{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T20:58:23Z","timestamp":1778878703762,"version":"3.51.4"},"reference-count":46,"publisher":"Australian Centre for Disease Control","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Commun Dis Intell"],"abstract":"<jats:p>Background Invasive Group A Streptococcus (iGAS) disease can cause permanent disability and death. The incidence of iGAS has increased in many developed countries since the 1980s. iGAS disease is not nationally notifiable in Australia or at the state level in Victoria. The Victorian Hospital Pathogen Surveillance Scheme (VHPSS) is a voluntary laboratory-based surveillance system established in 1988. We assessed the trends and molecular epidemiology of iGAS disease in Victoria from 2007-2017. Methods A case of iGAS was defined as an individual for whom Group A Streptococcus (GAS) was isolated from a normally sterile body site. Data on all iGAS cases, as reported to the VHPSS, between 1 January 2007 and 31 December 2017 were examined. Results A total of 1,311 iGAS cases had associated isolates, and M Protein Gene (emm) typing was performed for 91.6%. The mean annual incidence was 2.1 (95% CI: 1.8-2.5) per 100,000 population per year, increasing 2.7-fold over the study period. In total, 140 different iGAS emm-types were observed, with the ten most prevalent types comprising 63.1% of the sample. Conclusions Despite limitations in this surveillance data, we observed increasing rates of iGAS disease in Victoria. iGAS incidence exceeded the mean annual incidence for invasive meningococcal disease, calculated using Victorian data from the National Notifiable Diseases Surveillance System (2.1 vs. 0.6 cases per 100,000 population per year, respectively). Mandatory case notification could enhance disease control and prevention. Further, the diversity in emm-types emphasises the importance of effective secondary chemoprophylaxis in prevention, alongside GAS vaccine development.<\/jats:p>","DOI":"10.33321\/cdi.2019.43.8","type":"journal-article","created":{"date-parts":[[2019,3,17]],"date-time":"2019-03-17T21:12:35Z","timestamp":1552857155000},"source":"Crossref","is-referenced-by-count":19,"title":["Recent trends in invasive group A Streptococcus disease in Victoria"],"prefix":"10.33321","volume":"43","author":[{"given":"Jane","family":"Oliver","sequence":"first","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000 - Murdoch Children\u2019s Research Institute, Royal Children\u2019s Hospital, 50 Flemington Rd, Parkville, Victoria, Australia, 3052"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilda","family":"Wilmot","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Strachan","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siobhan","family":"St George","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney R","family":"Lane","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan A","family":"Ballard","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Sait","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Gibney","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000 - The Royal Melbourne Hospital and The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin P","family":"Howden","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah A","family":"Williamson","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia, 3000"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"18788","published-online":{"date-parts":[[2019,3,15]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5(11):685-94.","DOI":"10.1016\/s1473-3099(05)70267-x"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. Factor SH, Levine OS, Schwartz B, Harrison LH, Farley MM, McGeer A, et al. Invasive group A streptococcal disease: risk factors for adults. Emerg Infect Dis. 2003;9(8):970-7.","DOI":"10.3201\/eid0908.020745"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. Lamagni TL, Neal S, Keshishian C, Alhaddad N, George R, Duckworth G, et al. Severe Streptococcus pyogenes infections, United Kingdom, 2003-2004. Emerg Infect Dis. 2008;14(2):202-9.","DOI":"10.3201\/eid1402.070888"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. Public Health