We are seeing an increase in invasive Group A Streptococcus infections in Middlesex-London. We normally receive an average of 20 reported cases per year in Middlesex-London. To date in 2012, we have had 27 reported cases. There is no obvious connection between the cases except that eight people are using or have previously used injection drugs. Further investigation is taking place to determine if the Group A Streptococcus isolates are the same strain.

About Invasive Group A Streptococcus

Invasive Group A Streptococcus is defined as Group A Streptococcus identified from a normally sterile site, or clinically severe infection with Group A Streptococcus identified from a non-sterile site.

A fact sheet which provides additional information on Group A Streptococcus is available on our web site.

Please be on the alert for invasive Group A Streptococcus infection and ensure that any patient with known or suspected invasive Group A Streptococcus is reported to the Health Unit (519-663-5317 ext. 2330).

Counselling for patients who use injection drugs

If you have patients in your practice who use injection drugs, please counsel them on safer injection techniques such as:

• Use a new, sterile needle for every injection;
• Clean hands before touching any equipment;
• Use a new cooker to mix drugs;
• Use a new filter for each injection;
• Use sterile water for mixing drugs; 
• Clean skin with alcohol swabs before injecting;
• Rotate injection sites;
• Don’t share leftover mixed drugs (wash); and
• Don’t lick the injection site, needle or any other injection drug equipment.

If you would like to order some resources for your office regarding safer injection practices and Group A Streptococcus risk for those who use injection drugs, please contact Laurie Young at 519-663-5317 ext. 2346 or laurie.young@mlhu.on.ca.

Needle exchange services

Patients should be informed of the services of the Counterpoint Needle Exchange. Needle exchange is available at the following locations:

• Regional HIV/AIDS Connection (RHAC) (186 King Street – Unit 30);
• Middlesex-London Health Unit (50 King Street);
• My Sister’s Place (566 Dundas Street); or
• By calling the Needle Exchange Outreach Worker from the Regional HIV/AIDS Connection (519-851-3548). 

Additional information on safer injection practices and needle exchange services at the various locations is available on the Regional HIV/AIDS Connection (RHAC) web site.