth.
And while there is no vaccine for invasive Group A stretococcal disease, Macdonald reminds people that chicken pox vaccines can decrease the odds of children contracting the invasive bacterial infection.\
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