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Title: High burden of invasive group A streptococcal disease in the Northern Territory of Australia.
Authors: Boyd, R
Patel, M
Currie, B J
Holt, D C
Harris, T
Krause, V
Affiliation: Centre for Disease Control,Tiwi,NT,Australia..
National Centre for Epidemiology and Population Health,Australian National University,Canberra,ACT,Australia..
Royal Darwin Hospital,Tiwi,NT,Australia..
Division of Global and Tropical Health,Menzies School of Health Research,Charles Darwin University,Casuarina,NT,Australia..
Division of Global and Tropical Health,Menzies School of Health Research,Charles Darwin University,Casuarina,NT,Australia..
Centre for Disease Control,Tiwi,NT,Australia..
Issue Date: Apr-2016
Citation: Epidemiology and infection 2016-04; 144(5): 1018-27
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.
DOI: 10.1017/S0950268815002010
Type: Journal Article
Subjects: Infectious disease epidemiology
Streptococcus pyogenes
public health emerging infections
streptococcal infections
Aged, 80 and over
Child, Preschool
Infant, Newborn
Middle Aged
Molecular Typing
Northern Territory
Shock, Septic
Streptococcal Infections
Streptococcus pyogenes
Young Adult
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