Killer bug cases have risen all over the world

CASES OF a deadly microbial infection that causes rapid gangrene have increased worldwide in recent years, the World Health Organisation (WHO) said yesterday as the death toll in Britain since January rose to a possible 12.

But Dr Kenneth Calman, the Chief Medical Officer, last night sought to allay fears that the country was in the grip of an epidemic of 'flesh eating' bacteria. He said: 'Everything that can be done is being done to investigate the so-called killer bug infection.' There was no evidence of any increase in the normal incidence of Group A beta-haemolytic streptococcal infections, he said, and 'no firm evidence' that all cases reported in the media were necrotising fasciitis, the gangrene-like illness which causes skin, fat and muscle to liquefy and die.

A crisis team set up by the Government's Public Health Laboratory Service is collating information on all confirmed and suspected cases of severe Group A streptococcal disease, including blood poisoning, and cases of necrotising fasciitis.

Health departments in several European countries, New Zealand and Canada, were last night checking their reports of serious streptococcal A infections as concern has spread from the Gloucester 'cluster' of cases first reported in the Independent earlier this month.

A review by WHO of 166 reports of streptococcal A infections and necrotising fasciitis made between 1989 and 1993 appears to support the view of some scientists that the bacterium is becoming more virulent. A spokesman for WHO said: 'Most of the more recent ones (reports) are recording an increase (in cases and deaths).' Precise figures were not available but death rates range from single figures to 48 per cent. A genetic change may be responsible for the increased virulence, or a viral infection of the bacterium.

The latest British victims include a man aged 43 who died in Cardiff Royal Infirmary on 1 May and Margaret Buxton, 59, who died in Bognor Regis, West Sussex, last month. James Anderson, 57, from Andover, died in the Royal Hampshire County Hospital in March, and a woman in her 60s died in the same hospital last month. Two cases yet to be confirmed are Pamela Cunningham, 25, of Bathgate, West Lothian, who died in February, and an elderly patient who died in Devon last month.

Meanwhile the seventh member of the Gloucester cluster - six definite cases and one suspected - was 'critical but stable' in an isolation ward at Gloucester Royal Infirmary last night.

About a fifth of all cases of necrotising fasciitis are caused by Group A streptococci, and a mixture of different bacteria is responsible for the rest. An average of 10 or fewer cases of necrotising fasciitis linked to streptococcal A are expected each year.

Worldwide alert, page 2