Agency of Canada. Canada Communicable Disease Report. Guidelines for the Prevention and Control of Invasive Group A Streptococcal Disease. Ottawa, Canada: CCDR; 2006.","DOI":"10.14745\/ccdr.v41i04a02"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. O\u2019Brien KL, Beall B, Barrett NL, Cieslak PR, Reingold A, Farley MM, et al. Epidemiology of invasive group a streptococcus disease in the United States, 1995-1999. Clin Infect Dis. 2002;35(3):268-76.","DOI":"10.1086\/341409"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. Low DE, McGeer A, Schwartz B. The reemergence of severe group A streptococcal disease: an evolutionary perspective. Emerging Infections 1: American Society of Microbiology; 1998. p. 93-123.","DOI":"10.1128\/9781555816940.ch7"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. Moses AE, Ziv A, Harari M, Rahav G, Shapiro M, Englehard D. Increased incidence and severity of Streptococcus pyogenes bacteremia in young children. Pediatr Infect Dis J. 1995;14(9):767-70.","DOI":"10.1097\/00006454-199509000-00007"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8. Kaul R, McGeer A, Low DE, Green K, Schwartz B. Population-based surveillance for group A streptococcal necrotizing fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Ontario Group A Streptococcal Study. Am J Med. 1997;103(1):18-24.","DOI":"10.1016\/s0002-9343(97)00160-5"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. Stockmann C, Ampofo K, Hersh AL, Blaschke AJ, Kendall BA, Korgenski K, et al. Evolving epidemiologic characteristics of invasive group a streptococcal disease in Utah, 2002-2010. Clin Infect Dis. 2012;55(4):479-87.","DOI":"10.1093\/cid\/cis422"},{"key":"ref9","unstructured":"10. National Collaborating Centre for Infectious Diseases. Disease Debrief: Group A Streptococcus. Winnipeg, Canada, 2018 [updated 2018 Feb 13]. Available from: https:\/\/nccid.ca\/debrief\/group-a-streptococcus\/."},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11. Sivagnanam S, Zhou F, Lee AS, O\u2019Sullivan MV. Epidemiology of invasive group A Streptococcus infections in Sydney, Australia. Pathology. 2015;47(4):365-71.","DOI":"10.1097\/pat.0000000000000247"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12. Williamson DA, Morgan J, Hope V, Fraser JD, Moreland NJ, Proft T, et al. Increasing incidence of invasive group A streptococcus disease in New Zealand, 2002-2012: a national population-based study. J Infect. 2015;70(2):127-34.","DOI":"10.1016\/j.jinf.2014.09.001"},{"key":"ref12","unstructured":"13. Environmental Science Research Ltd. Invasive Group A Streptococcal Infection in New Zealand, 2016. Porirua, New Zealand; 2017 Dec 13."},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"14. Mearkle R, Saavedra-Campos M, Lamagni T, Usdin M, Coelho J, Chalker V, et al. Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013. Euro Surveill. 2017;22(19).","DOI":"10.2807\/1560-7917.es.2017.22.19.30532"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"15. GOV.UK. Notifiable diseases and causative organisms: how to report. London, United Kingdom, 2010. Available from: https:\/\/www.gov.uk\/guidance\/notifiable-diseases-and-causative-organisms-how-to-report#list-of-notifiable-diseases.","DOI":"10.18591\/bjuik.0551"},{"key":"ref15","unstructured":"16. Centers for Disease Control and Protection. National Notifiable Diseases Surveillance System (NNDSS). Atlanta, United States, 2018. Available from: https:\/\/wwwn.cdc.gov\/nndss\/conditions\/notifiable\/2016\/ ."},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"17. The Public Health Agency of Sweden. Notifiable diseases. Stockholm, Sweden, 2018 [updated 2018 Jul 10]. Available from: https:\/\/www.folkhalsomyndigheten.se\/the-public-health-agency-of-sweden\/communicable-disease-control\/surveillance-of-communicable-diseases\/notifiable-diseases\/ .","DOI":"10.1371\/journal.pone.0174491"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"18. Queensland Government. Invasive Group A Streptococcal Disease. Queensland Health Guidelines for Public Health Units. Brisbane, Australia: Queensland Department of Health; 2017 [updated 2017 Aug 10; cited 2017 Aug 12]. Available from: https:\/\/www.health.qld.gov.au\/cdcg\/index\/igas .","DOI":"10.5176\/2251-1857_m317.16"},{"key":"ref18","unstructured":"19. New South Wales Government. Invasive Group A Streptococcus control guideline. Sydney, Australia, 2016 [updated 2016 Sep 16]. Available from: http:\/\/www.health.nsw.gov.au\/Infectious\/controlguideline\/Pages\/invasive-group-a-strep.aspx ."