Most of the time, a common cold is just that: a common cold. This is precisely the reason why the Kassis family from Bathurst, Australia, suffered a tragedy in late 2023 that no family should ever have to suffer. Their five-year-old daughter, Cathy, came down with what their doctor thought was a simple cold – a common viral infection. Just days later, she was gone. Her cause of death? A Strep A infection. Medical experts are still warning of the potential of similar misdiagnoses and the need for both parents and doctors to be vigilant.
Cathy’s Story
In late 2023, five-year-old Cathy Kassis came down with what seemed to be a simple cold. Her parents took her to the doctor, who, seeing classic cold symptoms like a runny nose, diagnosed a viral infection and sent her home. Her condition, however, quickly went from bad to worse, so her parents took her to the hospital. There, doctors tested her for COVID-19 and RSV. With both tests coming up negative, they discharged her and Cathy went home. Days later, she passed away. What Cathy had wasn’t a virus at all: She had a strep A infection that had become invasive. Her story serves as a reminder of how dangerous bacterial infections can be and how quickly a minor illness can turn deadly.
What is Invasive Strep A?
Group A Streptococcus (GAS) bacteria are common and typically cause mild illnesses like strep throat and skin infections such as impetigo. However, in some cases, the bacteria can become what is known as invasive Group A Streptococcus (iGAS). This happens when the bacteria enter parts of the body they normally shouldn’t, such as the bloodstream, deep tissue, lungs, or bones. When iGAS takes hold, it can lead to severe and life-threatening conditions. These include:
- Sepsis: The body’s overwhelming and life-threatening response to an infection.
- Streptococcal Toxic Shock Syndrome (STSS): A severe, rapid-onset disease caused by bacterial toxins that can lead to organ failure.
- Necrotizing Fasciitis: A “flesh-eating” bacterial infection that destroys soft tissue.
These severe forms of iGAS have a high mortality rate, estimated to be between 5 and 15% in high-income countries, and even higher for STSS.
A Concerning Rise: Recent Data & Trends
While the exact reasons are still being studied, public health agencies in several countries have reported an unusual increase in iGAS cases in children since late 2022, following the easing of COVID-19 pandemic restrictions. A 2022-2023 study in Ireland, for example, noted a four-fold increase in pediatric iGAS cases, with many presenting as severe conditions like necrotizing pneumonia. A separate study from the Centers for Disease Control and Prevention (CDC) showed that the incidence of invasive strep infections in the United States more than doubled between 2013 and 2022, reversing a 17-year trend of stable rates. These increases have been linked to an increase in respiratory viral co-infections, as well as an increased prevalence of underlying health conditions.
Misdiagnosis and delays remain a significant concern. The initial symptoms of iGAS often overlap with common viral illnesses, making it difficult for even experienced medical professionals to distinguish between a cold and something more serious.
Signs Parents Should Watch For
Because of this overlap, parents play a crucial role in advocating for their children. While many illnesses are indeed viral and will resolve on their own, it is critical to know the red flags. Yes – the doctor should be able to correctly diagnose your child, but they are humans, too. If you know the signs and have a hunch, you will be better able to push for further answers. Look for signs that are not typical of a routine cold and indicate a more serious infection. These include:
- High fever that doesn’t improve or returns after a brief period.
- Severe, localized pain that seems disproportionate to the symptoms, such as severe muscle pain, chest pain, or a very sore throat that makes swallowing difficult.
- Unusual skin symptoms, including a spreading rash or redness and swelling around a wound or sore.
- Trouble breathing, shortness of breath, or a rapid heart rate.
- Extreme fatigue or lethargy: The child is unusually sleepy, hard to wake up, or unresponsive.
- Nausea and vomiting.
How to Advocate for Your Child
The most important takeaway from Cathy’s tragic story is to trust your parental instincts. If you feel something is seriously wrong with your child, you are likely right. Here are a few things you can do to make it easier to talk to doctors:
- Keep a symptom log: Write down when symptoms started, how they’ve changed, and any medications you’ve tried. This can help you clearly communicate a timeline of illness to a doctor.
- Ask direct questions: Don’t hesitate to ask your provider, “Could this be more than a viral infection?“ or “should we do a strep test or throat culture?” If a provider dismisses your concerns, be prepared to push for a follow-up or a second opinion.
- Monitor for deterioration: If your child seems to be getting worse quickly – breathing becomes labored, they stop eating or drinking, or they become confused – seek immediate medical care. Do not wait.
- Be clear with providers: When speaking with a doctor, be very specific about what you are observing. Connecting the dots for them – for instance, “she had a cold, then a fever, and now a spreading rash” – can help them consider a different diagnosis.
What’s Being Done and What More Is Needed
The rise in iGAS cases has prompted increased public health surveillance and the development of new guidelines in some regions. These efforts aim to improve the identification and management of iGAS, including better guidance for when to provide antibiotics to high-risk contacts. In the long term, the most promising solution is a vaccine. Scientists have been working on a Strep A vaccine for decades. Organizations such as Strep A Vaccine Global Consortium (SAVAC) are working to accelerate this process. Several vaccine candidates are currently in clinical development, which may one day prevent these devastating infections and their complications. Until then, raising awareness among both parents and medical providers is crucial. The memory of children like Cathy Kassis reminds us that what may appear to be “just a cold” can hide a deadly threat.
Read More: Sepsis: Woman, 24, dies weeks after getting flu symptoms