Materiały źródłowe

• #1 Bacterial Pharyngitis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/225243-overview

  Acute pharyngitis accounts for approximately 12 million annual ambulatory care visits in the United States. It ranks within the top 20 most-common primary diagnosis groups. […] In temperate climates, GAS pharyngitis occurs most commonly in the winter and early spring. Group A Streptococcus is responsible for 20-30% of sore throats in children and 5-15% of sore throats in adults. […] An estimated 616 million cases of GABHS pharyngitis occur annually worldwide. Rheumatic heart disease, which may be a consequence of GABHS pharyngitis, is estimated to cause about 6 million years of life lost annually. The burden of rheumatic heart disease disproportionately affects populations from developing countries. In terms of estimated global mortality, GABHS is one of the top 10 pathogens, behind HIV infection and malaria and ahead of tetanus and pertussis. […] GABHS pharyngitis is most common in individuals aged 5-15 years, although adults may also acquire the disease. Streptococcal pharyngitis is very uncommon in children younger than 3 years with the exception of children with risk factors such as an older close or household contact with GAS infection.

• #1 Incidence, causes, severity and treatment of throat discomfort: a four-region online questionnaire survey | BMC Ear, Nose and Throat Disorders | Full Text

  https://bmcearnosethroatdisord.biomedcentral.com/articles/10.1186/1472-6815-12-9

  Acute sore throat is commonly associated with viral infections. […] The aim of the current study was to investigate the incidence, causes, and degree of suffering associated with throat discomfort across four markets, and to better understand how these influence the attitudes and behaviour of consumers with regard to OTC therapies and other management approaches. […] A high proportion of respondents experienced one or more instances of throat discomfort in the previous 12 months, with an overall incidence of 54%. […] Infections including the common cold/influenza and other bacteria/viruses were commonly perceived causes of throat discomfort (72% and 46%, respectively). […] As the majority of sore throats are not of bacterial origin, the National Institute for Health and Clinical Excellence (NICE) and other international health authorities, recommend that antibiotics should not be used for primary treatment.

• #1 Treatment of acute sore throat in Malaysia: A consensus of multidiscip | IDR

  https://www.dovepress.com/treatment-of-acute-sore-throat-in-malaysia-a-consensus-of-multidiscipl-peer-reviewed-fulltext-article-IDR

  Sore throat (also known as pharyngitis) encompasses a burning, scratchy, or painful sensation in the throat, which is one of the most frequent reasons for seeking medical care. The incidence of sore throat is ubiquitous across the globe. Studies estimate that adults experience on average 13.5-14.4 episodes of sore throat per 100 patient-years, while children are more susceptible, enduring up to 82.2-82.5 episodes per 100 patient-years. Sore throat is typically a recurring condition; 48% of patients who experience sore throat and seek medical care report that they experienced sore throat 3-4 times a year, with each episode lasting for 2-5 days. Acute sore throat is a distressing condition, as 70% of patients will experience moderate-severe pain. It disrupts daily life, causing discomfort, difficulty swallowing, sleep disturbances and consequential decreased productivity because patients lack energy and experience difficulty concentrating. […]

• #1 Viral Pharyngitis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/225362-overview

  Each year, pharyngitis is responsible for more than 40 million visits to health care providers. Most children and adults experience 3-5 viral upper respiratory tract infections (including pharyngitis) per year. Approximately 50-80% of pharyngitis symptoms are caused by a variety of viral pathogens. […] Worldwide, acute infections of the respiratory tract are one of the main causes of disease, and most of these are due to viruses. […] Worldwide, viral pharyngitis is one of the most common causes of absence from school or work. The National Ambulatory Medical Care Survey showed that upper respiratory tract infections, including acute pharyngitis, accounted for 200 annual visits to a physician per 1000 population between 1980 and 1996. The vast majority of upper respiratory tract infections are due to viruses. […] Viral pharyngitis affects all races and ethnic groups equally. […] Viral pharyngitis affects both sexes equally. […] Viral pharyngitis affects both children and adults, but it is more common in children.

