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https://repository.monashhealth.org/monashhealthjspui/handle/1/58070| Title: | Increased burden of invasive group A streptococcal disease among Australian children, 2023-2024: a prospective cohort study. | Authors: | Oliver J.;Steer A.C.;Crawford N.W.;Blyth C.C.;Clark J.E.;Osowicki J.;Abo Y.-N.;McMinn A.;Smeesters P.R.;Carr J.P.;Britton P.N.;Francis J.R. | Monash Health Department(s): | Paediatric - Infection and Immunity | Institution: | (Carr) Monash University, Melbourne, VIC, Australia (Smeesters) Molecular Bacteriology Laboratory, Universite Libre de Bruxelles, Brussels, Belgium (Francis) Menzies School of Health Research, Charles Darwin University, NT, Australia (Abo, Oliver, McMinn, Osowicki, Crawford, Steer) Murdoch Children's Research Institute, Melbourne, VIC, Australia (Abo, Osowicki, Steer) Department of Infectious Diseases, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia (Abo) Department of Microbiology, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia (Abo, Osowicki, Crawford, Steer) Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia (Oliver, Blyth) The Kids Research Institute Australia, Nedlands, WA, Australia (Oliver) Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity and the University of Melbourne, Victoria, Australia (Oliver) UWA Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia (Clark) Queensland Children's Hospital, Queensland and School of Clinical Medicine, University of Queensland, Australia (Blyth) Perth Children's Hospital, WA, Australia (Blyth) Department of Microbiology, Pathwest Laboratory Medicine, Nedlands, WA, Australia (Francis) Royal Darwin Hospital, NT, Australia (Britton) Department of Infectious Diseases & Microbiology, Children's Hospital at Westmead and Sydney Infectious Diseases and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia (Carr) Infection & Immunity, Monash Children's Hospital, Melbourne, VIC, Australia (Smeesters) Department of Paediatrics, Brussels University Hospital, Academic Children Hospital Queen Fabiola, Universite Libre de Bruxelles, Brussels, Belgium |
Issue Date: | 11-Apr-2026 | Copyright year: | 2026 | Publisher: | Elsevier Ltd | Place of publication: | United Kingdom | Publication information: | The Lancet Regional Health - Western Pacific. 69(no pagination), 2026. Article Number: 101850. Date of Publication: 01 Apr 2026. | Journal: | The Lancet Regional Health - Western Pacific | Abstract: | Background: Global rates of invasive Group A Streptococcus (iGAS) disease surged from September 2022, exceeding pre-COVID-19 pandemic levels, showing atypical seasonality and disproportionately affecting children. We previously described the epidemiology of iGAS among Australian children from mid-2018 to end 2022 using data from the Paediatric Active Enhanced Diseases network and here provide updated clinical epidemiology for 2023 and 2024 to help inform public health strategies. Method(s): Prospective surveillance of 0-17-year-olds with iGAS admitted to six tertiary hospitals in five Australian states/territories in 2023 and 2024. Confirmed cases had GAS detected from >=1 sterile site specimen; probable cases had detection of GAS in >=1 non-sterile site specimen and diagnosis of septic shock, streptococcal toxic shock syndrome or necrotising fasciitis. Finding(s): In 2023, the annualised incidence was 5.10 per 100,000 (95% CI 4.50-5.75, n = 263 cases) and dropped significantly in 2024 (annualised incidence 2.13, 95% CI 1.75-2.57, n = 111 cases). Quarter three peaks were not as predominant across 2023 and 2024 compared to usual patterns. Intensive care unit admission occurred among 147/374 (39%) children with six deaths. At discharge, 137/374 (37%) had not returned to premorbid function. Respiratory virus co-infection was found among 133/267 (49.8%) patients tested and was associated with higher risk of severe disease, RR 1.6 (95% CI 1.26-2.07). Adjunctive clindamycin, linezolid or intravenous immunoglobulin was used in 201/374 (54%), including 126/147 (86%) of severe disease cases. Interpretation(s): We have captured the end of post-COVID-19 pandemic iGAS surge in sentinel Australian paediatric hospitals. High iGAS incidence peaked in 2023, before reducing to similar pre-pandemic incidence in 2024. The dynamic epidemiology and persistent burden of disease highlight the need for continued vigilant public health efforts, surveillance, and vaccine development. Funding(s): This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Copyright © 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/ | DOI: | https://dx.doi.org/10.1016/j.lanwpc.2026.101850 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/58070 | Type: | Article |
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