High burden of invasive group A streptococcal disease in the Northern Territory of Australia

Author:

BOYD R.,PATEL M.,CURRIE B. J.,HOLT D. C.,HARRIS T.,KRAUSE V.

Abstract

SUMMARYAlthough the incidence of invasive group A streptococcal disease in northern Australia is very high, little is known of the regional epidemiology and molecular characteristics. We conducted a case series of Northern Territory residents reported between 2011 and 2013 withStreptococcus pyogenesisolates from a normally sterile site. Of the 128 reported episodes, the incidence was disproportionately high in the Indigenous population at 69·7/100 000 compared to 8·8/100 000 in the non-Indigenous population. Novel to the Northern Territory is the extremely high incidence in haemodialysis patients of 2205·9/100 000 population; and for whom targeted infection control measures could prevent transmission. The incidences in the tropical north and semi-arid Central Australian regions were similar. Case fatality was 8% (10/128) and streptococcal toxic shock syndrome occurred in 14 (11%) episodes. Molecular typing of 82 isolates identified 28emmtypes, of which 63 (77%) were represented by fouremmclusters. Typing confirmed transmission between infant twins. While the diverse range ofemmtypes presents a challenge for effective coverage by vaccine formulations, the limited number ofemmclusters raises optimism should cluster-specific cross-protection prove efficacious. Further studies are required to determine effectiveness of chemoprophylaxis for contacts and to inform public health response.

Publisher

Cambridge University Press (CUP)

Subject

Infectious Diseases,Epidemiology

Reference40 articles.

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4. Australian Institute of Health and Welfare. National drug strategy household survey report. Canberra. 2011, cat. no. PHE 145, 2010.

5. Invasive Group A Streptococcal Disease in Children and Association With Varicella-Zoster Virus Infection

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