{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:25:46Z","timestamp":1793755546557,"version":"4.6.1"},"reference-count":18,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"unspecified","delay-in-days":85,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In 2022, an increase in invasive group A streptococcal (iGAS) infections was observed in the Netherlands. A particular increase was seen among children; therefore, we aimed to assess risk factors for iGAS infection in children aged 6\u00a0months to 5\u00a0years. A prospective case\u2013control study was conducted between February and May 2023. We approached parents of notified iGAS cases to complete a questionnaire on exposures during 4\u00a0weeks prior to disease onset. Controls were recruited via social media and matched to cases on sex and birthyear. Conditional logistic regression was performed to estimate odds ratios (OR) of exposures. For the analysis, we included 18 cases and 103 controls. Varicella prior to onset of iGAS disease was reported in two (11%) cases and one (1%) control (OR: 12.0, 95% CI: 1.1\u2013139.0). Exposure to group A streptococcal (GAS)-like illnesses such as impetigo, pharyngitis, and scarlet fever was reported in 8 (44%) cases and 15 (15%) controls (OR: 7.1, 95% CI: 1.8\u201329.0). Our findings are in line with previous studies by identifying varicella as a risk factor for iGAS among young children and highlight the association with non-invasive GAS infections in the community as a possible source of transmission.<\/jats:p>","DOI":"10.1017\/s0950268825000275","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T05:27:27Z","timestamp":1743053247000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Risk factors for invasive group A streptococcal infection in children aged 6\u00a0months to 5\u00a0years: a case\u2013control study, the Netherlands, February\u2013May 2023"],"prefix":"10.1017","volume":"153","author":[{"given":"Elizabeth I.","family":"Hazelhorst","sequence":"first","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"},{"name":"European Centre for Disease Prevention and Control (ECDC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina E.","family":"van Ewijk","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2413-9088","authenticated-orcid":false,"given":"Cornelia C.H.","family":"Wielders","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margreet J.M.","family":"te Wierik","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.M.","family":"Hahn\u00e9","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester E.","family":"de Melker","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam J.","family":"Knol","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-090X","authenticated-orcid":false,"given":"Brechje","family":"de Gier","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"S0950268825000275_r15","volume-title":"RStudio: Integrated Development for R","year":"2023"},{"key":"S0950268825000275_r1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw248"},{"key":"S0950268825000275_r13","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.00342"},{"key":"S0950268825000275_r12","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12658"},{"key":"S0950268825000275_r11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-695X.2011.00788.x"},{"key":"S0950268825000275_r7","volume-title":"Update on Group A Streptococcus","year":"2022"},{"key":"S0950268825000275_r6","volume-title":"Infection invasive \u00e0 streptocoque du Groupe A (IISGA): Point de situation au 6 d\u00e9cembre 2022","year":"2022"},{"key":"S0950268825000275_r9","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2024.29.20.2400242"},{"key":"S0950268825000275_r18","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.40.1900589"},{"key":"S0950268825000275_r10","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003810"},{"key":"S0950268825000275_r17","doi-asserted-by":"publisher","DOI":"10.3201\/eid2503.181518"},{"key":"S0950268825000275_r3","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2023.28.1.2200941"},{"key":"S0950268825000275_r5","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2023.28.1.2200942"},{"key":"S0950268825000275_r8","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(23)00295-X"},{"key":"S0950268825000275_r4","unstructured":"[4] European Center for Disease prevention and Control (ECDC) (2022) Increase in Invasive Group A streptococcal infections among children in Europe, including fatalities. Press release 12 Dec 2022. https:\/\/www.ecdc.europa.eu\/en\/news-events\/increase-invasive-group-streptococcal-infections-among-children-europe-including"},{"key":"S0950268825000275_r16","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2024.29.40.2300739"},{"key":"S0950268825000275_r2","unstructured":"[2] Landelijke Co\u00f6rdinatie Infectieziektenbestrijding (LCI) (2012) Richtlijn Groep A streptokokken infectie. Cited 20 Feb 2023. https:\/\/lci.rivm.nl\/groep-streptokokkeninfectie."},{"key":"S0950268825000275_r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.11.061"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268825000275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T14:51:46Z","timestamp":1759848706000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268825000275\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":18,"alternative-id":["S0950268825000275"],"URL":"https:\/\/doi.org\/10.1017\/s0950268825000275","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.11.13.24316742","asserted-by":"object"}]},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e57"}}