ABCs Report: group A Streptococcus, 1999

Active Bacterial Core Surveillance (ABCs): Emerging Infections Program Network

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ABCs Areas

California (3 county San Francisco Bay area); Connecticut; Georgia (20 county Atlanta area); Maryland (6 county
Baltimore area); Minnesota; New York (7county Rochester and 8 county Albany area); Oregon (3 county Portland area); Tennessee (5 urban counties)

ABCs Population

The surveillance areas represent 23,123,537 persons. Source: U.S. Bureau of the Census, 1999

ABCs Case Definition

Invasive group A streptococcal disease: isolation of group A Streptococcus (S. pyogenes) from a normally sterile site or from a wound culture accompanied by necrotizing fasciitis or Streptococcal Toxic Shock Syndrome in a resident of a surveillance area in 1999.

ABCs Methodology

Project personnel communicated at least monthly with contacts in all microbiology laboratories serving acute care hospitals in their area to identify cases. Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case. Strains were typed by the emm system at CDC. Regular laboratory audits assess completeness of active surveillance and detect additional cases.
All rates of invasive group A Streptococcal disease were calculated using U.S. Bureau of the Census postcensal population estimates for 1999. For national projections of cases, race- and age-specific rates of disease were applied from the aggregate surveillance area to the age and racial distribution of the 1999 U. S. population. Cases with unknown race were distributed by site based on reported race distribution for known cases within the eight age categories.

Reported ABCs Profiles

Race	No.	(Rate*)
White	565	(3.1)
Black	184	(5.3)
Other	56	(4.2)

Unknown race (n=120) distributed among knowns
^* Cases per 100,000 population for ABCs areas

Ethnicity	No.	(Rate*)
Hispanic	55	(4.4)
Non-Hispanic	352	------
Unknown	398	------

^*Cases per 100,000 population for ABCs areas

Citation

Centers for Disease Control and Prevention. 2000. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Group A Streptococcus, 1999.

Age (years)	Cases No. (Rate*)	Deaths No. (Rate*)
<1	15 (4.7)	0 (0.00)
1	21 (6.7)	1 (0.32)
2-4	23 (2.4)	0 (0.00)
5-17	61 (1.4)	6 (0.14)
18-34	111 (2.0)	6 (0.11)
35-49	196 (3.4)	23 (0.40)
50-64	147 (4.4)	12 (0.36)
≥ 65	231 (8.5)	56 (2.06)
Total	805 (3.5)	104 (0.45)

^*Cases or deaths per 100,000 population for ABCs areas

ABCs Area	Most common emm types*	% of area isolates
California	1, ST-2967, 28	34
Connecticut	1, 3, 28, 4, 89, 12	65
Georgia	1, 3, 28, 22	53
Maryland	1, 82, 43, 3, 13, 12	60
Minnesota	1, 3, 28, 18, 4, 6	61
New York	3, 28, 89	44
Oregon	1, 11, 28	65
Tennessee	1	50
Total	1, 3, 28, 27, L/77, 4, 12, ST-2967	54

^*Requires a minimum of 4 isolates 5% of isolates typed

Syndrome	No.	(%)
Cellulitis	260	(32.3)
Necrotizing fasciitis	50	(6.2)
Pneumonia	96	(11.9)
Primary bacteremia	279	(34.7)
Streptococcal toxic shock	27	(3.4)

Note: Some cases had more than one syndrome.

Potentially preventable invasive group A streptococcal disease

During 1999, 7 cases (ages 7 months and 1, 5, 6, 27, and 84 years) of invasive GAS disease were detected in patients with varicella.

National Estimates of Invasive Disease

Cases: 9,400 (3.5/100,000)
Deaths: 1,200 (0.45/100,000)

sumber:http://www.cdc.gov