Current Status of Group A Streptococcal Vaccine Development

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Group A streptococci (GAS) are ubiquitous human pathogens that cause a wide spectrum of clinical syndromes. The acute infections range from uncomplicated pharyngitis, cellulitis, and pyoderma to necrotizing fasciitis, sepsis, pneumonia, and streptococcal toxic shock syndrome. The non-suppurative sequelae that may follow GAS infections are acute rheumatic fever (ARF) and post-streptococcal glomerulonephritis (PSGN). The burden of disease caused by GAS in economically developed and developing countries is significant. The search for a safe and effective vaccine to prevent GAS infections and their complications has been ongoing for more than 80 years. This chapter details the worldwide burden of disease, the obstacles encountered in vaccine development, current vaccine strategies and an update on the clinical development of M protein-based vaccines.