The alarm from the Ministry of Health had arrived on December 15: the spread of infections from strep of group A (GAS) are causing in children under 15 years tonsillitis, pharyngitis, impetigo and scarlet fever. Just scarlet fever is at the center of a boom never seen before: from January to April the Veneto recorded it 1,506 almostin the face of 116 detected in the whole 2022. Thirteen times more. The peak in March (617 patients), while in April the trend began to decline, with 317 cases. Considering i 1166 infections diagnosed from January to March are the most affected provinces Vicenza with 316 e Verona con 309. Padova it counts 216, Treviso 159, Venezia 61, Belluno 56 e I rovigo 49. Eleven seriously ill patients, adults with an average age of 42 years.
Rezza: increased risk for nursing homes
The surge follows the calm induced by the anti-Covid measures in 2020 (145 cases) and 2021 (only 37), which favored the lowest data in history. «The increase observed in 2023 – writes the professor to the Regions Gianni Rezza, director general of Prevention at the Ministry of Health – is favored by the increase in post-Covid population movements. However, WHO estimates that the risk for the general population is low. But not for children, especially if you have other infections such as influenza e varicellaand over 65. And in fact the Regional Directorate for Prevention has sent a circular to the local health authorities to recommend particular attention to infections from strep A among patients in nursing homes, given the “increased risk of disease and death in this vulnerable population”.
How to recognize the infection
Returning to the little ones observe the doctor Franco Pisattaregional secretary of the Fimp (pediatricians of free choice): «In 40 years never seen one like it Epidemic of scarlet fever. We’re detecting carpet infections, each of us diagnosing them ten a week and we are 520 pediatricians. We carry out at least a dozen swabs a day, for the first time scarlet fever also affects one-year-old babies ». You get infected: by close contact with infected people through cough, sneezing or by touching one wound; through objects, surfaces and toys; rarely with the consumption of food contaminated by sick people. THE symptoms they are fever, tiredness, loss of appetite and small red spots all over the body. The disease is treated with antibiotics and stops being contagious after 24 hours.
The shortage of amoxicillin
The problem is that for months there has been a lack of the main antibiotic with which to treat scarlet fever in children, that is the amoxicillinand now i can no longer be found either equivalent drugs. “We have to use alternative antibiotics – confirms Pisetta – which, however, are broader spectrum and can induce antibiotic resistance”. «Amoxicillin cannot be found because the price is low and it is no longer convenient for pharmaceutical companies to produce it, it is uneconomicalespecially with the increase in the cost of raw materials and logistics,” he explains Andrea Bellon, president of Federfarma Veneto. Just the pharmacists are supporting the pediatricians in carrying out the swabs. «The requests increase – says Bellon – in the presence of suspicious symptoms many pediatricians ask for the pre-visit confirmation test. There is also a kit fai da te, but it takes a certain dexterity to touch a child’s tonsils. And so, for a cost between 15 and 20 euros, we rely on pharmacists. The do-it-yourself tampon, on the other hand, costs between 12 and 20 euros.
The recommendations of the Region to the Usl
To contain the spread of streptococcus infections in the directive to the Local Health Authorities, the Region specifies that: patients must be placed in isolation for 48 hours from the start of adequate antibiotic therapy; for the contacts close (including teachers and classmates) must take 7 days of health surveillancema la prophylaxis with antibiotics should be reserved for those at risk; the systematic execution of the throat swab it is foreseen in epidemic situations and if several cases of rheumatic fever have emerged in the same family or small community. They are recommended to all hygiene from the mani, the reaction interior spaces and respiratory protection. Lastly, the Region is asking the local health authorities to have a good supply of tampons rapid and to send the samples to the Epidemiological Coordination for Invasive Bacterial Diseases managed by the University of Padua for virus typing, to be notified to the Higher Institute of Health.