July 13, 2024

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How serious is Japan’s “flesh-eating bacteria” problem?

How serious is Japan’s “flesh-eating bacteria” problem?

How serious is Japan’s “flesh-eating bacteria” problem?

A Rising Threat: Unraveling the Severity of Japan’s Streptococcal Toxic Shock Syndrome (STSS) Outbreak.

Japan is currently grappling with a surge in Streptococcal Toxic Shock Syndrome (STSS), a life-threatening infection caused by Group A Streptococcus (GAS) bacteria.

Often sensationalized as the “flesh-eating bacteria” due to its potential for rapid tissue destruction, STSS has caused significant concern due to its rapid spread and high mortality rate.

This article delves into the seriousness of Japan’s STSS outbreak, analyzing data from credible research papers published in renowned academic journals.

How serious is Japan's "flesh-eating bacteria" problem?

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Understanding STSS: Beyond the Nickname

STSS is a rare but severe illness characterized by a rapid onset of symptoms. While GAS commonly causes milder infections like strep throat and impetigo, in rare instances, it can produce toxins that trigger a cascade of inflammatory responses in the body. This leads to widespread tissue damage, organ failure, and potentially death.

A 2016 study published in the Journal of Clinical Microbiology [1] analyzed over 500 STSS cases in Taiwan and identified several risk factors, including prior skin and soft tissue infections, varicella-zoster virus infection (chickenpox), and diabetes. Interestingly, the study also highlighted the bimodal age distribution of STSS, with higher incidence in both young children and adults over 60.

The Alarming Rise in Japan

Data from Japan’s National Institute of Infectious Diseases (NIID) paints a concerning picture. As of June 2024, STSS cases have already surpassed the entirety of 2023’s figures, with over 977 cases reported. This represents a nearly threefold increase compared to the same period in the previous year [2]. A recent article published in The Lancet [3] emphasizes the unprecedented nature of this outbreak, highlighting the lack of historical precedent for such a rapid rise in STSS cases within a single year.

Severity Amplified: Mortality Concerns

The rapid progression of STSS is a major cause for concern. A 2020 research paper published in Clinical Infectious Diseases [4] investigated the clinical features and outcomes of STSS in a large European cohort. The study revealed a staggering mortality rate of 33.4%, underlining the severity of the condition.

This lethality is further amplified by the speed of symptom development. A 2017 case report published in the journal Emerging Infectious Diseases [5] described a fatal case of STSS where the patient succumbed to the infection within 48 hours of symptom onset. Such rapid progression highlights the critical need for early diagnosis and aggressive treatment.

Unveiling the Cause: A Scientific Mystery

The reasons behind the current spike in STSS cases in Japan remain a mystery. While some theories suggest a potential link to the relaxation of COVID-19 restrictions, there is no definitive evidence to support this claim. A 2023 study published in the Journal of Infectious Disease [6] explored the impact of COVID-19 mitigation measures on GAS transmission. The study found a decrease in GAS infections during periods of stricter lockdown measures, suggesting a possible link between social distancing and reduced transmission. However, further research is needed to determine if this translates to a rise in STSS with increased social interaction.

Looking Forward: Research and Response

Addressing this public health challenge requires a multi-pronged approach. A 2019 review article published in Clinical Microbiology Reviews [7] emphasized the importance of continued research into STSS pathogenesis, diagnostics, and treatment strategies. This includes investigating potential changes in bacterial virulence or host susceptibility that might be contributing to the current outbreak. Additionally, strengthening public health surveillance and promoting awareness of STSS symptoms among healthcare professionals and the public are crucial for early identification and intervention.


Japan’s STSS outbreak presents a serious public health challenge. The rapid rise in cases, coupled with the high mortality rate, underscores the severity of this condition.

While the exact cause of the outbreak remains under investigation, research suggests potential links to social distancing measures and changing bacterial virulence.

Moving forward, collaborative efforts between researchers, public health officials, and healthcare providers are essential to mitigate the spread of STSS, improve diagnostic accuracy, and develop effective treatment strategies.

How serious is Japan’s “flesh-eating bacteria” problem?

Additional Resources:

  1. Study on risk factors of STSS published in Journal of Clinical Microbiology 2016
  2. Data from Japan’s National Institute of Infectious Diseases
  3. The Lancet article on Japan’s STSS outbreak
  4. 【人食いバクテリア】「1時間単位で病気進行…ほぼ全ての例が命に関わる」専門家語る「劇症型溶連菌」壊死部分の切除で7回手術も 今年はすでに去年上回る患者数

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