After contracting flesh-eating disease, patients question Nova Scotia Health's response

Two women in southwestern Nova Scotia are questioning the response by Public Health after they say invasive group A strep infections left them in hospital fighting flesh-eating disease.

The episode raises questions about public health messaging in the age of social media, according to one expert.

Kelly Doucet, who lives in Hebron, N.S., said she thought she had the flu when her ordeal began last month. But she said her mother encouraged her to go to Yarmouth Regional Hospital after hearing about a couple in the area who died as a result of invasive group A strep.

"I knew that it was in the province," she said. "I wasn't really aware of the symptoms, signs or severity of what it was."

Doucet said she needed surgery to treat flesh-eating disease as a result of the Strep A infection. And while the Yarmouth hospital team was excellent, she said,Public Health's response has been a disappointment.

"I got more information off of the internet than when [Public Health was] calling me in my hospital bed," she said.

Her grandson, who had stayed with Doucet in the days prior to her illness, was treated with a preventive antibiotic by Public Health, she said. But her daughter, who is the boy's mother and did not stay with Doucet, received no antibiotics and wound up in hospital with what she believes was a complication from a strep infection.

"When I was laying in my bed [after] being cut open, my daughter was going to the outpatients," Doucet said. "That was the worst 24 hours ofmy life."

Second case of flesh-eating disease

Crystal Dillon, who lives in Brooklyn, N.S., said her household wasn't contacted after she was hospitalized and diagnosed with flesh-eating disease as a result of an invasive group A strep infection.

She said there was a long wait when she visited the Yarmouth Regional Hospital on April 8 because the emergency departments in Shelburne and Digby were closed at that time.

"After seven hours, I left. I couldn't sit anymore," said Dillon, who returned to the hospital two days later, at which point she received surgery.

There should have also been more information communicated about invasive strep infections in the community, she said.

"People should have at least been given information so that it wasn't scary for them to hear that I had this."

Viral social media post

An anonymous Facebook message, purportedly written by a nurse, was posted more than a week after Doucet and Dillon arrived in hospital. It claimed there were five active cases of flesh-eating disease at the hospital. And it was shared by thousands of users.

Nova Scotia Health subsequently saidonline claims about flesh-eating disease in the Yarmouth area were inaccurate, and a spokesperson for the department said the claims had caused "unnecessary public concern."

But Doucet and Dillon said the post provided valuable information about the level of infection in the community.

Frustration with the health-care system is likely part of the reason why the post spread widely, according to Robert Huish, an associate professor of international development studies at Dalhousie University.

"That rumour mill becomes a vent for frustration on the way a public policy is acting right now," he said.

Public health messages about COVID-19 were well received by most in Nova Scotia during the pandemic, he said, but health officials can always do better by ensuring messages are inclusive and understandable.

"The architecture of Public Health now is to try to figure out ways to get ahead of the rumours and the scuttlebutt through social media," said Huish.

Infections were communicated appropriately

Dr. Robert Strang, the province's chief medical officer of health, said Nova Scotians should look at the source of information shared on social media.

He said there is a lack of trust in science and public health, particularly since the pandemic.

"We have to work with the general public to help them understand that there's a lot of misinformation," he said, "and some of it is deliberate disinformation on social media."

Strang said the "slightly increased" rates of invasive group A strep have been communicated appropriately.

As of May 2, Nova Scotia Health had reported 61 cases of invasive group A strep, and about half of those were classified as severe infections. There have been 12 deaths across the province.

Invasive group A strep

Invasive group A strep infections happen when usually harmless strep bacteria invades parts of the body that it's not normally found in. This can lead to complications like flesh-eating disease, meningitis and even death.

"There's nothing to suggest that there's any increased concern around invasive group A strep in the Yarmouth area than there is anywhere in the rest of Nova Scotia," Strang said.

He also said that while he could not comment on individual cases, there are clear protocols that dictate when Public Health can provide antibiotics to prevent infection.

Nova Scotia Health Minister Michelle Thompson said the department is constantly trying to provide accurate information in a timely fashion.

"Sometimes that information is well out in front of any of the communications teams or the media for example," said Thompson. "Not everything we read on social media is true, but it is immediate."

Huish said that dispelling misinformation or disinformation and rebuilding trust is vital before another public-health emergency hits.

"So if there is a need to try to co-ordinate trust and buy-in for another emergency down the road, it's little moments like that that will be a real hindrance going forward," he said.