Increase in invasive group A streptococcal infection notifications, England, 2022

Area of Science:

• Public Health
• Infectious Diseases
• Pediatrics

Background:

• An unprecedented surge in invasive group A streptococcal (iGAS) infections and fatalities has been observed in England.
• This increase exceeds typical seasonal levels, with 772 notifications reported between weeks 37 and 48 of 2022.
• Particular concern is noted for pediatric cases, with a significant rise in severe presentations.

Purpose of the Study:

• To alert medical practitioners to the heightened incidence of iGAS infections.
• To highlight the unusual number of pediatric cases, including severe conditions like pulmonary empyema.
• To provide an overview of the current iGAS outbreak in England.

Main Methods:

• Surveillance data analysis of iGAS notifications.
• Monitoring of infection trends in specific age groups, particularly children under 15.
• Clinical case reporting and trend analysis, including specific diagnoses like pulmonary empyema.

Main Results:

• A significant increase in iGAS notifications (772) reported in England from week 37 to 48, 2022.
• A marked rise in iGAS diagnoses from lower respiratory tract specimens in children under 15, reaching 28% in November 2022.
• An unusual number of pediatric patients presenting with pulmonary empyema, indicating severe infection.

Conclusions:

• England is facing an exceptional rise in invasive group A streptococcal infections and associated deaths.
• Children under 15 are disproportionately affected, with a notable increase in severe outcomes such as pulmonary empyema.
• Healthcare professionals must remain vigilant and prepared to manage the current iGAS outbreak.