title: High group A streptococcal carriage in the Orthodox Jewish community of north Hackney.
abstract: BACKGROUND
  General practitioners and the microbiologist serving north Hackney in north east London formed the impression, that of throat swabs sent to the laboratory, a disproportionate number of those positive for group A streptococcus appeared to come from Orthodox Jewish patients.
  
  
  OBJECTIVE
  To confirm the clinical impression that the pharyngeal carriage of group A streptococci was higher in the Orthodox Jewish population than in other members of the population in the same locality.
  
  
  METHODS
  A general practice questionnaire survey of all patients aged three years or over attending two practices that are about one kilometre apart, over a five-week period.
  
  
  METHODS
  Two general practices in north London, one of which had a significant Orthodox Jewish patient list.
  
  
  METHODS
  Throat swabs were taken from eligible patients who were invited to participate by completing a questionnaire and having a throat swab taken.
  
  
  RESULTS
  Swabs were taken from 1223 people. After correction for age (child or adult) and history of recent sore throat, the Orthodox Jewish community had a significantly higher carriage rate of group A streptococci than the rest of the population (odds ratio = 5.0 [2.1 to 11.9]). The proportion of adults with group A streptococci with and without sore throats was 6.4% and 2.4% respectively in the Orthodox Jewish group and 0.45% and 1% respectively in the 'others' group. The proportion of children with group A streptococci with and without sore throats was 17.4% and 5.9% respectively and 3.4% and 0% respectively in the others. These differences were not explained by the larger family size and domestic overcrowding in the Orthodox Jewish group.
  
  
  CONCLUSIONS
  Orthodox Jews in north London have a higher pharyngeal carriage rate of group A streptococci than the neighbouring population. These results may have implications for the diagnosis and treatment of acute sore throat in Orthodox Jewish patients, especially children.
authors.affiliation: Departmental of Environmental and Preventive Medicine, St Bartholomew's and the London School of Medicine and Dentistry, Queen Mary, University of London. j.spitzer@qmw.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Spitzer
authors.forename: E
authors.initials: E
authors.lastname: Hennessy
authors.forename: L
authors.initials: L
authors.lastname: Neville
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002353:Carrier State / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007585:Jews; D008131:London / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000175:diagnosis / Q000208:ethnology*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000208:ethnology*; D013297:Streptococcus pyogenes; D011795:Surveys and Questionnaires