Streptococcal Invasive Disease Group A, 2019

Invasive Group A Streptococcus disease (GAS) is defined as GAS isolated from a usually sterile site such as blood, cerebrospinal fluid, or a wound when accompanied with necrotizing fasciitis or streptococcal toxic shock syndrome (STSS). Three hundred twenty-six cases (5.8 cases per 100,000 population), including 21 deaths, were reported in 2019, compared to 367 cases and 37 deaths in 2018. The median age of cases was 56 years (range, newborn to 96 years). Forty-six percent of cases were residents of the metropolitan area. Allowing for multiple presentations per patient, 129 (40%) had cellulitis, 62 (19%) septic shock, 55 (17%) bacteremia without another focus of infection, 44 (14%) pneumonia, 34 (10%) septic arthritis and/or osteomyelitis, 27 (8%) necrotizing fasciitis, 25 (8%) abscess, and 13 (4%) had STSS. Twenty-five cases (8%) were injection drug users in 2018, including one death, compared to 23 cases (6%) in 2019. Nineteen (6%) cases were residents of long-term care facilities. Seventeen facilities had a single case, one facility had 2 cases.

The 21 deaths included 14 that presented with septic shock, 4 pneumonia, 3 bacteremia without another focus of infection, and 3 cellulitis (individuals could have more than one infection type). Of the 21 deaths, the most frequently reported underlying conditions were diabetes (8), current tobacco smoker (5), chronic kidney disease (4), solid organ malignancy (3), obesity (2), heart failure (2), atherosclerotic cardiovascular disease (2), asthma (2), dementia (2), cirrhosis (2), and chronic skin breakdown (2). Eighteen fatal cases had two or more underlying conditions, and 3 had none reported.

• Find up to date information at>> Group A Streptococcus (GAS)
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2019