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. 2022 Sep;28(9):1785-1795.
doi: 10.3201/eid2809.212129.

Increasing Incidence of Invasive Group A Streptococcus Disease, Idaho, USA, 2008-2019

Eileen M Dunne, Scott Hutton, Erin Peterson, Anna J Blackstock, Christine G Hahn, Kathryn Turner, Kris K Carter

Increasing Incidence of Invasive Group A Streptococcus Disease, Idaho, USA, 2008-2019

Eileen M Dunne et al. Emerg Infect Dis. 2022 Sep.

Abstract

We investigated invasive group A Streptococcus epidemiology in Idaho, USA, during 2008-2019 using surveillance data, medical record review, and emm (M protein gene) typing results. Incidence increased from 1.04 to 4.76 cases/100,000 persons during 2008-2019. emm 1, 12, 28, 11, and 4 were the most common types, and 2 outbreaks were identified. We examined changes in distribution of clinical syndrome, patient demographics, and risk factors by comparing 2008-2013 baseline with 2014-2019 data. Incidence was higher among all age groups during 2014-2019. Streptococcal toxic shock syndrome increased from 0% to 6.4% of cases (p = 0.02). We identified no differences in distribution of demographic or risk factors between periods. Results indicated that invasive group A Streptococcus is increasing among the general population of Idaho. Ongoing surveillance of state-level invasive group A Streptococcus cases could help identify outbreaks, track regional trends in incidence, and monitor circulating emm types.

Keywords: Idaho; Streptococcus pyogenes; United States; bacteria; bacterial infection; case-case study; group A Streptococcus; strep A; streptococcal disease; streptococci.

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Figures

Figure 1
Figure 1
Annual number of reported cases of invasive group A Streptococcus (n = 483) and incidence (cases per 100,000 persons) from an investigation in Idaho, USA, comparing cases reported during 2014–2019 with cases from a lower-incidence baseline period, 2008–2013.
Figure 2
Figure 2
Seasonality of invasive group A Streptococcus (n = 483) by month of diagnosis, from an investigation in Idaho, USA, comparing cases reported during 2014–2019 with cases from a lower-incidence baseline period, 2008–2013.
Figure 3
Figure 3
Average annual incidence of invasive group A Streptococcus (cases per 100,000 persons) during 2008–2013 (n = 89) and 2014–2019 (n = 394), by age group, Idaho, USA. The fold change for 2014–2019 compared with 2008–2013 is shown for each age group above the paired columns.
Figure 4
Figure 4
Invasive group A Streptococcus emm types (n = 194), Idaho, USA, 2012–2019, from an investigation in Idaho comparing invasive group A Streptococcus cases reported during 2014–2019 with cases from a lower-incidence baseline period, 2008–2013. The Idaho Bureau of Laboratories only began emm typing in 2014; 2012 data are from the Boise Veterans Administration Medical Center. Data for 2013 were unavailable.
See this image and copyright information in PMC

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