Post-pandemic increase in invasive group A strep infections in New Zealand

Background: Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras,...

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Main Authors: Sherif Ammar, Andrew Anglemyer, Julie Bennett, Julianna Lees, Michael Addidle, Julie Morgan, Kara DuBray, Yvonne Galloway, Corina Grey, Putu Duff
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S187603412400279X
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author Sherif Ammar
Andrew Anglemyer
Julie Bennett
Julianna Lees
Michael Addidle
Julie Morgan
Kara DuBray
Yvonne Galloway
Corina Grey
Putu Duff
author_facet Sherif Ammar
Andrew Anglemyer
Julie Bennett
Julianna Lees
Michael Addidle
Julie Morgan
Kara DuBray
Yvonne Galloway
Corina Grey
Putu Duff
author_sort Sherif Ammar
collection DOAJ
description Background: Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras, and acute respiratory infections (ARI). Methods: Analyses include national-level surveillance data on iGAS and ARI. Multivariable Poisson regression was used to examine relationships between COVID-19 era and iGAS incidence, and Pearson pairwise correlations were calculated to examine trends between ARI and iGAS. Findings: A sharp increase in iGAS was observed in 2023, with notable increases among children aged under ten years. Indigenous Māori and Pacific peoples were disproportionately affected. emm1 and emm12 were commonly reported in 2022–2023. Compared to pre-pandemic, iGAS decreased significantly during the COVID-19 restrictions era and increased once COVID-19 restrictions were relaxed, after adjusting for ethnicity, sex, and age. ARI was moderately correlated with iGAS (r = 0∙55) in 2022–2023. Interpretation: Though delayed, NZ’s recent iGAS trends mirror those seen in the 2022/2023 multi-country iGAS surge. These findings expand existing research, suggesting a link between the easing of COVID-19 measures, increased ARI circulation, and the rise in iGAS. Continued and improved iGAS surveillance, is needed to better understand iGAS epidemiology and support public health response. iGAS in NZ will become notifiable in late 2024, which should help improve iGAS monitoring and support public health response. Funding: This research received no specific funding, though iGAS surveillance and typing in NZ is funded by the Ministry of Health, which was not involved in the analysis, interpretation, design, or any aspect of this study. No authors were paid to write this manuscript.
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spelling doaj-art-68a6915bef534fd5b51c5e54e33b5f332025-08-20T02:11:37ZengElsevierJournal of Infection and Public Health1876-03412024-11-01171110254510.1016/j.jiph.2024.102545Post-pandemic increase in invasive group A strep infections in New ZealandSherif Ammar0Andrew Anglemyer1Julie Bennett2Julianna Lees3Michael Addidle4Julie Morgan5Kara DuBray6Yvonne Galloway7Corina Grey8Putu Duff9Institute of Environmental Science and Research, Wellington, New ZealandInstitute of Environmental Science and Research, Wellington, New Zealand; Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand; Correspondence to: Department of Preventive and Social Medicine, University of Otago, 362 Leith Street, Dunedin North, Dunedin 9016, New Zealand.Department of Public Health, University of Otago, Wellington, New ZealandInstitute of Environmental Science and Research, Wellington, New ZealandInstitute of Environmental Science and Research, Wellington, New Zealand; Pathlab, Tauranga, New ZealandInstitute of Environmental Science and Research, Wellington, New ZealandDepartment of Paediatrics, Dunedin Hospital, Dunedin, New ZealandInstitute of Environmental Science and Research, Wellington, New ZealandPacific Health Data and Insights, Auckland District Health Board, Auckland, New ZealandInstitute of Environmental Science and Research, Wellington, New ZealandBackground: Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras, and acute respiratory infections (ARI). Methods: Analyses include national-level surveillance data on iGAS and ARI. Multivariable Poisson regression was used to examine relationships between COVID-19 era and iGAS incidence, and Pearson pairwise correlations were calculated to examine trends between ARI and iGAS. Findings: A sharp increase in iGAS was observed in 2023, with notable increases among children aged under ten years. Indigenous Māori and Pacific peoples were disproportionately affected. emm1 and emm12 were commonly reported in 2022–2023. Compared to pre-pandemic, iGAS decreased significantly during the COVID-19 restrictions era and increased once COVID-19 restrictions were relaxed, after adjusting for ethnicity, sex, and age. ARI was moderately correlated with iGAS (r = 0∙55) in 2022–2023. Interpretation: Though delayed, NZ’s recent iGAS trends mirror those seen in the 2022/2023 multi-country iGAS surge. These findings expand existing research, suggesting a link between the easing of COVID-19 measures, increased ARI circulation, and the rise in iGAS. Continued and improved iGAS surveillance, is needed to better understand iGAS epidemiology and support public health response. iGAS in NZ will become notifiable in late 2024, which should help improve iGAS monitoring and support public health response. Funding: This research received no specific funding, though iGAS surveillance and typing in NZ is funded by the Ministry of Health, which was not involved in the analysis, interpretation, design, or any aspect of this study. No authors were paid to write this manuscript.http://www.sciencedirect.com/science/article/pii/S187603412400279XInvasive group A StreptococcusIGASStreptococcus pyogenesChildrenNew ZealandCOVID-19
spellingShingle Sherif Ammar
Andrew Anglemyer
Julie Bennett
Julianna Lees
Michael Addidle
Julie Morgan
Kara DuBray
Yvonne Galloway
Corina Grey
Putu Duff
Post-pandemic increase in invasive group A strep infections in New Zealand
Journal of Infection and Public Health
Invasive group A Streptococcus
IGAS
Streptococcus pyogenes
Children
New Zealand
COVID-19
title Post-pandemic increase in invasive group A strep infections in New Zealand
title_full Post-pandemic increase in invasive group A strep infections in New Zealand
title_fullStr Post-pandemic increase in invasive group A strep infections in New Zealand
title_full_unstemmed Post-pandemic increase in invasive group A strep infections in New Zealand
title_short Post-pandemic increase in invasive group A strep infections in New Zealand
title_sort post pandemic increase in invasive group a strep infections in new zealand
topic Invasive group A Streptococcus
IGAS
Streptococcus pyogenes
Children
New Zealand
COVID-19
url http://www.sciencedirect.com/science/article/pii/S187603412400279X
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