| Title | Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group. | | Author(s) | Laupland KB, Davies HD, Low DE, Schwartz B, Green K, McGeer A | | Institution | Department of Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada. | | Source | Pediatrics 2000 May; 105(5):E60. | | MeSH | Adolescent
Age Distribution
Chickenpox
Child
Child, Preschool
Comorbidity
Female
Humans
Incidence
Infant
Infant, Newborn
Logistic Models
Male
Ontario
Poisson Distribution
Population Surveillance
Prognosis
Prospective Studies
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Risk Factors
Streptococcal Infections
Streptococcus pyogenes
| | Abstract | OBJECTIVES: To describe the incidence and clinical features of invasive group A streptococcal (GAS) disease in children in Ontario and determine the risk of invasive GAS infection following chickenpox.
METHODS: During 1992-1996, we conducted prospective, active, population-based surveillance for pediatric invasive GAS disease in Ontario, Canada (population: 11 million; 2.5 million children) and reviewed clinical and laboratory records.
RESULTS: There were 1.9 cases of invasive GAS disease per 100,000 children per year. Streptococcal toxic shock syndrome (STSS) occurred in 7% of cases and necrotizing fasciitis (NF) in 4% for incidences of.08 and.13 per 100,000 per year, respectively. Case-fatality rates were 56% for STSS, 10% for NF, and 4% overall. The presence of chronic underlying illness other than asthma was associated with death (relative risk [RR]: 11; 95% confidence interval [CI]: 2.4-45). Fifteen percent of children identified had preceding chickenpox infection, which significantly increased the risk for acquisition of invasive GAS disease (RR: 58; 95% CI: 40-85). Children with invasive GAS and recent chickenpox were more likely to have NF (RR: 6.3; 95% CI: 1.8-22.3).
CONCLUSIONS: Childhood invasive GAS disease occurs at an incidence similar to the adult population but has a lower rate of STSS and case-fatality. Chickenpox dramatically increases the risk for acquiring invasive GAS disease, and universal chickenpox vaccination could potentially prevent up to 15% of all pediatric invasive GAS disease. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 10799624 |
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