• #1 Evaluation of acute pharyngitis in adults – UpToDate

  https://www.uptodate.com/contents/evaluation-of-acute-pharyngitis-in-adults/print

  Acute pharyngitis accounts for approximately 12 million ambulatory care visits, or 1 to 2 percent of all ambulatory care visits, in the United States annually. The incidence peaks in childhood and adolescence with approximately 50 percent of all cases occurring before age 18. Among adults, most cases of acute pharyngitis occur by age 40 and incidence declines thereafter. […] The epidemiology, clinical features, and evaluation of acute pharyngitis in adults are reviewed here.

• #1 Sore throat

  https://www.rch.org.au/clinicalguide/guideline_index/sore_throat/

  Viral pharyngitis is the most common cause of sore throat in children […] Group A streptococcus (GAS) is the most frequently implicated bacterial pathogen. It is usually self-limiting, difficult to distinguish from viral infection and empiric antibiotic therapy is not required for most patients […] Children identified to be at high-risk for acute rheumatic fever (ARF) should be treated with antibiotics if they develop a sore throat (irrespective of other clinical features) […] Viral infections are the most common cause of sore throat in children […] Despite periodic surges in the incidence of invasive GAS (iGAS), there is no current evidence that treatment of suspected GAS pharyngitis with antibiotics will prevent invasive disease. However, clinicians are encouraged to consider iGAS in children who present with more severe illness and provide appropriate treatment […] Antimicrobial recommendations may vary according to local antimicrobial susceptibility patterns. Refer to local guidelines.

• #1 Group A Strep | Strep Throat | For Clinicians | GAS | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html

  Humans are the only reservoir for group A strep. It is most common among children 5 through 15 years of age and rare in children younger than 3 years of age. In the United States, group A strep pharyngitis is most common during the winter and spring. […] However, CDC does not track the incidence of group A strep pharyngitis or other non-invasive group A strep infections. CDC tracks invasive group A strep infections through the Active Bacterial Core surveillance (ABCs) program. For information on the incidence of invasive group A strep infections, please visit the ABCs Surveillance Reports website.

• #1 Group A Strep Disease Surveillance and Trends | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/php/surveillance/index.html

  For example, strep throat causes an estimated 5.2 million outpatient visits each year among people younger than 65 years old. […] Group A strep infections can occur any time during the year. However, some infections are more common in the United States in certain seasons: Strep throat and scarlet fever: Winter and spring. […] Acute rheumatic fever incidence is significantly less common in the United States and developed countries compared to less developed countries. […] Worldwide, rheumatic heart disease remains a significant cause of cardiovascular disease and death.

• #1 Sore Throat | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617472/all/Sore_Throat?q=Influenza

  Sore throat is a common complaint year-round, but etiology depends on season and age of patient. […] In winter months, viral agents are more active. […] In spring and fall, postnasal drip from allergic rhinitis is a common cause of throat irritation.

• #1 Pharyngitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0315/p1465.html

  Sore throat is one of the most common reasons for visits to family physicians. While most patients with sore throat have an infectious cause (pharyngitis), fewer than 20 percent have a clear indication for antibiotic therapy (i.e., group A beta-hemolytic streptococcal infection). […] The 2000 National Ambulatory Medical Care Survey found that acute pharyngitis accounts for 1.1 percent of visits in the primary care setting and is ranked in the top 20 reported primary diagnoses resulting in office visits. […] Peak seasons for sore throat include late winter and early spring. […] Transmission of typical viral and GABHS pharyngitis occurs mostly by hand contact with nasal discharge, rather than by oral contact. […] Symptoms develop after a short incubation period of 24 to 72 hours.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Strep-Throat.aspx

  Beta-hemolytic group A streptococcus is easily transmitted by inhalation of organisms in large droplets or by direct contact with respiratory secretions. Strep throat is especially contagious early on in the course of the disease and for the first two weeks after the organism had been acquired unless antibiotic treatment is implemented. The incubation period ranges from 24 to 72 hours. […] There is a serological confirmation of beta-hemolytic group A streptococcus in approximately one in four school-aged children with an acute sore throat. Cases of strep throat usually peak in the late winter and early spring months. […] Most data on strep throat in young adults stems from research in semi-closed populations. Military training camps represent an ideal milieu for streptococcal infections, as a number of young men and women from diverse socioeconomic and ethnic backgrounds are housed in close quarters and subjected to extraordinary physical stress.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9474939/

