A Review of : Public Health Risk Factors, Prevention and Control

Overview

Journal Pathogens

Date 2021 Mar 6

PMID 33671684

Citations 48

Authors

Nelly Janira Avire

Harriet Whiley

Kirstin Ross

Affiliations

Soon will be listed here.

Abstract

(colloquially named "group A streptococcus" (GAS)), is a pathogen of public health significance, infecting 18.1 million people worldwide and resulting in 500,000 deaths each year. This review identified published articles on the risk factors and public health prevention and control strategies for mitigating GAS diseases. The pathogen causing GAS diseases is commonly transmitted via respiratory droplets, touching skin sores caused by GAS or through contact with contaminated material or equipment. Foodborne transmission is also possible, although there is need for further research to quantify this route of infection. It was found that GAS diseases are highly prevalent in developing countries, and among indigenous populations and low socioeconomic areas in developed countries. Children, the immunocompromised and the elderly are at the greatest risk of infections and the associated sequelae, with transmission rates being higher in schools, kindergartens, hospitals and residential care homes. This was attributed to overcrowding and the higher level of social contact in these settings. Prevention and control measures should target the improvement of living conditions, and personal and hand hygiene. Adherence to infection prevention and control practices should be emphasized in high-risk settings. Resource distribution by governments, especially in developed countries, should also be considered.

Citing Articles

Association between prenatal exposure to maternal metal and trace elements and Streptococcus infection: A prospective birth cohort in the Japan Environment and Children's Study.

Iwata H, Ikeda A, Itoh M, Ketema R, Tamura N, Yamaguchi T PLoS One. 2025; 20(2):e0319356.

PMID: 40014588 PMC: 11867319. DOI: 10.1371/journal.pone.0319356.

Comprehensive analysis of antimicrobial resistance dynamics among broiler and duck intensive production systems.

Szoke Z, Fauszt P, Mikolas M, David P, Szilagyi-Tolnai E, Pesti-Asboth G Sci Rep. 2025; 15(1):4673.

PMID: 39920217 PMC: 11806100. DOI: 10.1038/s41598-025-89432-z.

The burden of group A (GAS) infections: The challenge continues in the twenty-first century.

Thacharodi A, Hassan S, Vithlani A, Ahmed T, Kavish S, Geli Blacknell N iScience. 2025; 28(1):111677.

PMID: 39877071 PMC: 11773489. DOI: 10.1016/j.isci.2024.111677.

Streptococcus pyogenes carriage rate, associated factors and antimicrobial susceptibility profiles among urban and rural schoolchildren at Gondar city, Northwest Ethiopia.

Gashaw Y, Getaneh A, Kasew D, Tigabie M, Gelaw B Sci Rep. 2025; 15(1):2057.

PMID: 39814816 PMC: 11735781. DOI: 10.1038/s41598-024-82009-2.

Rheumatic heart disease burden and determinants in cardiac patients: A follow up care concern in Ethiopia.

Berhanu H, Tegene E, Sudhakar M, Gemechu T, Mossie A Int J Cardiol Cardiovasc Risk Prev. 2024; 24:200352.

PMID: 39691807 PMC: 11647114. DOI: 10.1016/j.ijcrp.2024.200352.

References

Marshall H, Richmond P, Nissen M, Lambert S, Booy R, Reynolds G . Group A Streptococcal Carriage and Seroepidemiology in Children up to 10 Years of Age in Australia. Pediatr Infect Dis J. 2015; 34(8):831-8. DOI: 10.1097/INF.0000000000000745. View

Bard J, Mongkolrattanothai K, Kachroo P, Beres S, Olsen R . Case Series Description and Genomic Characterization of Invasive Group A Streptococcal Infections in Pediatric Patients. Pediatr Infect Dis J. 2016; 36(6):618-620. DOI: 10.1097/INF.0000000000001519. View

Tartof S, Reis J, Andrade A, Ramos R, Reis M, Riley L . Factors associated with Group A Streptococcus emm type diversification in a large urban setting in Brazil: a cross-sectional study. BMC Infect Dis. 2010; 10:327. PMC: 2994873. DOI: 10.1186/1471-2334-10-327. View

Rottenstreich A, Benenson S, Levin G, Kleinstern G, Moses A, Amit S . Risk factors, clinical course and outcomes of pregnancy-related group A streptococcal infections: retrospective 13-year cohort study. Clin Microbiol Infect. 2018; 25(2):251.e1-251.e4. DOI: 10.1016/j.cmi.2018.10.002. View

Cornick J, Kiran A, Vivancos R, van Aartsen J, Clarke J, Bevan E . Epidemiological and Molecular Characterization of an Invasive Group A Streptococcus 32.2 Outbreak. J Clin Microbiol. 2017; 55(6):1837-1846. PMC: 5442540. DOI: 10.1128/JCM.00191-17. View

