Epidemiology of invasive group a streptococcus disease in the United States, 1995-1999.
Severe invasive group A streptococcal (GAS) disease is believed to have reemerged during the past 10-20 years. We conducted active, laboratory, population-based surveillance in 5 US states (total population, 13,214,992). From 1 July 1995 through 31 December 1999, we identified 2002 episodes of invasive GAS (3.5 cases per 100,000 persons). Rates varied by age (higher among those <2 or >/=65 years old), surveillance area, and race (higher among black individuals) but did not increase during the study period. The 5 most common emm types (1, 28, 12, 3, and 11) accounted for 49.2% of isolates; newly characterized emm types accounted for 8.9% of isolates. Older age; presence of streptococcal toxic shock syndrome, meningitis, or pneumonia; and infection with emm1 or emm3 were all independent predictors of death. We estimate that 9600-9700 cases of invasive GAS disease occur in the United States each year, resulting in 1100-1300 deaths.
Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. klobrien@jhsph.edu
Katherine L
KL
O'Brien
Bernard
B
Beall
Nancy L
NL
Barrett
Paul R
PR
Cieslak
Arthur
A
Reingold
Monica M
MM
Farley
Richard
R
Danila
Elizabeth R
ER
Zell
Richard
R
Facklam
Benjamin
B
Schwartz
Anne
A
Schuchat
D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D006801:Humans; D015994:Incidence; D015233:Models, Statistical; D011159:Population Surveillance; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D022541:Streptococcal Vaccines / Q000627:therapeutic use; D013297:Streptococcus pyogenes / Q000145:classification / Q000235:genetics / Q000276:immunology; D014481:United States / Q000453:epidemiology
D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D022541:Streptococcal Vaccines; C014689:streptococcal M protein