  Pharyngitis, more commonly known as sore throat, is caused by viral and/or bacterial infections. Group A Streptococcus (Strep A) is the most common bacterial cause of pharyngitis. […] We present a standardized surveillance protocol, including case definitions for pharyngitis and Strep A pharyngitis, as well as case classifications that can be used to differentiate between suspected, probable, and confirmed cases. […] An effective surveillance system for Strep A pharyngitis serves to (1) monitor trends in age- and sex-specific incidence (preferred) or period prevalence of symptomatic Strep A pharyngitis, accounting for season; (2) monitor trends in demographic and clinical characteristics of people with confirmed symptomatic Strep A pharyngitis; and (3) provide estimates of disease burden of Strep A pharyngitis estimates of disease burden.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9474939/

  Standardized case definitions are important for obtaining accurate surveillance data, enabling comparisons of surveillance data across jurisdictions, and monitoring the impact of interventions. […] The selection of surveillance strategies depends on specific epidemiologic and clinical characteristics of the disease outcome of interest, the overall surveillance objectives, surveillance location, services accessibility, and the resources available to conduct surveillance. […] A quality management plan should be written before the start of surveillance to establish and ensure the quality of processes, data, and documentation associated with surveillance activities.

• #1 Universal protocols for Strep A surveillance set to transform research for world-first vaccine

  https://www.thekids.org.au/news–events/news-and-events-nav/2022/september/protocols-for-strep-a-surveillance/

  A global consortium of Group A Streptococcus (Strep A) researchers has launched a series of best practice surveillance protocols designed to unite international research efforts for a world-first Strep A vaccine. […] The surveillance protocols address each of the seven disease endpoints responsible for the majority of the global health and economic burden of Strep A pharyngitis; impetigo; cellulitis; invasive Group A Strep infections; acute rheumatic fever (ARF); rheumatic heart disease (RHD) and acute poststreptococcal glomerulonephritis. […] The new protocols are designed to be used for Strep A surveillance studies throughout the globe, making sure that research studies can be compared with each other, and that results from different populations and different studies can be compiled and analysed together.

• #1 Universal protocols for Strep A surveillance set to transform research for world-first vaccine

  https://www.thekids.org.au/news–events/news-and-events-nav/2022/september/protocols-for-strep-a-surveillance/

  The Kids Research Institute Australia researchers have already put the new pharyngitis protocol into practice, following its recommendations for the design of the Sore Throat Study involving 1050 healthy Australian children. […] Conducted over a 12-month period, this study will evaluate how many children got sore throats, what was the most common cause of a sore throat and how sore throats could change during different seasons of the year, which will help inform how a vaccine could be used to prevent a wide range of illnesses caused by Strep A, Professor Carapetis said. […] Co-Chair of the SAVAC Burden of Disease Working Group that oversaw these protocols, Dr Chris Van Beneden from the US CDC Foundation, said a key aspect of robust surveillance for Strep A involves generating updated regional disease burden estimates and developing platforms for future impact evaluation. […] Given that the disease spectrum associated with Strep A is broad and complex, accurately estimating the global burden of disease is challenging. In particular, current estimates underrepresent the extent of disease in low-and middle-income countries, Dr Van Beneden said.

• #1 Standardisation Of Epidemiological Surveillance Of Group A Streptococcal Pharyngitis – MMGH Consulting

  https://www.mmglobalhealth.org/publications/standardisation-of-epidemiological-surveillance-of-group-a-streptococcal-pharyngitis/

  Pharyngitis, more commonly known as sore throat, is caused by viral and/or bacterial infections. Group A Streptococcus (Strep A) is the most common bacterial cause of pharyngitis. […] We present a standardised surveillance protocol, including case definitions for pharyngitis and Strep A pharyngitis, as well as case classifications that can be used to differentiate between suspected, probable, and confirmed cases. […] The type of surveillance methodology depends on the resources available and the objectives of surveillance. Active surveillance and laboratory confirmation is the preferred method for case detection. […] Participant eligibility, the surveillance population and additional considerations for surveillance of pharyngitis are addressed, including baseline sampling, community engagement, frequency of screening and season. Finally, we discuss the core elements of case report forms for pharyngitis and provide guidance for the recording of severity and pain associated with the course of an episode.

