An infection from ‘Group A Streptococcus’ can lead to skin infections or even death from toxic shock syndrome and has been detected in the country. As highly transmissible and lethal variants have been identified, health authorities are considering whether to designate it as a legally mandated infectious disease. Currently, there is no national surveillance system in place to accurately assess the scale of the outbreak.
Group A Streptococcus is known to typically cause relatively mild diseases such as pharyngitis and scarlet fever. However, if this bacterium invades abnormal parts of the body such as the blood, muscles, or lungs, it can transition into an ‘invasive infection,’ resulting in fatal complications such as sepsis, necrotizing fasciitis, and toxic shock syndrome. While developed countries like the United States and Japan manage it under national surveillance systems, Korea currently lacks such a monitoring system.
The Korea Disease Control and Prevention Agency said on the 3rd, “We are reviewing and promoting details to reflect Group A Streptococcus infection as a legally mandated infectious disease.” If designated as a legally mandated infectious disease, all medical institutions across the country must report cases of infection to authorities, allowing for systematic understanding and response to the outbreak.
This discussion follows the findings of a study conducted by Professor Lee Hyun-joo's team at Bundang Seoul National University Hospital, which was commissioned by the Korea Disease Control and Prevention Agency to establish a monitoring system for invasive Group A Streptococcus in the country. The study was carried out over approximately nine months from July of last year to March of this year and represents the first nationwide analysis of invasive infection cases.
According to the study, 383 cases of invasive Group A Streptococcus infections were confirmed in the country from 2015 to 2024. Among them, 319 cases (83.3%) were adults, while 64 cases (16.7%) involved children. 14.4% of all patients died from this infection, and 27.2% required intensive care unit treatment. Surgical procedures or skin incisions due to infections were performed in 41.5% (159 cases), and limb amputations occurred in 5 cases (1.3%). Additionally, 11.7% of the patients were left with lifelong disabilities.
The research team found that a highly toxic variant of the virus, known as ‘M1UK,’ was also confirmed in the country. M1UK leads to rapidly worsening symptoms upon infection and has a high mortality rate, and it is classified as a dangerous variant overseas. The research team identified two cases of M1UK infection in Korea, one in 2020 and another in 2023.
The research team pointed out that it is impossible to accurately assess the scale, characteristics, and risk factors of Group A Streptococcus outbreaks, and that in the case of a large-scale outbreak, early recognition and rapid response would be challenging. In a survey conducted among infectious disease experts, 70.7% of respondents indicated that comprehensive surveillance of invasive Group A Streptococcus infections is necessary, highlighting the importance of laboratory-based monitoring.