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dc.contributor.authorBoyd, R-
dc.contributor.authorPatel, M-
dc.contributor.authorCurrie, B J-
dc.contributor.authorHolt, D C-
dc.contributor.authorHarris, T-
dc.contributor.authorKrause, V-
dc.identifier.citationEpidemiology and infection 2016-04; 144(5): 1018-27-
dc.description.abstractAlthough 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.-
dc.subjectInfectious disease epidemiology-
dc.subjectStreptococcus pyogenes-
dc.subjectpublic health emerging infections-
dc.subjectstreptococcal infections-
dc.subject.meshAged, 80 and over-
dc.subject.meshChild, Preschool-
dc.subject.meshInfant, Newborn-
dc.subject.meshMiddle Aged-
dc.subject.meshMolecular Typing-
dc.subject.meshNorthern Territory-
dc.subject.meshShock, Septic-
dc.subject.meshStreptococcal Infections-
dc.subject.meshStreptococcus pyogenes-
dc.subject.meshYoung Adult-
dc.titleHigh burden of invasive group A streptococcal disease in the Northern Territory of Australia.-
dc.typeJournal Article-
dc.identifier.journaltitleEpidemiology and infection-
dc.identifier.affiliationCentre for Disease Control,Tiwi,NT,Australia..-
dc.identifier.affiliationNational Centre for Epidemiology and Population Health,Australian National University,Canberra,ACT,Australia..-
dc.identifier.affiliationRoyal Darwin Hospital,Tiwi,NT,Australia..-
dc.identifier.affiliationDivision of Global and Tropical Health,Menzies School of Health Research,Charles Darwin University,Casuarina,NT,Australia..-
dc.identifier.affiliationDivision of Global and Tropical Health,Menzies School of Health Research,Charles Darwin University,Casuarina,NT,Australia..-
dc.identifier.affiliationCentre for Disease Control,Tiwi,NT,Australia..-
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