Key Points

• A trend toward stabilization in the number of pediatric cases of severe invasive group A streptococcal infections (IGASIs) hospitalized in critical care units has been observed since the week of January 9, 2023. (+49 cases compared to the 121 cases reported in the last epidemiological update on January 29, 2023).

• Of the 170 cases recorded since September 2022, 13 have died. Six additional deaths from GAS-I before hospital admission have been reported. More than half of the cases occurred in the context of or following a viral infection such as influenza or RSV.

• The number of outpatient visits and emergency department visits for non-invasive SGA infections (scarlet fever) remains at levels higher than those observed before the COVID epidemic.

• The increase in the number of IISGA cases among adults, suggested by CNR data, will need to be confirmed by additional analyses based on data from the Epibac network (surveillance of invasive bacterial infections) and the PMSI (Program for the Medicalization of Information Systems).

• The current epidemiological situation regarding IISGA is not linked to the emergence of a new bacterial strain but possibly to an increase in the frequency of the already known emm-1 genotype of sequence type (ST) 28.

• A similar situation is observed in other European countries, notably in the United Kingdom, where a high incidence of IISGA affects all age groups and particularly children.

• A resurgence of RSV infections was observed in late 2022 amid widespread circulation of respiratory viruses, particularly among children (a triple epidemic of influenza, COVID-19, and bronchiolitis) but can be explained, at least in part, by a resurgence of SGA infections following the lifting of public health measures, particularly among children whose immune systems have not been exposed to the strains that typically circulate.