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Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013

Invasive group A streptococcal infection has a 15% case fatality rate and a risk of secondary transmission. This retrospective study used two national data sources from England; enhanced surveillance (2009) and a case management system (2011–2013) to identify clusters of severe group A streptococcal...

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Autores principales: Mearkle, Rachel, Saavedra-Campos, Maria, Lamagni, Theresa, Usdin, Martine, Coelho, Juliana, Chalker, Vicki, Sriskandan, Shiranee, Cordery, Rebecca, Rawlings, Chas, Balasegaram, Sooria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476984/
https://www.ncbi.nlm.nih.gov/pubmed/28537550
http://dx.doi.org/10.2807/1560-7917.ES.2017.22.19.30532
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author Mearkle, Rachel
Saavedra-Campos, Maria
Lamagni, Theresa
Usdin, Martine
Coelho, Juliana
Chalker, Vicki
Sriskandan, Shiranee
Cordery, Rebecca
Rawlings, Chas
Balasegaram, Sooria
author_facet Mearkle, Rachel
Saavedra-Campos, Maria
Lamagni, Theresa
Usdin, Martine
Coelho, Juliana
Chalker, Vicki
Sriskandan, Shiranee
Cordery, Rebecca
Rawlings, Chas
Balasegaram, Sooria
author_sort Mearkle, Rachel
collection PubMed
description Invasive group A streptococcal infection has a 15% case fatality rate and a risk of secondary transmission. This retrospective study used two national data sources from England; enhanced surveillance (2009) and a case management system (2011–2013) to identify clusters of severe group A streptococcal disease. Twenty-four household pairs were identified. The median onset interval between cases was 2 days (range 0–28) with simultaneous onset in eight pairs. The attack rate during the 30 days after first exposure to a primary case was 4,520 per 100,000 person-years at risk (95% confidence interval (CI): 2,900–6,730) a 1,940 (95% CI: 1,240–2,880) fold elevation over the background incidence. The theoretical number needed to treat to prevent one secondary case using antibiotic prophylaxis was 271 overall (95% CI: 194–454), 50 for mother-neonate pairs (95% CI: 27–393) and 82 for couples aged 75 years and over (95% CI: 46–417). While a dramatically increased risk of infection was noted in all household contacts, increased risk was greatest for mother-neonate pairs and couples aged 75 and over, suggesting targeted prophylaxis could be considered. Offering prophylaxis is challenging due to the short time interval between cases emphasising the importance of immediate notification and assessment of contacts.
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spelling pubmed-54769842017-07-03 Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013 Mearkle, Rachel Saavedra-Campos, Maria Lamagni, Theresa Usdin, Martine Coelho, Juliana Chalker, Vicki Sriskandan, Shiranee Cordery, Rebecca Rawlings, Chas Balasegaram, Sooria Euro Surveill Research Article Invasive group A streptococcal infection has a 15% case fatality rate and a risk of secondary transmission. This retrospective study used two national data sources from England; enhanced surveillance (2009) and a case management system (2011–2013) to identify clusters of severe group A streptococcal disease. Twenty-four household pairs were identified. The median onset interval between cases was 2 days (range 0–28) with simultaneous onset in eight pairs. The attack rate during the 30 days after first exposure to a primary case was 4,520 per 100,000 person-years at risk (95% confidence interval (CI): 2,900–6,730) a 1,940 (95% CI: 1,240–2,880) fold elevation over the background incidence. The theoretical number needed to treat to prevent one secondary case using antibiotic prophylaxis was 271 overall (95% CI: 194–454), 50 for mother-neonate pairs (95% CI: 27–393) and 82 for couples aged 75 years and over (95% CI: 46–417). While a dramatically increased risk of infection was noted in all household contacts, increased risk was greatest for mother-neonate pairs and couples aged 75 and over, suggesting targeted prophylaxis could be considered. Offering prophylaxis is challenging due to the short time interval between cases emphasising the importance of immediate notification and assessment of contacts. European Centre for Disease Prevention and Control (ECDC) 2017-05-11 /pmc/articles/PMC5476984/ /pubmed/28537550 http://dx.doi.org/10.2807/1560-7917.ES.2017.22.19.30532 Text en This article is copyright of The Authors, 2017. http://creativecommons.org/licenses/by/4.0/ 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.
spellingShingle Research Article
Mearkle, Rachel
Saavedra-Campos, Maria
Lamagni, Theresa
Usdin, Martine
Coelho, Juliana
Chalker, Vicki
Sriskandan, Shiranee
Cordery, Rebecca
Rawlings, Chas
Balasegaram, Sooria
Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013
title Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013
title_full Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013
title_fullStr Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013
title_full_unstemmed Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013
title_short Household transmission of invasive group A Streptococcus infections in England: a population-based study, 2009, 2011 to 2013
title_sort household transmission of invasive group a streptococcus infections in england: a population-based study, 2009, 2011 to 2013
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476984/
https://www.ncbi.nlm.nih.gov/pubmed/28537550
http://dx.doi.org/10.2807/1560-7917.ES.2017.22.19.30532
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