ArticleThe Lancet regional health. Western Pacific2023
Increase in invasive group A streptococcal disease among Australian children coinciding with northern hemisphere surges.
Article in The Lancet regional health. Western Pacific, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
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Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it, 80 citations in OpenAlex.
- Group A Streptococcal meningitis in children: a short case series and systematic review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Pooled it
- Tracing the recent evolution of Group AEmerging microbes & infections · 2026Review
- The Severity and Characteristics of Pediatric Group A Streptococcal Meningitis in the Netherlands (2015-June 2024): Results From a Nationwide Multicenter Cohort Study.The Pediatric infectious disease journal · 2026Observational
- Promoting expertise knowledge sharing in paediatric virology: An update (Review).Experimental and therapeutic medicine · 2026Review
- Article
- Epidemiology of Pediatric Invasive Group A Streptococcal Infections in 10 US States, 2004-2023.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Emerging epidemiology of invasive group a Streptococcus in tropical Australia: a 21-year population-based data linkage study.Infection · 2026Article
- Invasive group A streptococcal infections requiring paediatric intensive care in children and adolescents: a nationwide retrospective cohort study in Austria.European journal of pediatrics · 2026Observational
- Burden of invasive group a streptococcus infection in Australia: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- SpxA1 and SpxA2 Function as a Stoichiometry-Dependent Regulatory Rheostat Governing Virulence Gene Expression in Group A Streptococcus.bioRxiv : the preprint server for biology · 2026Article
- Epidemiology and clinical characteristics of invasive group A streptococcal infection in the Republic of Korea, 2015-2024: a nationwide multicenter study.The Lancet regional health. Western Pacific · 2026Article
- Usefulness and Description of the Test Puncture Method for Necrotizing Fasciitis Caused by Group A β-HemolyticJournal of plastic and reconstructive surgery · 2026Article
- Increased burden of invasive group A streptococcal disease among Australian children, 2023-2024: a prospective cohort study.The Lancet regional health. Western Pacific · 2026Article
- Before and after the bottleneck: pediatric group A streptococcal infections in Houston, TX, from 2013 to 2023.Microbiology spectrum · 2026Article
- Dynamics of public health messaging and healthcare activity in children during the 2022 iGAS surge: an observational study in England.Journal of public health (Oxford, England) · 2026Observational
- Clinical features and trends of severe paediatric group A streptococcal infections in Japan in the post-COVID-19 pandemic era.Epidemiology and infection · 2026Article
- Post-pandemic increase of Group A streptococcal infections in adults: a retrospective cohort study from 2012 to 2024.Infection · 2026Article
- A validated model for early prediction of group A streptococcal aetiology in necrotising soft tissue infections using minimal patient data.BMC medicine · 2026Article
- Mortality Among Patients With Invasive Group A Streptococcal Infections Caused by the M1UK Lineage: A Retrospective Cohort Study in England and Wales.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Evidence for early circulation of the M1UK sublineage of Streptococcus pyogenes in Germany, 2015-2023.Emerging microbes & infections · 2025Article
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Increases in invasive group A streptococcal disease (iGAS) have recently been reported in multiple countries in the northern hemisphere, occurring during, and outside of, typical spring peaks. We report the epidemiology of iGAS among children in Australia from 1 July 2018 to 31 December 2022. Methods: The Paediatric Active Enhanced Disease Surveillance (PAEDS) Network prospectively collected iGAS patient notifications for children and young people aged less than 18 years admitted to five major Australian paediatric hospitals in Victoria, Queensland, Western Australia and the Northern Territory. Patients were eligible for inclusion if they had GAS isolated from a normally sterile body site, or met clinical criteria for streptococcal toxic shock syndrome or necrotising fasciitis with GAS isolated from a non-sterile site. We report patients' clinical and demographic characteristics, and estimate minimum incidence rates. Findings: We identified 280 paediatric iGAS patients, median age 4.5 years (interquartile range 1.4-6.4). We observed a pre-pandemic peak annualised incidence of 3.7 per 100,000 (95% CI 3.1-4.4) in the 3rd quarter of 2018, followed by a decline to less than 1.0 per 100,000 per quarter from 2020 to mid-2021. The annualised incidence increased sharply from mid-2022, peaking at 5.2 per 100,000 (95% CI 4.4-6.0) in the 3rd quarter and persisting into the 4th quarter (4.9 per 100,000, 95% CI 4.2-5.7). There were 3 attributable deaths and 84 (32%) patients had severe disease (overall case fatality rate 1%, 95% CI 0.2-3.3). Respiratory virus co-infection, positive in 57 of 119 patients tested, was associated with severe disease (RR 1.9, 95% CI 1.2-3.0). The most common Interpretation: Australia experienced an increase in the incidence of iGAS among children and young people in 2022 compared to pandemic years 2020-2021. This is similar to northern hemisphere observations, despite differences in seasons and circulating respiratory viruses. Outbreaks of iGAS continue to occur widely. This emphasises the unmet need for a vaccine to prevent significant morbidity associated with iGAS disease. Funding: Murdoch Children's Research Institute funded open access publishing of this manuscript.
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