• #1 Missing Piece Study protocol: prospective surveillance to determine the epidemiology of group A streptococcal pharyngitis and impetigo in remote Western Australia | BMJ Open

  https://bmjopen.bmj.com/content/12/4/e057296

  Group A -haemolytic Streptococcus (GAS), a Gram-positive bacterium, causes skin, mucosal and systemic infections. […] Aboriginal and Torres Strait Islander peoples in Australia have the highest rates of ARF and RHD in the world. Despite this, the contemporaneous prevalence and incidence of GAS pharyngitis and impetigo in remote Australia remains unknown. […] The Missing Piece Study aims to document the epidemiology of GAS pharyngitis and impetigo through collection of clinical, serological, microbiological and bacterial genomic data among remote-living Australian children. […] The study objectives are to: Determine the prevalence and incidence of laboratory-confirmed GAS pharyngitis and impetigo in remote-living school children aged 5-15 years. […] A well-designed prospective surveillance programme with predefined research questions, using feasible clinical assessment methodologies, provides a platform to concurrently study the epidemiology of GAS pharyngitis and impetigo, and explore additional pathogenesis and molecular epidemiology questions of interest.

• #1 Sore Throat Study – ASAVI

  https://www.asavi.org.au/get-involved/sore-throat-study/

  The Sore Throat Study is looking for healthy children and young people to take part in a new study investigating sore throats, also known as pharyngitis, and how best to prevent them. […] This study is an important step towards creating a vaccine against sore throats caused by Strep A, so that we can prevent other, more serious diseases caused by the bacteria. […] Strep A infections are a major cause of illness and death throughout the world each year. […] Taking part in the Sore Throat Study will help researchers learn more about: how many children get sore throats, what is the most common cause of sore throat in children, how sore throats can change during different seasons of the year, how a vaccine could be used to prevent sore throats caused by Strep A bacteria. […] The information collected will provide researchers with the necessary information needed to proceed with Strep A vaccine trials in both Melbourne and Perth.

• #1 The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9124702/

  The World Health Organization cites Strep A sore throat as one of several preferred clinical indications for vaccines. […] Our global estimate of 288.6 million episodes of Strep A sore throat among children aged 514 years is lower than the global estimate of 446 million episodes among children 514 years published in 2005. […] This study suggests that estimating the DALYs caused by all Strep A clinical manifestations could significantly increase our understanding of the burden of Strep A and provide evidence for the importance of Strep A sore throat as a clinical indicator for vaccines.

• #1 The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9124702/

  Contemporary data for the global burden of sore throat and group A Streptococcus (Strep A) pharyngitis are required to understand the frequency of disease and develop value propositions for Strep A vaccines. […] The pooled incidence rate, calculated for children only, was 82.2 episodes per 100 child-years (95% CI 25.2286.3, I2 = 100%) for sore throat (7 studies; 7,964 person years) and 22.1 episodes per 100 child-years (95% CI 14.733.1, I2 = 98%) for Strep A sore throat (9 studies; 15,696 person years). […] Strep A sore throat has a considerable global burden. However, methodologically standardised studies are required to quantify that burden, analyse differences in rates between populations, and evaluate the likely impact of future Strep A vaccines. […] We present contemporary estimates for the global burden of Strep A sore throat and first-ever estimates of associated DALYs.

• #1 LSHTM LSHTM Research Online

  https://researchonline.lshtm.ac.uk/5375/

  There were 61 episodes of GAS culture-positive sore throat during the study period equating to an incidence of 14.7 cases per 100 child-years (95% CI, 11.2-18.8). […] The incidence of GCS/GGS culture-positive sore throat was 28.8 cases per 100 child-years (95% CI, 23.9-34.5). […] The molecular epidemiology of pharyngeal GAS in our study differed greatly from that in industrialized nations and this has implications for GAS vaccine clinical research in Fiji and other tropical developing countries.

