To the Editor: The toll of group A Streptococcus is dramatically unappreciated, despite increasing evidence of its burden.1 In Australia and New Zealand, we recently demonstrated that group A streptococcal throat and skin infections cause a sizable burden at the population level — cellulitis is the main contributor to the total burden of all group A streptococcal diseases and acute rheumatic fever and rheumatic heart disease contribute disproportionately relative to their frequency of occurrence.2,3
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- 1. Barnett TC, Bowen AC, Carapetis JR. The fall and rise of group A Streptococcus diseases. Epidemiol Infect 2019; 147: e4.
- 2. Cannon J, Zhung J, Bennett J, et al. The economic and health burdens of diseases caused by Group A Streptococcus in New Zealand. Int J Infect Dis 2020; 103: 176–181.
- 3. Cannon JW, Jack S, Wu Y, et al. An economic case for a vaccine to prevent group A Streptococcus skin infections. Vaccine 2018; 36: 6968–6978.
- 4. Global Burden of Disease Collaborative Network. Global Burden of Disease study 2019 (GBD 2019) results. Seattle: Institute for Health Metrics and Evaluation, 2020. http://ghdx.healthdata.org/gbd-results-tool (viewed Dec 2020).
- 5. Beaton A, Kamalembo FB, Dale J, et al. The American Heart Association’s call to action for reducing the global burden of rheumatic heart disease: a policy statement from the American Heart Association. Circulation 2020; 142: e358–e368.
- 6. Lewnard JA, King LM, Fleming‐Dutra KE, et al. Incidence of pharyngitis, sinusitis, acute otitis media, and outpatient antibiotic prescribing preventable by vaccination against group A Streptococcus in the United States. Clin Infect Dis 2020; https://doi.org/10.1093/cid/ciaa529 [Epub ahead of print].
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