Increasing Rates of Invasive Group A Streptococcal Disease in Alberta, Canada; 2003–2017

Tyrrell, Gregory J.; Fathima, Sumana; Kakulphimp, Jocelyne; Bell, Christopher

doi:10.1093/ofid/ofy177

Cited by 29 publications

(40 citation statements)

References 25 publications

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“…Given the recent epidemic of ISD in Canada ( 4 ), we asked whether passive immunotherapy with J8 and SpeC antibodies could have theoretically provided treatment for the infections. We examined 77 S. pyogenes strains from 2017–2018 (11 different emm types) isolated from patients in Alberta who presented with ISD, of whom 8 had a diagnosis of STSS.…”

Section: Resultsmentioning

confidence: 99%

“…Most of these data were garnered from multiple surveys conducted between 1996 and 2007 ( 1 ). However, more recent data point to an alarming increase in rates ( 2 – 4 ). In Alberta, Canada, for example, the rate has steadily risen from 4.2 per 100,000 in 2003 to 10.2 per 100,000 in 2017 ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, more recent data point to an alarming increase in rates ( 2 – 4 ). In Alberta, Canada, for example, the rate has steadily risen from 4.2 per 100,000 in 2003 to 10.2 per 100,000 in 2017 ( 4 ). In developing countries, very high rates are reported among the young and the elderly (up to 75 per 100,000) ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Antibodies to the conserved region of the M protein and a streptococcal superantigen cooperatively resolve toxic shock-like syndrome in HLA-humanized mice

et al. 2019

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Invasive streptococcal disease (ISD) and toxic shock syndrome (STSS) result in over 160,000 deaths each year. We modelled these in HLA-transgenic mice infected with a clinically lethal isolate expressing Streptococcal pyrogenic exotoxin (Spe) C and demonstrate that both SpeC and streptococcal M protein, acting cooperatively, are required for disease. Vaccination with a conserved M protein peptide, J8, protects against STSS by causing a dramatic reduction in bacterial burden associated with the absence of SpeC and inflammatory cytokines in the blood. Furthermore, passive immunotherapy with antibodies to J8 quickly resolves established disease by clearing the infection and ablating the inflammatory activity of the M protein, which is further enhanced by addition of SpeC antibodies. Analysis of 77 recent isolates of Streptococcus pyogenes causing ISD, demonstrated that anti-J8 antibodies theoretically recognize at least 73, providing strong support for using antibodies to J8, with or without antibodies to SpeC, as a therapeutic approach.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antibodies to the conserved region of the M protein and a streptococcal superantigen cooperatively resolve toxic shock-like syndrome in HLA-humanized mice

et al. 2019

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“…In addition, a group of isolates were identified that were part of a large and sustained clonal iGAS outbreak occurring at a local men’s shelter in 2016 [6]. A variety of different emm types were identified within this sample, including isolates of emerging emm types such as emm 101 [8]. In addition, TIBDN provided isolates from the 5 GAS emm types most frequently isolated in metropolitan Toronto from 2012 to 2016 ( emm type 1, 3, 4, 12, and 28) (TIBDN, written personal communication, December 5, 2016), 21 isolates that were emm 59—a strain that caused a major outbreak in Ontario before 2010 [9]—and 30 isolates of emm types that are less frequently seen in Ontario.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry and ClinPro Tools as a Rapid Tool for Typing Streptococcus pyogenes

Tadros

Cabrera

Matukas

et al. 2019

Open Forum Infectious Diseases

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Background Timely strain typing of group A Streptococci (GAS) is necessary to guide outbreak recognition and investigation. We evaluated the use of (matrix-assisted laser desorption ionization time-of-flight mass spectrometry) combined with cluster analysis software to rapidly distinguish between related and unrelated GAS isolates in real-time. Methods We developed and validated a typing model using 177 GAS isolates with known emm types. The typing model was created using 43 isolates, which included 8 different emm types, and then validated using 134 GAS isolates of known emm types that were not included in model generation. Results Twelve spectra were generated from each isolate during validation. The overall accuracy of the model was 74% at a cutoff value of 80%. The model performed well with emm types 4, 59, and 74 but showed poor accuracy for emm types 1, 3, 12, 28, and 101. To evaluate the ability of this tool to perform typing in an outbreak situation, we evaluated a virtual outbreak model using a “virtual outbreak strain; emm74” compared with a non-outbreak group or an “outgroup “ of other emm types. External validation of this model showed an accuracy of 91.4%. Conclusions This approach has the potential to provide meaningful information that can be used in real time to identify and manage GAS outbreaks. Choosing isolates characterized by whole genome sequencing rather than emm typing for model generation should improve the accuracy of this approach in rapidly identifying related and unrelated GAS strains.

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“…It is more prevalent in children aged 3–9 years [3], so clustered outbreaks are more common in overcrowded places, such as kindergartens and schools. It is worth noting that currently no vaccine is available to prevent scarlet fever [4]. With antibiotic treatment, scarlet fever can be completely cured, and complications can be prevented.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Epidemiological Characteristics of Scarlet Fever in Zhejiang Province, China, 2004–2018

Ding

et al. 2019

IJERPH

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Objective: The aim of this study was to analyze the trends and epidemiological characteristics of scarlet fever in Zhejiang Province in 2004–2018, intending to provide a basis for targeted prevention and control of this disease. Method: We collated the epidemiological data for cases of scarlet fever from the China Information System for Disease Control and Prevention (CISDCP) in Zhejiang province between 1 January 2004 and 31 December 2018. Descriptive statistical analysis was used to analyze epidemiological characteristics of scarlet fever, whereas the Getis-Ord Gi* statistic was used to determine the hotspot incidence of scarlet fever. Results: In 2004–2018, a total of 22,194 cases of scarlet fever were reported in Zhejiang Province, with no death reports. The annual average of scarlet fever incidence was 2.82/100,000 (range,1.12 to 6.34/100,000). The male incidence was higher than that among female (χ2 = 999.834, p < 0.05), and a majority of the cases (86.42%) occurred in children aged 3–9 years. Each year, the incidence of scarlet fever in Zhejiang Province appeared two seasonal peaks: the first peak occurred from March to June (the constituent ratio was 49.06%), the second peak was lower than the first one during November and the following January (the constituent ratio was 28.67%). The two peaks were almost in accordance with the school spring semester and autumn–winter semester, respectively. The incidence in the northern regions of the province was generally higher than that in the southern regions. High-value clusters were detected in the central and northern regions, while low-value clusters occurred in the southern regions via the Getis-Ord Gi* statistical analysis. Conclusions: The prevalence of scarlet fever in Zhejiang Province showed a marked seasonality variation and mainly clustered in the central and northern regions in 2004–2018. Children under 15 years of age were most susceptible to scarlet fever. Kindergartens and primary schools should be the focus of prevention and control, and targeted strategies and measures should be taken to reduce the incidence.

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Increasing Rates of Invasive Group A Streptococcal Disease in Alberta, Canada; 2003–2017

Cited by 29 publications

References 25 publications

Antibodies to the conserved region of the M protein and a streptococcal superantigen cooperatively resolve toxic shock-like syndrome in HLA-humanized mice

Antibodies to the conserved region of the M protein and a streptococcal superantigen cooperatively resolve toxic shock-like syndrome in HLA-humanized mice

Evaluation of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry and ClinPro Tools as a Rapid Tool for Typing Streptococcus pyogenes

Analysis of Epidemiological Characteristics of Scarlet Fever in Zhejiang Province, China, 2004–2018

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