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The argument for Strep A vaccine development has to date focussed on prevention of non\u2010invasive disease (e.g. pharyngitis) and immune\u2010mediated complications (especially rheumatic heart disease). Because of the poorer prognosis and theoretically more precisely known burden of invasive, compared to non\u2010invasive disease, exploration of the burden of invasive Strep A disease could lend further support to the vaccine business case. This narrative review critically assesses the Australian incidence of invasive Strep A disease. Case notification data were first assessed through government sources, expressing annual incidence as cases per 100\u2009000 population. Published literature accessed through PubMed and MEDLINE was assessed to March 2020. Where estimates could be updated by replicating reported methods with publicly available data, this was performed. Invasive Strep A disease is currently notifiable in Queensland and the Northern Territory only. The magnitude, degree of certainty and recency of estimates vary by state\/territory and between sub\u2010populations, including higher incidence among Indigenous Australians compared to non\u2010Indigenous Australians. According to inpatient records from 2017 to 2018, the Australian incidence of invasive Strep A disease was 8.3 per 100\u2009000. However, this is likely to be an underestimate. Preventing invasive Strep A disease is an important use for a Strep A vaccine. This narrative review highlights deficiencies in our current understanding of the Australian disease burden. These difficulties would be overcome by nationally consistent mandatory case reporting.<\/jats:p>","DOI":"10.1111\/imj.14885","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T03:28:41Z","timestamp":1588735721000},"page":"835-844","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The Australian burden of invasive group A streptococcal disease: a narrative review"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1145-947X","authenticated-orcid":false,"given":"Cameron M.","family":"Wright","sequence":"first","affiliation":[{"name":"School of Medicine, Faculty of Health and Medical Sciences The University of Western Australia  Perth Western Australia Australia"},{"name":"Health Economics and Data Analytics, School of Public Health, Faculty of Health Sciences Curtin University  Perth Western Australia Australia"},{"name":"School of Medicine, College of Health and Medicine University of Tasmania  Hobart Tasmania Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristyn","family":"Langworthy","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fiona Stanley Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-5351","authenticated-orcid":false,"given":"Laurens","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fiona Stanley Hospital  Perth Western Australia Australia"},{"name":"Faculty of Health and Medical Sciences, Harry Perkins Research Institute, Fiona Stanley Hospital The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.10.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70178-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1601-0825.2002.1o816.x"},{"key":"e_1_2_7_5_1","first-page":"1","article-title":"Case definitions for infectious conditions under public health surveillance","volume":"46","author":"Centers for Disease Control and Prevention","year":"1997","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldv027"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2016.02.078"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2016.10.090"},{"key":"e_1_2_7_9_1","unstructured":"SteerAC KimJ. 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