Evaluating Household Transmission of Invasive Group A Streptococcus Disease in the United States Using Population-based Surveillance Data, 2013–2016

Abstract

Using population-based surveillance data, we quantified the secondary invasive group A Streptococcus disease risk among household contacts. The disease risk in the 30 days postexposure to an index-case patient was highest among individuals aged ≥65 years, versus the annual background incidence of all ages.

Use of whole-genome sequencing to detect transmission of group A Streptococcus in Houston, TX

“…Previous studies examining surveillance-based GAS transmission included only invasive disease and included direct interview of index cases to facilitate linking PTEs [5,6]. In the absence of index case interviews, we chose to confirm PTEs using bacterial WGS.…”

“…Expert opinion is divided regarding recommendations to provide antimicrobial prophylaxis to close contacts of severe iGAS disease [ 4 ]. Using national-level invasive GAS disease surveillance, the CDC has identified secondary cases of GAS infection and reported that such cases were more likely to occur in those 65 years of age [ 5 ]. However, non-invasive GAS disease (e.g.…”

“…Further, there is increasing interest in detecting potential transmission events (PTEs) for GAS disease and in employing surveillance data to inform recommendations for chemoprophylaxis of close contacts [4]. Studies conducted by the CDC have demonstrated utility in epidemiological investigations that have shown an increase in secondary attack rate from 66.1 to 102 per 100 000 when comparing 2003 to 2019, a rate that is higher among older adults with co-morbidities [5,6]. However, previous studies were limited to iGAS disease and did not include pharyngitis or superficial skin infections that are known to occur more frequently and are likely to contribute to overall disease transmission.…”

Biphasic Outbreak of Invasive Group A Streptococcus Disease in Eldercare Facility, New Zealand

“…Although infection control measures are undoubtedly of utmost importance, the evidence as to whether targeted or mass chemoprophylaxis is preferable in eldercare settings is conflicting, because risk for secondary invasive GAS infection is higher among elderly persons than among other contacts (24,25). Authors of a recent UK study demonstrated a considerably increased risk for invasive GAS infection among household contacts, particularly for persons >75 years of age, for whom the fatality rate for secondary cases was 19% (24).…”

Group B streptococcal necrotizing soft‐tissue infection: role of pharyngeal and perineal carriage

“…C. Charpentier, 1,*, † F. Kouby, 1, † C. Hua, 1 E. Sbidian, 1,2 M. Darty, 3 R. Bosc, 4 N. De Prost, 5 C. Gomart, 6 P.-L. Woerther, 6,7 A. Tazi, 8,9,10 J.-W. Decousser, 6,7, † O. Chosidow, 1,2,11,12, † Henri Mondor Hospital Necrotizing Fasciitis Group , ‡…”