Group A Streptococcal Diseases and Their Global Burden

  • Anna P. RalphEmail author
  • Jonathan R. Carapetis
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 368)


Group A streptococcus (GAS) or Streptococcus pyogenes has been recognised as an important human pathogen since early days of modern microbiology, and it remains among the top ten causes of mortality from an infectious disease. Clinical manifestations attributable to this organism are perhaps the most diverse of any single human pathogen. These encompass invasive GAS infections, with high mortality rates despite effective antimicrobials, toxin-mediated diseases including scarlet fever and streptococcal toxic shock syndrome, the autoimmune sequelae of rheumatic fever and glomerulonephritis with potential for long-term disability, and nuisance manifestations of superficial skin and pharyngeal infection, which continue to consume a sizable proportion of healthcare resources. Although an historical perspective indicates major overall reductions in GAS infection rates in the modern era, chiefly as a result of widespread improvements in socioeconomic circumstances, this pathogen remains as a leading infectious cause of global morbidity and mortality. More than 18 million people globally are estimated to suffer from serious GAS disease. This burden disproportionally affects least affluent populations, and is a major cause of illness and death among children and young adults, including pregnant women, in low-resource settings. We review GAS transmission characteristics and prevention strategies, historical and geographical trends and report on the estimated global burden disease attributable to GAS. The lack of systematic reporting makes accurate estimation of rates difficult. This highlights the need to support improved surveillance and epidemiological research in low-resource settings, in order to enable better assessment of national and global disease burdens, target control strategies appropriately and assess the success of control interventions.


Rheumatic Heart Disease Acute Rheumatic Fever Scarlet Fever Streptococcal Toxic Shock Syndrome Puerperal Sepsis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



APR is supported by National Health and Medical Research Council (Australia) Fellowship 1016567.


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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Global and Tropical HealthMenzies School of Health ResearchDarwinAustralia
  2. 2.Division of MedicineRoyal Darwin HospitalDarwinAustralia
  3. 3.Telethon Institute for Child Health Research, Centre for Child Health ResearchUniversity of Western AustraliaPerthWestern Australia

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