When Colleen Watters caught a rare form of invasive group A strep disease, she went from being healthy one day to almost dying the next. Watters is not an isolated case.

In 2016, Alberta experienced its highest number of incidences in nine years, and these rates are continuing to climb.

In February 2016, Watters, now 52, was at work when she began to feel a severe headache and stomach pain. She was told she had a flu, but she knew something wasn’t right.

“I just felt so sick,” Watters said. “I was taking Tylenol 3, codeine, and nothing would even touch it. It just got worse and worse.”

Within 24 hours, Watters was rushed to the emergency room and fell into a coma. She stopped breathing and her fingers and her legs turned black. The doctors could not figure out what was wrong and after trying several different medications, Watters received her last rites.

On April 30 doctors were forced to amputate the toes on Watters’ right foot and the ends of four of her fingers. On May 1 they amputated her left leg below the knee. Photo by Andrea Wong.

When they received Watters’ lab results from Ontario over a week later, they discovered she had been infected with a disease called group A streptococcus.

Though the doctors were able to treat the infection with penicillin, they had to remove the dead tissue, amputating Watters’ toes on her left foot, her right leg from the knee down, and the ends of four fingers.

“It’s taken away my mobility and my freedom,” she said. “I do wonder sometimes, what did I do wrong to deserve this? What did I do that caused it?”

Who does group A strep affect?

Up to the day she got sick, Watters said she felt fine. She regularly exercised, didn’t smoke, and even had yearly check-ups. By any indication she seemed healthy.

Dr. Gregory J. Tyrell, who researches group A strep at the University of Alberta’s department of laboratory medicine and pathology, said the disease occurs in the general population as strep throat. Many people can carry the bacteria on their skin or in their throat without being infected, but if it enters the body, it can quickly produce toxins and multiply within muscle tissues, as was the case for Watters.

Tyrell said those with weakened immune systems, such as the elderly and disadvantaged groups, are more at risk of being infected with group A strep, but this does not mean everyone else is immune.

“Healthy and well people can contract the disease … that’s not beyond the realm of possibility,” Tyrell said. “As to why they would have that, I don’t think anybody has a real clear understanding of why that would be the case.”

Why Watters was infected is a question still left unanswered. “I wish my life to be back the way it was,” she said. “What did I do so wrong that caused it? How can a healthy person one day almost die the next?” Photo by Andrea Wong.

National surveillance of invasive group A strep began in 2000. Anna Maddison, the senior media relations advisor for Health Canada and the Public Health Agency of Canada, said the number of cases and incidence rates have been steadily increasing, with several outbreaks occurring across the country since 2016.

Though Alberta has not reached the point of an outbreak, Alberta Health has called for more public awareness and surveillance in response to the elevated rates. In 2016, the incidence rate was 7.78 cases per 100,000 population, but according to Tyrell, this number is now closer to nine or 10.

“It’s a little disconcerting that it keeps creeping up with the way it is and for reasons that we don’t fully understand at this time. Is it going to get worse? I really can’t say.”

How to protect yourself from group A strep

Tyrell says washing your hands is always a good preventive measure to remove any bacteria you may have acquired through skin-to-skin contact. As with other respiratory infections, you should also be cautious of people coughing or touching your mouth.

Since the disease can progress fairly quickly once it enters the body, patients should seek help as soon as they notice symptoms. Early signs include fever, severe pain and swelling and abdominal pain.

Watters reads through the medical notes from her hospital stay. For the first month and a half she was on 24-hour dialysis and now only has the use of 24 per cent of her kidney. Her uterus, which had turned black and broke apart like tissue paper, was removed. She was also treated for a bleeding ulcer. Photo by Andrea Wong.

Watters also agrees that patients should trust their instincts if they notice something is wrong.

“We know ourselves when our body just is not right,” Watters said. “You know the difference between a flu and being very sick, and if I had given up in getting help, I would have just died in my sleep.”

While there is no commercial vaccination for group A strep, the bacteria is extremely susceptible to penicillin. Tyrell said the University of Alberta? is working with colleagues in Australia to launch a trial vaccine.

“It’s not something we’re going to ignore. As the rates continue to go up, it gives the lab cause for concern and we are looking at putting more resources into why this is happening.”

awong@cjournal.ca

Editor: Ian Tennant | itennant@cjournal.ca