Lanitis S, Khan M, Sgourakis G, Kontovounisios C, Papaconstandinou T, Karaliotas C . Severe monobacterial necrotizing soft tissue infection by group A Streptococcus: A surgical emergency. Asian Pac J Trop Biomed. 2013; 2(3):250-2. PMC: 3609267. DOI: 10.1016/S2221-1691(12)60052-5. View

Harris P, Siew D, Proud M, Buettner P, Norton R . Bacteraemia caused by beta-haemolytic streptococci in North Queensland: changing trends over a 14-year period. Clin Microbiol Infect. 2010; 17(8):1216-22. DOI: 10.1111/j.1469-0691.2010.03427.x. View

Gordon G, Dale B, Lochhead D . An outbreak of group A haemolytic streptococcal puerperal sepsis spread by the communal use of bidets. Br J Obstet Gynaecol. 1994; 101(5):447-8. DOI: 10.1111/j.1471-0528.1994.tb11922.x. View

Watts V, Balasegaram S, Brown C, Mathew S, Mearkle R, Ready D . Increased Risk for Invasive Group A Streptococcus Disease for Household Contacts of Scarlet Fever Cases, England, 2011-2016. Emerg Infect Dis. 2019; 25(3):529-537. PMC: 6390732. DOI: 10.3201/eid2503.181518. View

10.

Oliver J, Pierse N, Stefanogiannis N, Jackson C, Baker M . Acute rheumatic fever and exposure to poor housing conditions in New Zealand: A descriptive study. J Paediatr Child Health. 2017; 53(4):358-364. DOI: 10.1111/jpc.13421. View

11.

Cohen R, Cohen S, Afraimov M, Finn T, Babushkin F, Geller K . Screening asymptomatic households for Streptococcus pyogenes pharyngeal carriage as a part of in-hospital investigation of puerperal sepsis. Am J Infect Control. 2019; 47(12):1493-1499. DOI: 10.1016/j.ajic.2019.05.029. View

12.

Fittipaldi N, Tyrrell G, Low D, Martin I, Lin D, Hari K . Integrated whole-genome sequencing and temporospatial analysis of a continuing Group A Streptococcus epidemic. Emerg Microbes Infect. 2015; 2(3):e13. PMC: 3630956. DOI: 10.1038/emi.2013.13. View

13.

Dohoo C, Stuart R, Finkelstein M, Bradley K, Gournis E . Risk factors associated with group A Streptococcus acquisition in a large, urban homeless shelter outbreak. Can J Public Health. 2019; 111(1):117-124. PMC: 7046842. DOI: 10.17269/s41997-019-00258-5. View

14.

Bi S, Xu M, Zhou Y, Xing X, Shen A, Wang B . A Multicomponent Vaccine Provides Immunity against Local and Systemic Infections by Group A Streptococcus across Serotypes. mBio. 2019; 10(6). PMC: 6879722. DOI: 10.1128/mBio.02600-19. View

15.

Nakauyaca A, Ralph A, Majoni W, Kangaharan N . Case Report: Concurrent Rheumatic Fever and Acute Post-Streptococcal Glomerulonephritis in a High-Burden Setting. Am J Trop Med Hyg. 2019; 101(5):1054-1057. PMC: 6838557. DOI: 10.4269/ajtmh.18-0954. View

16.

Dickinson H, Reacher M, Nazareth B, Eagle H, Fowler D, Underwood A . Whole-genome sequencing in the investigation of recurrent invasive group A streptococcus outbreaks in a maternity unit. J Hosp Infect. 2018; 101(3):320-326. DOI: 10.1016/j.jhin.2018.03.018. View

17.

Anderson B . Puerperal group A streptococcal infection: beyond Semmelweis. Obstet Gynecol. 2014; 123(4):874-82. DOI: 10.1097/AOG.0000000000000175. View

18.

Waddington C, Snelling T, Carapetis J . Management of invasive group A streptococcal infections. J Infect. 2014; 69 Suppl 1:S63-9. DOI: 10.1016/j.jinf.2014.08.005. View

19.

Engelthaler D, Valentine M, Bowers J, Pistole J, Driebe E, Terriquez J . Hypervirulent emm59 Clone in Invasive Group A Streptococcus Outbreak, Southwestern United States. Emerg Infect Dis. 2016; 22(4):734-8. PMC: 4806960. DOI: 10.3201/eid2204.151582. View

20.

Liu Y, Zhao J, Li B, Yang J, Dong X, Zhang J . A report on the first outbreak of a single clone group A Streptococcus (emm-type 89) tonsillopharyngitis in China. J Microbiol Immunol Infect. 2013; 47(6):542-5. DOI: 10.1016/j.jmii.2013.08.011. View