{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:57:38Z","timestamp":1781153858334,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Invasive Group A Streptococcal (iGAS) disease, associated with severe clinical outcomes and high morbidity and mortality, resurged globally following suppression during the early COVID\u201019 pandemic. This retrospective observational study examines the frequency and clinical characteristics of iGAS cases admitted to an Australian tertiary paediatric hospital over 5\u2009years (1 July 2018\u201330 June 2023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data was gathered from electronic medical records of patients diagnosed with iGAS at The Children's Hospital at Westmead (CHW) during the study period. Demographic and clinical characteristics were analysed using Student\n                      <jats:italic>T<\/jats:italic>\n                      , Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      and Chi\u2010squared tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the study, 61 iGAS patients were admitted to CHW. Admissions peaked in late 2018 and 2019 (22\/61), declined sharply throughout 2020 and 2021 (5\/61), and rose steeply in 2022 and early 2023 (34\/61). The most common iGAS isolates were from blood (40%) and pleural fluid (28%), correlating with the most common iGAS diagnoses: pneumonia (41%), empyema (39%) and sepsis (28%). Many patients presented with cough (48%) and coryza (39%), with 63% of tested individuals having viral coinfections. Pre\u2010pandemic cases showed higher peak neutrophil counts (median: 22.8\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L vs. 17.1\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and ICU admission rates (64% vs. 29%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), while other severity indices remained similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study observed an initial decline in iGAS cases during pandemic restrictions, followed by a resurgence post\u2010pandemic with no concurrent increase in severity. Viral coinfections were frequent, which may complicate clinical assessment, emphasising the need for heightened vigilance. The acute severity of iGAS highlights the importance of early recognition and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70359","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:54:22Z","timestamp":1774979662000},"page":"974-982","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive Group A Streptococcal Infections Admitted to the Children's Hospital at Westmead\u2014July 2018 to June 2023"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1571-2496","authenticated-orcid":false,"given":"Damian","family":"Lees","sequence":"first","affiliation":[{"name":"Department of General Medicine The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-6000","authenticated-orcid":false,"given":"Philip","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; Microbiology The Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"Sydney ID and Sydney Medical School University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-4320","authenticated-orcid":false,"given":"Christine","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-7495","authenticated-orcid":false,"given":"Jacqueline","family":"Dalby\u2010Payne","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Clinical School, University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-023-00865-7"},{"key":"e_1_2_13_3_1","unstructured":"\u201cClinical Practice Guidelines: Invasive Group A Streptococcal Infections: Management of Household Contacts [Internet] \u201d Royal Children's Hospital Melbourne Clinical Practice Guidelines. 2023 www.rch.org.au https:\/\/www.rch.org.au\/clinicalguide\/guideline_index\/Invasive_group_A_streptococcal_infections__management_of_household_contacts\/."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-55512-8.00040-5"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/11634180-000000000-00000"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1402.070888"},{"key":"e_1_2_13_7_1","unstructured":"Centers for Disease Control and Prevention \u201cActive Bacterial Core Surveillance Report. Emerging Infections Program Network Group A Streptococcus 2019 \u201d2019 https:\/\/www.cdc.gov\/abcs\/downloads\/GAS_Surveillance_Report_2019.pdf."},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy177"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2013.18.33.20556"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.33321\/cdi.2019.43.8"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.09.001"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2809.212129"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-8085-2"},{"issue":"1","key":"e_1_2_13_14_1","article-title":"Increase in Invasive Group A Streptococcal (Streptococcus pyogenes) Infections (iGAS) in Young Children in The Netherlands, 2022","volume":"28","author":"Gier B.","year":"2023","journal-title":"Eurosurveillance"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2023.28.1.2200942"},{"key":"e_1_2_13_16_1","unstructured":"WHO \u201cIncreased Incidence of Scarlet Fever and Invasive Group A Streptococcus Infection\u2014multi\u2010Country [Internet] \u201d2022 www.who.int https:\/\/www.who.int\/emergencies\/disease\u2010outbreak\u2010news\/item\/2022\u2010DON429."},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100873"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7210a4"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(23)00295-X"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad035"},{"key":"e_1_2_13_21_1","volume-title":"Australian Immunisation Handbook","author":"Australian Technical Advisory Group on Immunisation (ATAGI)","year":"2022"},{"issue":"1","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.37201\/req\/s01.09.2023","article-title":"Group A Streptococcus Invasive Infection in Children: Epidemiologic Changes and Implications","volume":"36","author":"Ramos T.","year":"2023","journal-title":"Revista Espa\u00f1ola de Quimioterapia: Publicaci\u00f3n Oficial de la Sociedad Espa\u00f1ola de Quimioterapia"},{"key":"e_1_2_13_23_1","unstructured":"Australian Government Department of Health and Aged Care \u201cCurrent Coverage Data Tables for All Children [Internet] \u201d2023 https:\/\/www.health.gov.au\/topics\/immunisation\/immunisation\u2010data\/childhood\u2010%20immunisation\u2010coverage\/current\u2010coverage\u2010data\u2010tables\u2010for\u2010all\u2010children."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.77.7.4104-4112.2003"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02860-4"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70359","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70359","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:06:23Z","timestamp":1781150783000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/jpc.70359"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70359","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]},"assertion":[{"value":"2025-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}