{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T21:30:51Z","timestamp":1780608651781,"version":"3.54.1"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"unspecified","delay-in-days":49,"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":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    A global increase in severe group A\n                    <jats:italic>Streptococcus<\/jats:italic>\n                    (GAS) infections has been reported following the COVID-19 pandemic, but data from Asia remain limited. We examined epidemiology and clinical characteristics of severe paediatric GAS infections across 86 Japanese hospitals, focusing on patients under 18\u00a0years of age, hospitalized between 1 January 2019 and 31 March 2024. Severe GAS infection was defined by the isolation of GAS from sterile sites, or from non-sterile sites under specific conditions, such as streptococcal toxic shock syndrome (STSS). A total of 83 cases were analysed. Cases increased from the summer of 2023, exceeding pre-pandemic levels. The median age was 4 (interquartile range: 1\u20138) years, with the highest number among 1-year-olds. No cases were reported in Hokkaido, northern Japan. Only 6% (5\/83) of the cases had preceding GAS pharyngitis. Pneumonia was the most prevalent diagnosis (25%), with 76% of these cases being complicated by empyema, often necessitating intensive care or surgical intervention. Only 17% (14\/83) of cases were reported as STSS in Japan\u2019s national surveillance system. This study represents the first multicentre nationwide hospital-based investigation of severe paediatric GAS infections in Japan, identifying the recent increase in cases, thereby highlighting limitations of current STSS-based surveillance.\n                  <\/jats:p>","DOI":"10.1017\/s0950268826101162","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:22:17Z","timestamp":1771482137000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Clinical features and trends of severe paediatric group A streptococcal infections in Japan in the post-COVID-19 pandemic era"],"prefix":"10.1017","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1040-0221","authenticated-orcid":false,"given":"Ayumi","family":"Tada","sequence":"first","affiliation":[{"name":"Chiba University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Otake","sequence":"additional","affiliation":[{"name":"Kobe University Graduate School of Medicine School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taizo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Chiba Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Chiba Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6291-7186","authenticated-orcid":false,"given":"Masayoshi","family":"Shinjoh","sequence":"additional","affiliation":[{"name":"Keio University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taizo","family":"Wada","sequence":"additional","affiliation":[{"name":"Kanazawa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Mori","sequence":"additional","affiliation":[{"name":"Institute of Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Moriuchi","sequence":"additional","affiliation":[{"name":"Nagasaki University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7508-1330","authenticated-orcid":false,"given":"Naruhiko","family":"Ishiwada","sequence":"additional","affiliation":[{"name":"Chiba University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,19]]},"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268826101162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:31:54Z","timestamp":1774521114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268826101162\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"alternative-id":["S0950268826101162"],"URL":"https:\/\/doi.org\/10.1017\/s0950268826101162","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. 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":"e35"}}