Keywords:
Epidemiologic measurements; Streptococcus pyogenes
Introduction:
Well publicised, rapid onset deaths in previously healthy children from invasive group A streptococcal disease (iGAS) in Australia in recent years have highlighted the emerging burden of iGAS. Here we explore the evidence and knowledge gaps to inform clinicians, public health units and the Australian public regarding iGAS definition and epidemiological trends in Australia.
iGAS is associated with high morbidity, mortality and substantial health expenditure. Clinical forms include sepsis, streptococcal toxic shock syndrome, necrotising fasciitis, pneumonia/empyema, bacteraemia and postpartum endometritis. Group A Streptococcus (GAS) infections are not currently vaccine preventable, but through the Australian Strep A Vaccine Initiative, the Australian Government and global philanthropic partners have invested heavily in accelerating the vaccine development. Although GAS remains susceptible to penicillin and most β-lactam antibiotics, mortality rates as high as 70–80% have been reported for iGAS necrotising fasciitis, and overall case fatalities remain high (8–16%) for the other phenotypes.