Abstract
We aimed to assess the effect of invasive group A streptococcal (GAS) infection and the potential effects of a multivalent GAS vaccine in New Zealand. During January 2005–December 2006, we conducted prospective population-based laboratory surveillance of Auckland residents admitted to all public hospitals with isolation of GAS from normally sterile sites. Using emm typing, we identified 225 persons with confirmed invasive GAS infection (median 53 years of age; range 0–97 years). Overall incidence was 8.1 cases per 100,00 persons per year (20.4/100,000/year for Maori and Pacific Islanders; 24.4/100,000/year for persons >65 years of age; 33/100,000/year for infants <1 year of age). Nearly half (49%) of all cases occurred in Auckland’s lowest socioeconomic quintile. Twenty-two persons died, for an overall case-fatality rate of 10% (63% for toxic shock syndrome). Seventy-four percent of patients who died had an underlying condition. To the population in our study, the proposed 26-valent vaccine would provide limited benefit.
Highlights
We aimed to assess the effect of invasive group A streptococcal (GAS) infection and the potential effects of a multivalent GAS vaccine in New Zealand
Patients with streptococcal toxic shock syndrome (STSS) were included in accordance with the consensus definition [19]; STSS was the diagnosis for patients who were dead on arrival or who died within 48 hours after illness onset and for whom laboratory data were insufficient in accordance with the methodology of Davies et al [1]
Invasive GAS infection was defined as postpartum if it occurred in a woman who was pregnant or
Summary
We aimed to assess the effect of invasive group A streptococcal (GAS) infection and the potential effects of a multivalent GAS vaccine in New Zealand. We previously published a population-based approach of laboratory surveillance for invasive bacterial diseases in Auckland’s public hospitals where all persons with acute disease would be admitted [8,15,16,17,18]. Using this approach, we demonstrate the effects of invasive GAS on the Auckland population to complement our knowledge of other GAS-associated diseases by using prospectively collected incidence data, clinical characteristics, associated underlying conditions, and the associated emm types.
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