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Flu, invasive strep infections increasing in Colorado as health officials warn of holiday gatherings

Health officials warned invasive group A strep and flu infections are going up in Colorado, and could continue to increase due to holiday gatherings in coming weeks.

DENVER — Officials with the Colorado Department of Public Health and Environment (CDPHE) said Wednesday that influenza infections remain high, while case rates for various illnesses including COVID-19, RSV and strep throat are improving. They also warned that post-holiday spikes are likely as many people attend holiday gatherings in the coming weeks.

Multiple respiratory infections have inundated Colorado's healthcare system in the last month, but it's a bacteria infection that has some doctors scratching their heads. 

Cases of group A strep have increased in the state over the last couple of months. Most of the cases are mild, but invasive cases in children have begun to surface.

"I want to emphasize these are very rare infections. There's not very many of them, but definitely an increase that we've seen in the past," Dr. Sam Dominguez with Children's Hospital Colorado said on Wednesday. 

Group A strep infections can impact anyone since the bacteria easily spreads from person to person. While often it is easily treated, it has brought about dangerous complications in some cases Children's Hospital has seen lately.

"These types of infections present in several different ways at the hospital, including kids presenting with very severe pneumonia, sepsis, toxic shock, bone joint and muscle infection, serious sinus disease and severe skin infections," Dominguez said. 

"I think we have lots of questions trying to understand what might be driving these increases," State Epidemiologist Dr. Rachel Herlihy said.

Two children have already died from severe strep infections in Colorado. State health leaders are trying to find ways to prevent more, and they say oftentimes the way to do that is preventing everything else. 

RELATED: 2 pediatric deaths from severe strep since November; hospitalizations rise

"While group A strep is a bacteria infection, children with a respiratory virus like RSV, COVID or influenza may be at a higher risk of getting a secondary infection like group A strep, either at the same time or shortly following these infections," Dominguez said. "While there is no vaccine for group A strep, people should be up to date with their COVID-19, influenza and chicken pox vaccines as we do know that getting these infections can increase your risk of getting a group A strep infection." 

CDPHE has detected 672 cases of group A strep throat this year, which is significantly more than 2017 through 2021, which ranged between 298 and 383 cases annually. 

Among children under 18, the 32 cases detected this year is also significantly higher. Those case totals ranged between 6 and 21 between 2017 and 2021.

Credit: CDPHE
COVID-19 case counts in Colorado as of December 21, 2022.

Herlihy said COVID-19 case counts are decreasing statewide since peaking in late November and early December, but remain elevated.

"We're still seeing elevated case numbers, but a bit of a plateau in the last week-and-a-half or so, so not seeing that steady downward trajectory we were seeing a couple weeks ago," Herlihy said.

She also said that case counts are increasing for COVID infections caused by the newer BQ1 and BQ1.1 omicron subvariants, while cases caused by other subvariants are decreasing.

Similar to the COVID case rates, the percent positivity rate has shown a steady decrease in recent weeks, and currently stands at 9.32%.

Credit: CDPHE
COVID-19 positivity rate in Colorado as of December 21, 2022.

COVID-19 hospitalizations have also decreased in recent weeks, with 339 patients hospitalized as of Wednesday, a decrease of 56 from the previous week.

Credit: CDPHE
COVID-19 hospitalizations in Colorado as of December 21, 2022.

Moving on to RSV, Herlihy said there has been a steady decline in the positivity rate since peaking in November. 

Hospitalizations for RSV have also decreased significantly in recent weeks to what the state typically sees during a normal RSV season. 

"Things with RSV do seem to be moving in the right direction," she said.

Credit: CDPHE
RSV positivity in Colorado as of December 21, 2022.
Credit: CDPHE
RSV hospitalizations in Colorado as of December 21, 2022.

Herlihy said the positivity rate for the flu has decreased over the past week, with the majority of infections being caused by influenza A. 

Hospitalizations for the flu have been fluctuating in recent weeks. There are currently 345 patients hospitalized, which is a slight increase from last week, but fewer than two weeks ago. 

"We continue to be well ahead of schedule for a typical influenza season," she said. "Much higher numbers than we would typically see at this time of year, though we are starting to move into that typical influenza season."

She added that with the numbers fluctuating, it's hard to tell at this point whether the upward trajectory in the past week will continue.

Credit: CDPHE
Flu hospitalizations in Colorado as of December 21, 2022.

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