},{"key":"ref19","unstructured":"20. Department of Health & Human Services. State Government of Victoria Australia. Streptococcal disease (Group A beta-haemolytic streptococcus). Melbourne, Australia, 2017. Available from: https:\/\/www2.health.vic.gov.au\/public-health\/infectious-diseases\/disease-information-advice\/streptococcal-disease."},{"key":"ref20","unstructured":"21. Centre for Disease Control, Northern Territory of Australia. Public health management of invasive group A streptococcal infection. Darwin, Australia, 2015 Nov. Available from: https:\/\/digitallibrary.health.nt.gov.au\/prodjspui\/bitstream\/10137\/1187\/1\/iGAS%20guidelines%20Nov%202015.pdf."},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"22. The Working Group on Prevention of Invasive Group A Streptococcal Infections. Prevention of invasive group A streptococcal disease among household contacts of case-patients: is prophylaxis warranted? JAMA. 1998;279(15):1206-10.","DOI":"10.1001\/jama.279.15.1206"},{"key":"ref22","unstructured":"23. Centers for Disease Control and Protection. Group A Streptococcal (GAS) Disease. Atlanta, United States, 2016 [updated 2016 Sep 16]. Available from: https:\/\/www.cdc.gov\/groupastrep\/surveillance.html ."},{"key":"ref23","unstructured":"24. Interim UK guidelines for management of close community contacts of invasive group A streptococcal disease. Commun Dis Public Health. 2004;7(4):354-61."},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"25. Public Health England. Notifiable diseases and causative organisms: how to report. London, United Kingdom, 2010 [updated 2010 May 1]. Available from: https:\/\/www.gov.uk\/guidance\/notifiable-diseases-and-causative-organisms-how-to-report#list-of-notifiable-diseases.","DOI":"10.18591\/bjuik.0551"},{"key":"ref25","unstructured":"26. Public Health Agency of Canada. Reported cases of disease in Canada - Notifiable diseases on-line. 2017 [updated 2017 May 3]. Available from: http:\/\/diseases.canada.ca\/notifiable\/charts."},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"27. O\u2019Grady KA, Kelpie L, Andrews RM, Curtis N, Nolan TM, Selvaraj G, et al. The epidemiology of invasive group A streptococcal disease in Victoria, Australia. Med J Aust. 2007;186(11):565-9.","DOI":"10.5694\/j.1326-5377.2007.tb01054.x"},{"key":"ref27","unstructured":"28. Strachan J, Easton M, Zaia A, Tomita T, Hogg G. Group A streptococcal infections in Victoria 2005\u20132009. Vic Infect Dis Bull. 2010;13(3):78-81."},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"29. Wong NX, Crawford N, Oliver J, McMinn A, Ching N, Baker C, et al. A cluster of paediatric invasive group A streptococcus disease in Melbourne, Australia coinciding with a high burden influenza season. J Ped Infect Dis. 2018;In press.","DOI":"10.1055\/s-0038-1677456"},{"key":"ref29","unstructured":"30. St George S. Personal communication, May 26, 2018."},{"key":"ref30","unstructured":"31. Australian Government Department of Health. National Notifiable Diseases System. Canberra, Australia, 2018. [updated 2018 Jun 1]. Available from: http:\/\/www9.health.gov.au\/cda\/source\/cda-index.cfm."},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"32. Beall B, Facklam R, Thompson T. Sequencing emm-specific PCR products for routine and accurate typing of group A streptococci. J Clin Microbiol. 1996;34(4):953-8.","DOI":"10.1128\/JCM.34.4.953-958.1996"},{"key":"ref32","unstructured":"33. Australian Bureau of Statistics. 3101.0 - Australian Demographic Statistics, Sep 2017 Canberra, Australia, 2017 [updated 2018 Mar 23; cited 2018 Apr 9]. Available from: http:\/\/www.abs.gov.au\/AUSSTATS\/abs@.nsf\/DetailsPage\/3101.0Sep%202017?OpenDocument."},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"34. StataCorp. