‘Unmet need’ for a vaccine to counter Strep A rise: Study

A sharp increase in invasive group A Streptococcus cases, which has caused three deaths among children, has underlined the need for a vaccine, Australian researchers have said.
 
In an article published in The Lancet Regional Health – Western Pacific journal this week, authors said Australian spike is similar to a trend in the Northern Hemisphere, where the World Health Organization (WHO) flagged a significant rise in cases last year.
 
Using the Paediatric Active Enhanced Disease Surveillance (PAEDS) Network in Australia, they identified 280 children aged under 18 admitted to five paediatric hospitals in Victoria, Queensland, Western Australia and the Northern Territory with invasive group A Streptococcus.
 
Of the 280 children, almost a third (84 or 32%) had severe disease, while there were three deaths among the cohort.
 
Apart from during 2020–21, when the figures dipped, group A Streptococcus has risen in many other high-income countries, the researchers found.
 
Within the Australian hospitals included in the study, invasive group A Streptococcus cases stood at 23 in 2020, rising to 107 in 2022.
 
The study, which was funded by the Murdoch Children’s Research Institute, looked at cases from 1 July 2018 to 31 December 2022.
 
‘At this stage, it is unclear whether this high incidence of invasive group A Streptococcus will persist or increase further in 2023,’ the authors wrote.
 
They say the pattern in Australia is running simultaneously to the same trend in the Northern Hemisphere ‘despite differences in seasons and circulating respiratory viruses’.
 
Contending that the overall rise could be due to ‘a combination of environmental, population and microbial virulence factors’, the authors called for more research to establish whether new hypervirulent strains could be a factor.
 
The increase also ‘emphasises the unmet need for a vaccine to prevent significant morbidity associated with [the] disease,’ they wrote.
 
According to the WHO, group A Streptococcus infections are linked to more than 500,000 deaths around the world each year.
 
While the bacteria usually causes mild illness including sore throat and impetigo, it can also lead to more severe disease such as sepsis, meningitis, pneumonia, toxic shock syndrome, and necrotising fasciitis.
 
Group A Streptococcus is also linked to the development of acute rheumatic fever (ACF) and rheumatic heart disease (RHD), with Aboriginal and Torres Strait Islander people having one of the highest rates in the world.
 
Young children, the elderly, pregnant women and Aboriginal and Torres Strait Islander people are among the most high-risk groups for those diseases.
 
More broadly, the number of serious bacterial infections among children in Australia has risen in the past year. While infections have increased from other bacteria, group A Streptococcus is most responsible for driving the trend.
 
Invasive group A Streptococcus became a notifiable disease in Australia in July 2021. While there is no vaccine available yet, trials are planned.
 
One of the authors of the The Lancet Regional Health article, Professor Andrew Steer of the Murdoch Children’s Research Institute, said he hopes the study will accelerate prevention efforts, including vaccination.
 
‘A vaccine for Strep A will save hundreds of thousands of lives every year and prevent millions of infections that send children and adults to the hospital or doctor,’ he said.
 
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