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

O'Grady, Kerry-Ann, Kelpie, Loraine, Andrews, Ross M., Curtis, Nigel, Nolan, Terence M., Selvaraj, Gowri, Passmore, Jonathan W., Oppedisano, Frances, Carnie, John A. and Carapetis, Jonathan R. (2007). The epidemiology of invasive group A streptococcal disease in Victoria, Australia. Medical Journal of Australia,186(11):565-569.

Document type: Journal Article
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IRMA ID 10452xPUB34
Title The epidemiology of invasive group A streptococcal disease in Victoria, Australia
Author O'Grady, Kerry-Ann
Kelpie, Loraine
Andrews, Ross M.
Curtis, Nigel
Nolan, Terence M.
Selvaraj, Gowri
Passmore, Jonathan W.
Oppedisano, Frances
Carnie, John A.
Carapetis, Jonathan R.
Journal Name Medical Journal of Australia
Publication Date 2007
Volume Number 186
Issue Number 11
ISSN 0025-729X   (check CDU catalogue open catalogue search in new window)
Start Page 565
End Page 569
Total Pages 5
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
Field of Research 1199 - Other Medical and Health Sciences
HERDC Category C1 - Journal Article (DEST)
Abstract Objective: To estimate the incidence and severity of invasive group A streptococcal infection in Victoria, Australia.

Prospective active surveillance study.

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

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.

We identified 333 confirmed cases: an average annualised 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.

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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