Annual Summary of Disease Activity:
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Streptococcal Invasive Disease - Group A, 2006
One hundred seventy-one cases of invasive group A streptococcal (GAS) disease (3.4 per 100,000), including 17 deaths, were reported in 2006, compared to 122 cases and nine deaths in 2005. Ages of case-patients ranged from 1 month to 93 years (mean, 50 years). Forty-seven percent of case-patients were residents of the metropolitan area. Fifty-nine (35%) case-patients had bacteremia without another focus of infection, and 38 (22%) case-patients had cellulitis with bacteremia. There were 22 (13%) cases of primary pneumonia and 11 (6%) cases of necrotizing fasciitis. Nine (5%) case-patients had septic arthritis and/or osteomyelitis, and three (2%) had streptococcal toxic shock syndrome (STSS) accompanied by another focus of infection. Six (4%) case-patients were residents of long-term care facilities. None of the facilities had more than one case-patient.
The 17 deaths included six cases of bacteremia without another focus of infection and five cases of pneumonia. The six remaining fatal cases had bacteremia with cellulitis (2), meningitis (2), necrotizing fasciitis, and vasculitis. The deaths occurred in persons ranging in age from 15 to 91 years. For the 16 deaths in patients with known health histories, significant underlying medical conditions were reported for 13 of the case-patients.
Isolates were available for 159 (93%) cases, and 155 were subtyped using PFGE; 64 different molecular subtypes were identified. Forty-three subtypes were represented by one isolate each; other subtypes were represented by two to 31 isolates each. No direct epidemiologic links were noted among cases with indistinguishable subtypes.
Isolates were available for 15 of the deaths and were distributed among 12 different PFGE subtypes. Three deaths were attributed to the most common subtype, and two other deaths had indistinguishable subtypes.
- For up to date information see>> Group A Streptococcus (GAS)
- Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2006