Epidemiology of Invasive Group a Streptococcus Disease in the United States, 1995-1999

Clin Infect Dis. 2002 Aug 1;35(3):268-76. doi: 10.1086/341409. Epub 2002 Jul 10.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antigens, Bacterial*
  • Bacterial Outer Membrane Proteins / genetics
  • Carrier Proteins / genetics
  • Humans
  • Incidence
  • Models, Statistical
  • Population Surveillance
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / physiopathology
  • Streptococcal Infections / prevention & control
  • Streptococcal Vaccines / therapeutic use
  • Streptococcus pyogenes* / classification
  • Streptococcus pyogenes* / genetics
  • Streptococcus pyogenes* / immunology
  • United States / epidemiology

Substances

  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins
  • Carrier Proteins
  • Streptococcal Vaccines
  • streptococcal M protein