Increase in invasive group A streptococcal disease among Australian children coinciding with northern hemisphere surges

• DOI: 10.1016/j.lanwpc.2023.100873
• Publication Date: 2023-08-22T10:02:22Z
• Authors: Yara-Natalie Abo; Jane Oliver; Alissa McMinn; Joshua Osowicki; Ciara Baker; Julia E. Clark; Christopher C. Blyth; Joshua R. Francis; Jeremy Carr; Pierre R. Smeesters; Nigel W. Crawford; Andrew C. Steer
• Keywords: Case fatality rate; Interquartile range

BackgroundIncreases in invasive group A streptococcal disease (iGAS) have recently been reported multiple countries the northern hemisphere, occurring during, and outside of, typical spring peaks. We report epidemiology of iGAS among children Australia from 1 July 2018 to 31 December 2022.MethodsThe Paediatric Active Enhanced Disease Surveillance (PAEDS) Network prospectively collected patient notifications for young people aged less than 18 years admitted five major Australian paediatric hospitals Victoria, Queensland, Western Northern Territory. Patients were eligible inclusion if they had GAS isolated a normally sterile body site, or met clinical criteria toxic shock syndrome necrotising fasciitis with non-sterile site. patients’ demographic characteristics, estimate minimum incidence rates.FindingsWe identified 280 patients, median age 4.5 (interquartile range 1.4–6.4). observed pre-pandemic peak annualised 3.7 per 100,000 (95% CI 3.1–4.4) 3rd quarter 2018, followed by decline 1.0 2020 mid-2021. The increased sharply mid-2022, peaking at 5.2 4.4–6.0) persisting into 4th (4.9 100,000, 95% 4.2–5.7). There 3 attributable deaths 84 (32%) patients severe (overall case fatality rate 1%, 0.2–3.3). Respiratory virus co-infection, positive 57 119 tested, was associated (RR 1.9, 1.2–3.0). most common emm-type emm-1 (60 163 isolates that underwent emm-typing, 37%), emm-12 (18%).InterpretationAustralia experienced an increase 2022 compared pandemic 2020–2021. This is similar hemisphere observations, despite differences seasons circulating respiratory viruses. Outbreaks continue occur widely. emphasises unmet need vaccine prevent significant morbidity disease.FundingMurdoch Children's Research Institute funded open access publishing this manuscript.