Group A Streptococcus Vaccine Research

Abstract

Streptococcus pyogenes, commonly referenced to as Lancefield group A Streptococcus (GAS), is a gram positive human pathogen that causes a variety of diseases including pharyngitis, scarlet fever, necrotizing fasciitis, and streptococcal toxic shock syndrome (STSS). Post-infectious sequelae such as acute rheumatic fever (ARF), subsequent rheumatic heart disease (RHD), and acute glomerulonephritis can occur after GAS infection.1 ARF and RHD are the most common causes of preventable pediatric heart disease globally. The only known reservoir of GAS is humans, and the organism is generally disseminated by individuals with symptomatic infection of the mucous membranes or skin, although asymptomatic carriers can also transmit the pathogen. GAS is the most common cause of bacterial upper respiratory tract infection in all age groups in the United States.2 Prompt diagnosis and treatment of acute GAS pharyngitis is necessary to reduce the risk of transmission, and to prevent suppurative complications and post-streptococcal sequelae. The intent of this chapter is to provide a historical synopsis of GAS vaccine research, discuss recent advances in the field, and highlight prospects for the future. The reader is referred to refs. 1, and 3, 4, 5, 6, 7, 8 for additional information about GAS pathogenesis and the history of GAS disease.