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Rheumatic heart disease (RHD) is responsible for a significant burden of cardiovascular morbidity and mortality, and remains the most common cause of acquired heart disease among children and young adults in low-income and middle-income countries. Additionally, the global COVID-19 pandemic has forced the emergency restructuring of many health systems, which has had a broad impact on health in general, including cardiovascular disease.
Infection by group A Streptococcus (Strep A) results in a diverse range of clinical conditions, including pharyngitis, impetigo, cellulitis, necrotising fasciitis, and rheumatic heart disease. In this article, we outline the recommended strategies for Strep A treatment and prevention and review the literature for economic evaluations of competing treatment and prevention strategies.
Streptococcus pyogenes, also known as group A streptococcus (StrepA), is a bacterium that causes a range of human diseases, including pharyngitis, impetigo, invasive infections, and post-infection immune sequelae such as rheumatic fever and rheumatic heart disease. StrepA infections cause some of the highest burden of disease and death in mostly young populations in low-resource settings. Despite decades of effort, there is still no licensed StrepA vaccine, which if developed, could be a cost-effective way to reduce the incidence of disease.
Among genes present in all group A streptococci (GAS), those encoding M-fibril and T-pilus proteins display the highest levels of sequence diversity, giving rise to the two primary serological typing schemes historically used to define strain. A new genotyping scheme for the pilin adhesin and backbone genes is developed and, when combined with emm typing, provides an account of the global GAS strain population.
This paper presents a comprehensive cardiac safety framework for early clinical development of Streptococcus pyogenes (Group A Streptococcus) vaccines, endorsed by the Strep A Vaccine Global Consortium and the Australian Strep A Vaccine Initiative. Given historical concerns about vaccine-associated acute rheumatic fever, we have established standardized echocardiography protocols integrated with clinical assessment for monitoring cardiac safety in early-phase vaccine trials.
"I had never heard of invasive Streptococcus A disease before, and I was shocked to hear that it is actually three times more common than meningococcal disease and just as deadly yet there is no vaccine to protect against it."
STopping Acute Rheumatic Fever Infections to Strengthen Health (STARFISH) brings together a diverse and multidisciplinary research team to investigate the most effective environmental health initiatives (EHIs) aimed at reducing Strep A infections and prevent Acute Rheumatic Fever (ARF).
Outputs from the Strep A Burden of Disease Working Group
Streptococcus pyogenes (Group A Streptococcus, Strep A) is a Gram-positive bacterium and one of the most significant global bacterial pathogens, with disproportionate disease burden affecting low and middle-income countries. Despite substantial mortality and immune sequelae caused by Strep A, no licensed vaccines exist, and correlates of protection remain unestablished.
Streptococcus A is a bacterium often found in the throat and on the skin.