{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:13:38Z","timestamp":1788200018355,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000030","name":"centers for disease control and prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Routine surveillance for streptococcal toxic shock syndrome (STSS), a severe manifestation of invasive group A Streptococcus (GAS) infections, likely underestimates its true incidence. The objective of our study was to evaluate routine identification of STSS in a national surveillance system for invasive GAS infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Active Bacterial Core surveillance (ABCs) conducts active population-based surveillance for invasive GAS disease in selected US counties in 10 states. We categorized invasive GAS cases with a diagnosis of STSS made by a physician as STSS\u2013physician and cases that met the Council of State and Territorial Epidemiologists (CSTE) clinical criteria for STSS based on data in the medical record as STSS\u2013CSTE. We evaluated agreement between the 2 methods for identifying STSS and compared the estimated national incidence of STSS when applying proportions of STSS\u2013CSTE and STSS\u2013physician among invasive GAS cases from this study with national invasive GAS estimates for 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 2014-2017, of 7572 invasive GAS cases in ABCs, we identified 1094 (14.4%) as STSS\u2013CSTE and 203 (2.7%) as STSS\u2013physician, a 5.3-fold difference. Of 1094 STSS\u2013CSTE cases, we identified only 132 (12.1%) as STSS\u2013physician cases. Agreement between the 2 methods for identifying STSS was low (\u03ba = 0.17; 95% CI, 0.14-0.19). Using ABCs data, we estimated 591 cases of STSS\u2013physician and 3618 cases of STSS\u2013CSTE occurred nationally in 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found a large difference in estimates of incidence of STSS when applying different surveillance methods and definitions. These results should help with better use of currently available surveillance data to estimate the incidence of STSS and to evaluate disease prevention efforts, in addition to guiding future surveillance efforts for STSS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549211013460","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T03:58:11Z","timestamp":1620532691000},"page":"687-694","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017"],"prefix":"10.1177","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0681-2790","authenticated-orcid":false,"given":"Srinivas Acharya","family":"Nanduri","sequence":"first","affiliation":[{"name":"Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Onukwube","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirasol","family":"Apostol","sequence":"additional","affiliation":[{"name":"California Emerging Infections Program, Oakland, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Alden","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Petit","sequence":"additional","affiliation":[{"name":"Connecticut Department of Public Health, Hartford, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Farley","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Atlanta VA Medical Center, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee H.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Como-Sabetti","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Smelser","sequence":"additional","affiliation":[{"name":"New Mexico Department of Health, Santa Fe, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Burzlaff","sequence":"additional","affiliation":[{"name":"New York State Department of Health, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cieslak","sequence":"additional","affiliation":[{"name":"Oregon Health Authority Public Health Division, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Schaffner","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris A.","family":"Van Beneden","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"bibr1-00333549211013460","unstructured":"Centers for Disease Control and Prevention. Active Bacterial Core surveillance report: Emerging Infections Program Network, group A\n                      Streptococcus\n                      , 2017. Accessed August 26, 2019. https:\/\/www.cdc.gov\/abcs\/reports-findings\/survreports\/gas17.html"},{"key":"bibr2-00333549211013460","doi-asserted-by":"publisher","DOI":"10.3201\/eid1402.070888"},{"key":"bibr3-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00070-11"},{"key":"bibr4-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02155-08"},{"key":"bibr5-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw248"},{"key":"bibr6-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1086\/341409"},{"key":"bibr7-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1086\/521264"},{"key":"bibr8-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500030088038"},{"key":"bibr9-00333549211013460","unstructured":"Centers for Disease Control and Prevention. Streptococcal toxic shock syndrome (STSS) (\n                      Streptococcus pyogenes\n                      ) 2010 case definition. Accessed May 30, 2018. https:\/\/wwwn.cdc.gov\/nndss\/conditions\/streptococcal-toxic-shock-syndrome\/case-definition\/2010\/"},{"key":"bibr10-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy401"},{"key":"bibr11-00333549211013460","unstructured":"Wright C., Schuchat A., Beall B. Active Bacterial Core Surveillance Team. Burden of streptococcal toxic shock syndrome and necrotizing fasciitis\u2014United States, 2002. Abstract presented at the 41st Annual Meeting of the Infectious Diseases Society of America; October 9-12, 2003; San Diego, CA."},{"key":"bibr12-00333549211013460","unstructured":"Centers for Disease Control and Prevention. Active Bacterial Core surveillance\u2014methodology. Accessed June 27, 2018. https:\/\/www.cdc.gov\/abcs\/methodology\/index.html"},{"key":"bibr13-00333549211013460","unstructured":"US Department of Health and Human Services. Pediatric basic and advanced life support. 2017. Accessed March 20, 2019. https:\/\/chemm.nlm.nih.gov\/pals.htm"},{"key":"bibr14-00333549211013460","first-page":"3585","volume-title":"Harrison\u2019s Principles of Internal Medicine: Volumes 1 and 2","author":"Kratz A.","year":"2012","edition":"18"},{"key":"bibr15-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02122-15"},{"key":"bibr16-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00422-08"},{"key":"bibr17-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu304"},{"key":"bibr18-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306601"},{"key":"bibr19-00333549211013460","doi-asserted-by":"publisher","DOI":"10.4161\/viru.26400"},{"key":"bibr20-00333549211013460","volume-title":"International Statistical Classification of Diseases and Related Health Problems, 10th Revision","author":"World Health Organization","year":"2016"},{"key":"bibr21-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002002"},{"key":"bibr22-00333549211013460","doi-asserted-by":"publisher","DOI":"10.3201\/eid1011.121547"},{"key":"bibr23-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.07.010"},{"key":"bibr24-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.13836"},{"key":"bibr25-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu750"},{"key":"bibr26-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199206000-00025"},{"key":"bibr27-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-1662-x"},{"key":"bibr28-00333549211013460","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"bibr29-00333549211013460","volume-title":"National Notifiable Diseases Surveillance System, 2017 Annual Tables of Infectious Disease Data","author":"Centers for Disease Control and Prevention","year":"2018"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549211013460","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549211013460","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549211013460","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:37:06Z","timestamp":1777628226000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549211013460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,7]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1177\/00333549211013460"],"URL":"https:\/\/doi.org\/10.1177\/00333549211013460","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,7]]}}}