ArticleThe Lancet regional health. Western Pacific2026
Increased burden of invasive group A streptococcal disease among Australian children, 2023-2024: a prospective cohort study.
Article in The Lancet regional health. Western Pacific, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Global rates of invasive Group A Methods: Prospective surveillance of 0-17-year-olds with iGAS admitted to six tertiary hospitals in five Australian states/territories in 2023 and 2024. Confirmed cases had GAS detected from ≥1 sterile site specimen; probable cases had detection of GAS in ≥1 non-sterile site specimen and diagnosis of septic shock, streptococcal toxic shock syndrome or necrotising fasciitis. Findings: In 2023, the annualised incidence was 5.10 per 100,000 (95% CI 4.50-5.75, n = 263 cases) and dropped significantly in 2024 (annualised incidence 2.13, 95% CI 1.75-2.57, n = 111 cases). Quarter three peaks were not as predominant across 2023 and 2024 compared to usual patterns. Intensive care unit admission occurred among 147/374 (39%) children with six deaths. At discharge, 137/374 (37%) had not returned to premorbid function. Respiratory virus co-infection was found among 133/267 (49.8%) patients tested and was associated with higher risk of severe disease, RR 1.6 (95% CI 1.26-2.07). Adjunctive clindamycin, linezolid or intravenous immunoglobulin was used in 201/374 (54%), including 126/147 (86%) of severe disease cases. Interpretation: We have captured the end of post-COVID-19 pandemic iGAS surge in sentinel Australian paediatric hospitals. High iGAS incidence peaked in 2023, before reducing to similar pre-pandemic incidence in 2024. The dynamic epidemiology and persistent burden of disease highlight the need for continued vigilant public health efforts, surveillance, and vaccine development. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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