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP; 2015.","DOI":"10.7717\/peerj.4598\/supp-10"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"35. De Zoysa A, Coelho J, Daniel R, Dhami C, Kafatos G, Lamagni T, et al. Invasive group A streptococcal disease in the UK, 2008-2012 and molecular characterisation of isolates during enhanced surveillance. Int J Antimicrob Agents. 2013;42:S92.","DOI":"10.1016\/s0924-8579(13)70402-3"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"36. Rudolph K, Bruce MG, Bruden D, Zulz T, Reasonover A, Hurlburt D, et al. Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013. J Clin Microbiol. 2016;54(1):134-41.","DOI":"10.1128\/jcm.02122-15"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"37. Nelson GE, Pondo T, Toews KA, Farley MM, Lindegren ML, Lynfield R, et al. Epidemiology of Invasive Group A Streptococcal Infections in the United States, 2005-2012. Clin Infect Dis. 2016;63(4):478-86.","DOI":"10.1093\/cid\/ciw248"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"38. Steer AC, Lamagni T, Curtis N, Carapetis JR. Invasive group a streptococcal disease: epidemiology, pathogenesis and management. Drugs. 2012;72(9):1213-27.","DOI":"10.2165\/11634180-000000000-00000"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"39. Parks T, Barrett L, Jones N. Invasive streptococcal disease: a review for clinicians. Br Med Bull. 2015;115(1):77-89.","DOI":"10.1093\/bmb\/ldv027"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"40. Pelton SI. The Global Evolution of Meningococcal Epidemiology Following the Introduction of Meningococcal Vaccines. J Adolesc Health. 2016;59(2 Suppl):S3-S11.","DOI":"10.1016\/j.jadohealth.2016.04.012"},{"key":"ref40","unstructured":"41. Department of Health & Human Services. State Government of Victoria Australia. Notifiable conditions in Victoria Melbourne. Australia, 2016. Available from: https:\/\/webcache.googleusercontent.com\/search?q=cache:9xsd-Fn4VT8J:https:\/\/www2.health.vic.gov.au\/Api\/downloadmedia\/%257B727191F6-45C5-47B0-94F7-BDE2C9FCE7EF%257D+&cd=3&hl=en&ct=clnk&gl=au"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"42. Baroux N, D\u2019Ortenzio E, Smeesters P, Steer A. GAS emm-types probably involved in acute rheumatic fever. Glob Heart. 2014;(1):e37.","DOI":"10.1016\/j.gheart.2014.03.1344"},{"key":"ref42","unstructured":"43. Cannon J, Jack S, Wu Y, Zhang J, Geelhoed E, Baker M, et al. CANVAS Economic Evaluation of GAS Vaccine in Australia and New Zealand. Supplimentary Report, June 2016."},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"44. Steer AC, Law I, Matatolu L, Beall BW, Carapetis JR. Global emm type distribution of group A streptococci: systematic review and implications for vaccine development. Lancet Infect Dis. 2009;9(10):611-6.","DOI":"10.1016\/s1473-3099(09)70178-1"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"45. Pandey M, Batzloff MR, Good MF. Mechanism of protection induced by group A Streptococcus vaccine candidate J8-DT: contribution of B and T-cells towards protection. PLoS One. 2009;4(4):e5147.","DOI":"10.1371\/journal.pone.0005147"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"46. Pandey M, Ozberk V, Langshaw EL, Calcutt A, Powell J, Batzloff MR, et al. Skin infection boosts memory B-cells specific for a cryptic vaccine epitope of group A streptococcus and broadens the immune response to enhance vaccine efficacy. NPJ Vaccines. 2018;3:15.","DOI":"10.1038\/s41541-018-0053-9"}],"container-title":["Communicable Diseases Intelligence"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.health.gov.au\/internet\/main\/publishing.nsf\/Content\/75F30C0D2C126CAECA2583940015EDE3\/$File\/recent_trends_in_invasive_group_a_streptococcus_disease_in_victoria.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T18:35:17Z","timestamp":1749580517000},"score":1,"resource":{"primary":{"URL":"https:\/\/ojs.cdi.cdc.gov.au\/index.php\/cdi\/article\/view\/555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,15]]},"references-count":46,"URL":"https:\/\/doi.org\/10.33321\/cdi.2019.43.8","archive":["Portico","Portico","Portico"],"relation":{},"ISSN":["2209-6051"],"issn-type":[{"value":"2209-6051","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,15]]}}}