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ABCs Report: group A Streptococcus, 2000

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

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ABCs Areas

California (3 county San Francisco Bay area); Connecticut; Georgia; Maryland (6 county Baltimore area); Minnesota; NewYork (7 county Rochester and 8 county Albany area); Oregon (3 county Portland area); Tennessee (11 urban counties)

ABCs Population

The surveillance areas represent 28,565,842 persons. Source: U.S. Bureau of the Census, 2000

ABCs Case Definition

Invasive group A streptococcal disease: isolation of group A Streptococcus 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 2000.

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. Strainswere 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 population
estimates for 2000. For national projections of cases, raceand age-specific rates of disease were applied from the
aggregate surveillance area to the age and racial distribution of the 2000 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 601 (2.9)
Black 256 (5.3)
Other 59 (2.1)

Unknown race (n=109) distributed among knowns

* Cases per 100,000 population for ABCs areas

Ethnicity No. (Rate*)
Hispanic 42 (2.4)
Non-Hispanic 413 ------
Unknown 461 ------

*Cases per 100,000 population for ABCs areas

Age (years) Cases
No. (Rate*)
Deaths
No. (Rate*)
<1 20 (5.2) 1 (0.3)
1 23 (6.0) 0 (0.0)
2-4 20 (1.7) 0 (0.0)
5-17 82 (1.5) 5 (0.1)
18-34 123 (1.8) 4 (0.1)
35-49 223 (3.2) 18 (0.3)
50-64 149 (3.5) 20 (0.5)
≥ 65 276 (8.5) 59 (1.8)
Total 916 (3.2) 107 (0.4)

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

ABCs Area Most common emm types*
% of area
isolates
California 1, 12, 41, 114, 2, 3, 11, 31 56.8
Connecticut 1, 28, 3, 89, 12, 22 67.9
Georgia 1, 3, 12, 75, 22, 77, 73, 28 77.7
Maryland 82, 1, 28, 73, 89 60.5
Minnesota 1, 3, 28, 12 59.0
New York 1, 3, 4, 12, 28, 89, 83 70.1
Oregon 114, 1, 11, 3 63.3
Tennessee 1, 12 48.6
Total 1, 3, 12, 28, 82 50.4

*Requires a minimum of 4 isolates and ≥ 5% of isolates typed

Syndrome No. (%)
Cellulitis 305 (33.3)
Necrotizing fasciitis 55 (6.0)
Pneumonia 128 (14.0)
Primary bacteremia 323 (35.3)
Streptococcal toxic shock 37 (4.0)

Note: Some cases had more than one syndrome.

Potentially preventable invasive group A streptococcal disease

During 2000, 16 cases (ages 4, 8, 10, and 11 months and 1, 4, 5, 6, 7, 9, 11, 12, 27, and 33 years) of invasive GAS disease were detected in patients with varicella.

National Estimates of Invasive Disease

Cases: 8,800 (3.1/100,000)
Deaths: 1,000 (0.4/100,000)

Citation

Centers for Disease Control and Prevention. 2001. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Group A Streptococcus, 2000.

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