The changing epidemiology of invasive group A streptococcal infections and the emergence of streptococcal toxic shock-like syndrome: a retrospective population-based study

Article Abstract:

Clinical features and complications associated with group A streptococcal infections changed significantly between 1985 and 1990 in one Arizona county studied. Previously unconfirmed studies reported an increase in the rate and severity of group A streptococcal infections since the mid-1980s. Of 128 patients in Pima County, AZ, with group A streptococcal infections examined over the five-year period, the proportion of patients with low blood pressure, kidney impairment, skin problems, vomiting and diarrhea increased significantly. The elderly and children under age five were more likely to die from infection as were patients with low blood pressure and multi-organ system involvement. Overall, the streptococcal infection rate was 4.3 per 100,000 people, but the rate among Native Americans was 46.0 per 100,000. After 1988, 8% of the cases were associated with toxic shock-like syndrome, but before 1988, none were. Patients with toxic shock-like syndrome tended to be younger and were less likely to have underlying medical illnesses such as diabetes.

Streptococcal infections, Diseases, Native Americans, Native North Americans, Streptococcus pyogenes

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Decline of childhood Haemophilus influenzae type b (Hib) disease in the Hib vaccine era

Article Abstract:

The widespread use of vaccines against the bacterium Hemophilus influenzae type b (Hib) has led to a dramatic reduction in Hib disease in children under five years of age. Data from two surveillance systems at the Centers for Disease Control and Prevention show that the incidence of Hib disease dropped 71% between 1989 - one year after the vaccine was licensed for children 18 months of age or older - and 1991. Cases of Hib meningitis, which affects at least 60% of children with Hib disease, declined 82% between 1985 and 1991. Between 1988 and 1991, an estimated 30 million doses of vaccine were administered. The same data show that the incidence of Hib disease in infants also began to decline in 1988, but this was two years before the vaccine was licensed for infants. This could be explained if the vaccine reduces the number of carriers. If this is true, Hib disease might be eliminated by routine vaccination.

Usage, Hemophilus infections, Hib vaccines

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