COVID Impacts

Group A Streptococcal infections ("Group A Strep infections", most commonly caused by Streptococcus pyogenes)

• Cellulitis/Impetigo (skin infections)
• Pharyngitis (Strep Throat)
• Scarlet Fever ("Scarlatina", characterized by Strep Throat + a rash)
• Invasive Group A Strep infections (Streptococcal Toxic Shock Syndrome, Necrotizing Fasciitis)

Viral infections of the upper respiratory tract (including Influenza, RSV, and COVID-19) are associated with increased susceptibility to invasive diseases caused by Streptococcus pyogenes (group A streptococcus), including pneumonia, necrotizing fasciitis, toxic shock syndrome, and bacteremia. Chickenpox (Varicella) can also increase susceptibility to infections by Streptococcus pyogenes.

**Note: In the United States, Group A Strep infections are not required to be reported to health officials. Only one type of invasive infection (STSS) is nationally notifiable. Therefore, it is nearly impossible to determine if and where Group A Strep outbreaks are occurring.

Since late 2022, the United Kingdom has documented a surge in Strep Throat and Scarlet Fever infections. There has also been a significant increase in invasive Group A Strep infections, with dozens of confirmed deaths (mostly in school-age children). Other European and Asian countries have also documented an increase in invasive Group A Strep infections.

On December 22, 2022, the CDC announced a health alert regarding an increase in pediatric invasive Group A Strep infections. Since then, many U.S. states have been documenting a significant increase in both invasive Group A Strep infections as well as non-invasive Strep Throat and Scarlet Fever infections. The U.S. is also experiencing a nationwide shortage of amoxicillin, the standard antibiotic treatment for Group A Strep infections.

On April 7, 2023 New York State Department of Health announced a state-wide health advisory regarding an increase in invasive Group A Strep infections, mostly in adults over 65.

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any organ or part of the body.

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist:

• latent TB infection (asymptomatic non-contagious infection)
• TB disease (active symptomatic illness)

It has been documented that COVID-19 infection can activate/reactivate latent TB infections.

Staphylococcal infections ("Staph infections" - most commonly caused by Staphylococcus aureus)

• Cellulitis/Impetigo/Folliculitis (skin infections)
• Mastitis (breast infection)
• Pneumonia (lung infection)
• Bacteremia/Sepsis (blood infection)
• Endocarditis (infection of the heart valves)
• Osteomyelitis (bone infection)
• Nosocomial/Healthcare Associated Infections
• methicillin-resistant Staphylococcus aureus (MRSA)
• vancomycin-resistant Staphylococcus aureus (VRSA)

Pneumococcal infections (most commonly caused by Streptococcus pneumoniae)

• Sinusitis (sinus infection)
• Pneumonia (lung infection)
• Otitis media (middle ear infection)
• Bacteremia/Sepsis (blood infection)
• Meningitis (infection of the brain and/or spinal cord)

Klebsiella infections (most commonly caused by Klebsiella pneumoniae)

• Pneumonia (lung infection)
• Urinary Tract Infections (UTIs)
• Gastroenteritis (food-borne infection that causes diarrhea and vomiting)
• Bacteremia/Sepsis (blood infection)
• Meningitis (infection of the brain and/or spinal cord)
• Nosocomial/Healthcare Associated Infections (increasing becoming antibiotic resistant)