Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 13

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Title: Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 13
Authors: Mearkle, R
Saavedra-Campos, M
Lamagni, T
Usdin, M
Coelho, J
Chalker, V
Sriskandan, S
Cordery, R
Rawlings, C
Balasegaram, S
Item Type: Journal Article
Abstract: Invasive group A s treptococcal infection has a 15% case fatality rate and a risk of secondary transmission. This retrospective study us ed two national data sources from England ; enhanced surveillance ( 2009) and a case management system ( 2011 - 13) to identify clusters of sever e group A streptococcal disease . 2 4 household pairs were identified. The median onset interval between cases was 2 days (range 0 - 28) with simultaneous onset in 8 pairs . The attack rate during the 30 days after first exposure to a primary case was 4 52 0 per 100000 person - years at risk (95% CI 2 900 - 673 0 ) a 19 40 ( 12 40 - 28 80 ) fold elevation over the background incidence . The theoretical number needed to treat ( NNT ) to prevent one secondary case using antibiotic prophylaxis was 2 71 ( 194 - 454 ) overall, 50 for mother - neonate pairs ( 2 7 - 3 93 ) and 8 2 for couples aged 75 years and over ( 46 - 417 ). Whilst a dramatic increased risk of infection was noted in all household contacts, increased ris k was greatest for mother - neonate pairs and couples aged 75 and over , suggesting targeted prophylaxis c ould be considered. Offering prophylaxis is challenging due to the short time interval between cases emphasising the importance of immediate notification and assessment of contacts .
Issue Date: 11-May-2017
Date of Acceptance: 21-Dec-2016
ISSN: 1560-7917
Publisher: European Centre for Disease Prevention and Control
Journal / Book Title: Eurosurveillance
Volume: 22
Issue: 19
Copyright Statement: This article is copyright of the authors, 2017. This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
Sponsor/Funder: Imperial College Trust
National Institute for Health Research
National Institute for Health Research
Funder's Grant Number: PC1992, ICT
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Invasive streptococcal infections
Streptococcus pyogenes, Group A Streptococcus
disease outbreaks
public health policy
Publication Status: Published
Article Number: 30532
Appears in Collections:Department of Medicine
Faculty of Medicine

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