Standardization of Epidemiological Surveillance of Invasive Group A Streptococcal Infections

SAVAC Burden Dis Working Grp, Kate M. Miller, Theresa Lamagni, Thomas Cherian, Jeffrey W. Cannon, Tom Parks, Richard A. Adegbola, Janessa Pickering, Tim Barnett, Mark E. Engel, Laurens Manning, Asha C. Bowen, Jonathan R. Carapetis, Hannah C. Moore, Dylan D. Barth, David C. Kaslow, Chris A. Van Beneden

Research output: Contribution to journalArticlepeer-review


Invasive group A streptococcal (Strep A) infections occur when Streptococcus pyogenes, also known as beta-hemolytic group A Streptococcus, invades a normally sterile site in the body. This article provides guidelines for establishing surveillance for invasive Strep A infections. The primary objective of invasive Strep A surveillance is to monitor trends in rates of infection and determine the demographic and clinical characteristics of patients with laboratory-confirmed invasive Strep A infection, the age- and sex-specific incidence in the population of a defined geographic area, trends in risk factors, and the mortality rates and rates of nonfatal sequelae caused by invasive Strep A infections. This article includes clinical descriptions followed by case definitions, based on clinical and laboratory evidence, and case classifications (confirmed or probable, if applicable) for invasive Strep A infections and for 3 Strep A syndromes: streptococcal toxic shock syndrome, necrotizing fasciitis, and pregnancy-associated Strep A infection. Considerations of the type of surveillance are also presented, noting that most people who have invasive Strep A infections will present to hospital and that invasive Strep A is a notifiable disease in some countries. Minimal surveillance necessary for invasive Strep A infection is facility-based, passive surveillance. A resource-intensive but more informative approach is active case finding of laboratory-confirmed Strep A invasive infections among a large (eg, state-wide) and well defined population. Participant eligibility, surveillance population, and additional surveillance components such as the use of International Classification of Disease diagnosis codes, follow-up, period of surveillance, seasonality, and sample size are discussed. Finally, the core data elements to be collected on case report forms are presented.
Original languageEnglish
Pages (from-to)S31-S40
Number of pages10
JournalOpen Forum Infectious Diseases
Issue numberSUPP 1
Publication statusPublished - 15 Sep 2022


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