Invasive group A Streptococcus disease in Australian children: 2016 to 2018 - a descriptive cohort study

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BMC Public Health. 2019 Dec 30;19(1):1750. doi: 10.1186/s12889-019-8085-2. Invasive group A Streptococcus disease in Australian children: 2016 to 2018 - a descriptive cohort study.

Oliver J^1,2, Thielemans E^3,4, McMinn A³, Baker C³, Britton PN^5,6, Clark JE⁷, Marshall HS⁸, Blyth CC^9,10,11, Francis J^12,13, Buttery J^3,14, Steer AC³, Crawford NW^3,15; PAEDS investigators.
Collaborators (50)

Author information

1 Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, 3052, Australia. jane.oliver@mcri.edu.au. 2 The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia. jane.oliver@mcri.edu.au. 3 Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, 3052, Australia. 4 Universit? Libre de Bruxelles, Bruxelles, Belgium. 5 The Children's Hospital at Westmead, Sydney, Australia. 6 Medical School University of Sydney, Sydney, New South Wales, Australia. 7 Queensland Children's Hospital, and School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia. 8 Women's and Children's Hospital, Adelaide, South Australia, Australia. 9 School of Medicine angeid Telethon Kids Institute, University of Western Australia, Perth, Australia. 10 Perth Children's Hospital, Perth, Western Australia, Australia. 11 PathWest Laboratory Medicine, Nedlands, Perth, Australia. 12 Royal Darwin Hospital, Darwin, Northern Territory, Australia. 13 Menzies School of Health Research, Darwin, Northern Territory, Australia. 14 Monash Health, Monash University, Melbourne, Victoria, Australia. 15 The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.

Abstract

OBJECTIVES:

Invasive group A Streptococcus (iGAS) disease is serious and sometimes life-threatening. The Paediatric Active Enhanced Disease Surveillance (PAEDS) Network collects voluntary notifications from seven major Australian paediatric hospitals on patients with certain conditions, including iGAS disease. Our aims were to: 1) Describe the epidemiological distribution of paediatric iGAS disease in Australia and correlate this with influenza notifications, 2) Identify GAS strains commonly associated with invasive disease in children.
METHODS:

IGAS and influenza notification data were obtained (from the PAEDS Network and the Australian Institute of Health and Welfare, respectively, for the period 1 July 2016 to 30 June 2018). Included iGAS patients had GAS isolated from a normally sterile body site. Data were described according to selected clinical and demographic characteristics, including by age group and Australian State, with proportions and minimum incidence rates estimated.
RESULTS:

A total of 181 patients were identified, with most (115, 63.5%) <5 years old. The mean annual minimum incidence rate was 1.6 (95% confidence interval: 1.1-2.3) per 100,000 children across the study period. An epidemiological correlation with the seasonal burden of influenza was noted. Contact prophylaxis was not consistently offered. Of 96 patients with emm-typing results available, 72.9% showed emm-1, -4 or - 12.
CONCLUSIONS:

Robust surveillance systems and cohesive patient management guidelines are needed. Making iGAS disease nationally notifiable would help facilitate this. Influenza vaccination may contribute to reducing seasonal increases in iGAS incidence. The burden of disease emphasises the need for ongoing progress in GAS vaccine development.


KEYWORDS:

Child health; Group A Streptococcus; Infectious diseases; Invasive; Public health

PMID: 31888568 PMCID: PMC6937995 DOI: 10.1186/s12889-019-8085-2
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