It was a Friday in January when Celina Klinger Evans started having contractions and went to a London, Ont., hospital to give birth to Isaiah, a little brother to four-year-old twin sisters.
Two days later, the 29-year-old mother of three was pronounced dead. Her family has been told it was the result of a common infection that in rare cases can aggressively spread and be lethal.
“It was just a wildfire in her body once she had the C-section surgery, and she took a quick downturn within 24 hours,” said Celina’s dad, Markus Klinger. “The speed at which this bacterial infection can go through her body — it’s just scary.”
Celina died on Jan. 19. The coroner has told the family his final report won’t be available for two or three months, but the cause of death will be listed as Group A strep sepsis.
Invasive strep cases are on the rise in Canada after a dip during the pandemic, said John McCormick, a microbiology and immunology professor at Western University.
“These infections are still rare but they’re devastating when they happen,” McCormick said.
“Strep can cause these invasive infections that can be extremely aggressive and very fast.”
‘She was the best mom’
Celina came from a large family — she was the second oldest of eight children and loved music, said William Evans, her husband.
“She was amazing. Everyone she came into contact with, she made them better just by being her.”
A graduate of Clarke Road Secondary School and then Western University with a degree in environmental science, Celina loved playing instruments and singing in her church choir, family members say. When she became a mom to twins Alexandria and Anastasia more than four years ago, she was a natural, William said.
“She not only stepped up to the plate, she did it with grace,” he said. “It’s the hardest job there is and she nailed it. She had so much patience.”
There’s some dispute about whether Celina was already sick before she went into the hospital on Jan. 17 to give birth. Her dad said she had a fever and the coroner said her white blood cell count was high, indicating an infection.
“During the C-section, the hospital team started intravenous antibiotics. Unfortunately Group A strep infection can be very aggressive and can proceed even in the face of antibiotic treatment,” the coroner told Markus.
Either way, Group A strep has evolved to be a quiet enemy that can strike without warning, said McCormick.
“It sort of hides out from your immune system and then it can cause these very, very aggressive infections.”
There are antibiotics that work on Group A strep, but it can spread too quickly to be treated, McCormick added.
“The general public doesn’t have to be overly concerned because these infections are rare. But when they happen, they’re a complete medical emergency.”
William is now settling in to life as a single dad to three kids. Fundraisers have been set up to help him because he wants to focus on the twins and newborn Isaiah.
Celina’s parents, meanwhile, want to raise awareness about invasive Strep A infections and the devastating damage they can do.
“I encourage Londoners to better educate themselves about Streptococcus A. These bacteria are out there and things can take a really bad turn,” said Markus, who himself has dealt with debilitating infections as a diabetic.
According to the World Health Organization, Canada’s maternal mortality ratio has increased from about 9 to 11 deaths per 100,000 births over the last two decades.
The London Health Sciences Centre (LHSC), where Celina gave birth and died, offered condolences to her family members and loved ones.
“Our thoughts are with her family and with all who will feel this heartbreaking loss,” hospital officials said.
Ontario reports 17.5 deaths in every 100,000 births. LHSC’s maternal mortality rate lower, with 16.5 deaths in every 100,000 births in the last 5 years, officials told CBC News.
“Our care teams grieve these losses along with our patients’ families,” they wrote in a statement.
“Several things contribute to our maternal mortality rates. LHSC is a high-risk, tertiary-care obstetrical centre, with 30 per cent of our patients identified as high risk. Additionally, we are a regional centre for several medical specialties including trauma, cardiac, neurology, cancer, mental health, renal and transplant. Finally, during the COVID-19 pandemic, we were responsible for caring for critically ill maternal COVID-19 patients from out of region and out of province.”
