The high mortality “flesh-eating disease,” Streptococcal Toxic Shock Syndrome (STSS), is continuing to spread in Japan. Last year, a total of 941 cases of STSS were reported here, a record figure. That number looks set to be easily eclipsed in 2024. In the first three months of this year (up until March 24), 556 cases were already reported. For travelers planning to visit Japan in the near future, these are worrying statistics, though the Japanese Health Ministry recently released a statement informing them that there was no need to panic.  

How Concerned Should Travelers to Japan Be About STSS?

“For individuals planning to travel to Japan, there’s no need to cancel travel plans due to the outbreak of this disease. However, it’s advisable to practice basic infection prevention measures such as hand hygiene and cough etiquette, including mask wearing, as appropriate, when traveling,” according to the Japanese Health Ministry’s report.  

The ministry added that the World Health Organization (WHO) did not recommend any restrictions on travel in 2022 when there were outbreaks there. Last month, North Korea suddenly canceled their World Cup qualifying game against the Samurai Blue that was set to take place in Pyongyang due to “epidemic prevention for the contagious disease spreading in Japan.” The Japanese side were subsequently awarded a 3-0 victory.  

What is STSS?  

STSS is a rare but serious bacterial infection. Most cases are caused by a bacterium called streptococcus pyogenes. It often begins with influenza-like symptoms, including fever, chills, nausea, vomiting and myalgia. The bacterium enters through mucus membranes or a compromised barrier, such as a skin injury. It then spreads to deep tissues before entering the bloodstream. While STSS can occur in anyone, it is more common in people aged 65 and over. An estimated 30% of STSS cases end in death.

“There are still many unknown factors regarding the mechanisms behind fulminant (severe and sudden) forms of streptococcus, and we are not at the stage where we can explain them,” said The National Institute of Infectious Diseases (NIID). 

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