17 Streptococcal Toxic Shock Syndrome (STSS)

CDC Toxic Shock Syndrome page

34 cases

11 deaths

82.4 % of cases were hospitalized

2.8 cases per 100,000 population


17.1 Epidemiologic Review

17.1.1 Disease Information

Overview: Streptococcal toxic shock syndrome (STSS) is a serious complication from a Group A Streptococcus (GAS) infection.

Symptoms: Common symptoms include fever, diarrhea, muscle aches, hypotension (low bood pressure), and multi-system organ involvement.

Transmission: Group A Streptococcus is transferred person-to-person through respiratory droplets and direct contact with infected secretions. STSS itself is not communicable person to person but the organism that causes it (GAS) is.

Treatment: Treatment includes antibiotics, supportive care and severe infections may require surgical debridement (removal of dead or nonviable tissue from a wound to facilitate healing).

Prevention There are no specific prevention recommendations for STSS. Practicing good hygiene habits like washing your hands often can help avoid spreading infections. It is also important that people using needles to inject themselves are always using new, clean needles and not reusing or sharing needles.

17.1.2 Demographics


Rates for <1, 1-4, 5-17, and 18-29 years of age are not displayed due to low case counts.


Racial and Ethnicity demographic data are not presented due to low counts.

17.1.3 Outbreaks

No outbreaks were identified in 2023.

17.1.4 Monthly and Historical Comparisons



Data for Utah and the CDC were retrieved from the CDC’s Notifiable Infectious Disease Data Tables.

17.2 Key Things to Know

  • 27 cases (68%) were admitted to the ICU, 24 (70%) were given medications to help increase blood pressure, and 14 (43%) were intubated.
  • 10 cases (29%) experienced soft tissue necrosis (tissue and skin death due to bacterial invasion) with their illness.
  • 82% of cases experienced thrombocytopenia (low platelet count and reduced ability for blood to clot to stop bleeding) with severely decreased platelet counts.
  • Common comorbidities among cases include diabetes, chronic lung disease and cancer.
  • Risk factors included drug abuse (17%), foot ulcer (29%), homelessness (20%), and smoking (17%).
  • 29 cases (85%) were associated with a wound.