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

R Boyd, Mahomed Said Patel, Bart Currie, Deborah Holt, Tegan Harris, Vicki Krause

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Although 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 with Streptococcus pyogenes isolates 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 28 emm types, of which 63 (77%) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters 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.
    Original languageEnglish
    Pages (from-to)1018-1027
    Number of pages10
    JournalEpidemiology and Infection
    Volume144
    Issue number5
    DOIs
    Publication statusPublished - Apr 2016

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    Northern Territory
    Incidence
    Cross Protection
    Molecular Typing
    Molecular Epidemiology
    Streptococcus pyogenes
    Chemoprevention
    Infection Control
    Septic Shock
    Population Groups
    Population
    Renal Dialysis
    Vaccines
    Public Health

    Cite this

    Boyd, R ; Patel, Mahomed Said ; Currie, Bart ; Holt, Deborah ; Harris, Tegan ; Krause, Vicki. / High burden of invasive group A streptococcal disease in the Northern Territory of Australia. In: Epidemiology and Infection. 2016 ; Vol. 144, No. 5. pp. 1018-1027.
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    abstract = "Although 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 with Streptococcus pyogenes isolates 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 28 emm types, of which 63 (77{\%}) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters 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.",
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    High burden of invasive group A streptococcal disease in the Northern Territory of Australia. / Boyd, R; Patel, Mahomed Said; Currie, Bart; Holt, Deborah; Harris, Tegan; Krause, Vicki.

    In: Epidemiology and Infection, Vol. 144, No. 5, 04.2016, p. 1018-1027.

    Research output: Contribution to journalArticleResearchpeer-review

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