Invasive group A streptococcal infection and vaccine implications, Auckland, New Zealand

• Published in: Emerging infectious diseases Vol. 17; no. 6; pp. 983 - 989
• Main Authors: Safar, Atheer, Lennon, Diana, Stewart, Joanna, Trenholme, Adrian, Drinkovic, Dragana, Peat, Briar, Taylor, Susan, Read, Kerry, Roberts, Sally, Voss, Lesley
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.06.2011; Centers for Disease Control and Prevention
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibacterial agents; bacteria; Bacterial infections; Bacterial pneumonia; Child; Child, Preschool; Children; Cross infection; Diseases; emm types; Female; Health aspects; Humans; Immunoglobulins; Incidence; Infant; Infant, Newborn; Infants; invasive disease; Male; Medical research; Medicine, Experimental; Microbiology; Middle Aged; New Zealand; New Zealand - epidemiology; Nosocomial infections; Patient outcomes; Pneumonia; Risk Factors; Septic shock; Streptococcal Infections - epidemiology; Streptococcal Infections - immunology; Streptococcal Infections - microbiology; Streptococcal Infections - mortality; Streptococcal Vaccines - immunology; Streptococcus pyogenes; Streptococcus pyogenes - immunology; Streptococcus pyogenes - isolation & purification; toxic shock syndrome; Vaccines; Young Adult; New Zealand
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid1706.100804

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.