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Multicenter Study
. 2007 Jun 4;186(11):565-9.
doi: 10.5694/j.1326-5377.2007.tb01054.x.

The epidemiology of invasive group A streptococcal disease in Victoria, Australia

Kerry-Ann F O'Grady  1 , Loraine Kelpie, Ross M Andrews, Nigel Curtis, Terence M Nolan, Gowri Selvaraj, Jonathan W Passmore, Frances Oppedisano, John A Carnie, Jonathan R Carapetis
Affiliations
Multicenter Study

The epidemiology of invasive group A streptococcal disease in Victoria, Australia

Kerry-Ann F O'Grady et al. Med J Aust. .

Abstract

Objective: To estimate the incidence and severity of invasive group A streptococcal infection in Victoria, Australia.

Design: Prospective active surveillance study.

Setting: Public and private laboratories, hospitals and general practitioners throughout Victoria.

Patients: People in Victoria diagnosed with group A streptococcal disease notified to the surveillance system between 1 March 2002 and 31 August 2004.

Main outcome measure: Confirmed invasive group A streptococcal disease.

Results: We identified 333 confirmed cases: an average annual incidence rate of 2.7 (95% CI, 2.3-3.2) per 100,000 population per year. Rates were highest in people aged 65 years and older and those younger than 5 years. The case-fatality rate was 7.8%. Streptococcal toxic shock syndrome occurred in 48 patients (14.4%), with a case-fatality rate of 23%. Thirty cases of necrotising fasciitis were reported; five (17%) of these patients died. Type 1 (23%) was the most frequently identified emm sequence type in all age groups. All tested isolates were susceptible to penicillin and clindamycin. Two isolates (4%) were resistant to erythromycin.

Conclusion: The incidence of invasive group A streptococcal disease in temperate Australia is greater than previously appreciated and warrants greater public health attention, including its designation as a notifiable disease.

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