The epidemiology of invasive group A streptococcal disease in Victoria, 2007–2017: an analysis of linked datasets

Abstract

Objective: To describe the incidence and severity of invasive group A streptococcal disease (iGAS) in Victoria, Australia. Methods: Retrospective analysis of iGAS cases identified in linked datasets, 2007–2017: laboratory data from the Victorian Hospital Pathogen Surveillance Scheme; hospitalisation data from the Victorian Admitted Episodes Dataset; and deaths reported by the Australian Coordinating Registry. Results: There were 1,369 confirmed and 610 probable cases of iGAS identified from 2007 to 2017 in Victoria, Australia. The median annual incidence was 3.1 (range 2.4–5.2) per 100,000 population. The incidence was highest in 2017, with 5.2 (95%CI: 4.6–5.8) cases per 100,000 population. The median length of stay in hospital was 10 days, with 33.1% (578/1,744) of cases admitted to the intensive care unit, of whom 49.5% (286/578) were mechanically ventilated. The case fatality rate was 5.6% (110/1,979), reaching 13.5% (51/378) among those aged 75 years or older. Conclusions: There was an increased incidence of iGAS in 2017 in Victoria, with substantial healthcare utilisation and a high case fatality rate among older Victorians. Implications for public health: These data support mandatory notification of iGAS, which will enable better characterisation of the disease, rapid identification of changes in epidemiology and targeted public health responses.