• #1 Protocol for the systematic review of the epidemiology of superficial Streptococcal A infections (skin and throat) in Australia | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255789

  We have produced a protocol for the comprehensive systematic review of the current literature around superficial group A Streptococcal infections in Australia. […] A rigorous and well-organised search of the current literature will be performed to determine the current and evolving epidemiology of superficial group A Streptococcal infections in Australia. […] Similarly, throat infection, including pharyngitis and tonsillitis are common infections affecting children and young adults and account for approximately 3% of presentations to general practitioners in Australia. […] Pharyngitis is characterised predominately by sore throat and difficulty swallowing. […] sGAS infections disproportionately affect Indigenous, geographically remote and marginalised populations globally. […] The disproportionate disease burden of sGAS infections among Aboriginal and Torres Strait Islander communities in Australia has spurred a range of research initiatives over many years.

• #1 Group A streptococcal (GAS) pharyngitis: A practical guide to diagnosis and treatment | Canadian Paediatric Society

  https://cps.ca/documents/position/group-a-streptococcal

  Group A Streptococcus (GAS) pharyngitis is a common clinical syndrome in primary care, yet controversy remains regarding the best approach to diagnosis and treatment, including the benefits of antibiotics. […] GAS pharyngitis occurs most often in children 5 to 11 years of age and during winter and spring months each year. […] Although the incidence and prevalence of ARF and RHD have decreased significantly in high-income countries, they remain important causes of morbidity and mortality in low- and middle-income countries and in Indigenous populations worldwide. […] In settings where the disease burden is high, interventions to improve living conditions, ensure early diagnosis and treatment of GAS pharyngitis through public and health care provider education, and improve access to medical care have been shown to reduce ARF incidence.

• #1 Treatment of acute sore throat in Malaysia: A consensus of multidiscip | IDR

  https://www.dovepress.com/treatment-of-acute-sore-throat-in-malaysia-a-consensus-of-multidiscipl-peer-reviewed-fulltext-article-IDR

  Viral infections are the primary etiological infectious agents of upper respiratory tract infections (URTIs), although non-infectious reasons can sometimes result in acute sore throats. In Malaysia, a single-center study conducted in the primary care clinic of University Hospital Kuala Lumpur concluded that viral pharyngitis is the commonest form of pharyngitis (64%). Meanwhile, in neighboring Singapore, the National Healthcare Group Polyclinics identified that the prevalence of viral infection in URTI symptoms was 10 times that of bacterial infection. […] […] Despite the fact that non-bacterial infections account for 80% of sore throats, retrospective studies revealed an antibiotic-prescription rate of 68.4% for URTI in private clinics and 28.7% in public hospitals. An in-depth investigation was conducted to analyze the prescriptions issued for URTI at 10 publicly financed primary healthcare clinics in Malaysia. The prescription procedures demonstrated inconsistencies with established standards, which might facilitate the development of resistance. A study on URTI patients (aged above 3 years) found that 29% of cases received inappropriate antibiotic prescription. […]

• #1 Group A Strep Disease Surveillance and Trends | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/php/surveillance/index.html

  CDC tracks invasive group A Streptococcus (group A strep) disease using 2 surveillance systems. […] Rates of serious group A strep disease have been increasing since 2014. […] Preliminary 2023 data indicate the number of serious infections caused by group A strep reached a 20-year high. […] Overall, the number of serious group A strep infections has been increasing in the United States over the past decade. […] The U.S. rates of invasive group A strep disease began increasing in 2014. […] The increase was largest among adults aged 18 through 64 years old, but the rate also increased among older adults. […] Through ABCs, CDC tracks data on group A strep isolate resistance to certain antibiotics. […] Experts estimate that several million cases of non-invasive group A strep infections occur in the United States each year.

• #1 CDC study finds substantial US increase in invasive group A strep infections | CIDRAP

  https://www.cidrap.umn.edu/antimicrobial-stewardship/cdc-study-finds-substantial-us-increase-invasive-group-strep-infections

  A surveillance study of 10 US states shows the incidence of invasive group A Streptococcus (GAS) infection more than doubled from 2013 through 2022, researchers reported yesterday in JAMA. […] The authors of the study say that while that trend has continued, the substantial increase they found over the following decade reflects elevated incidence and outbreaks among groups that have been socially and economically marginalized. […] From 2013 through 2022, surveillance in the 10 states (California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee) identified 21,312 cases of invasive GAS, with 20,247 hospitalizations and 1,981 deaths. […] Incidence of invasive GAS rose from 3.6 per 100,000 in 2013 to 8.2 per 100,000 in 2022. […] The increase in invasive GAS incidence came despite significant decreases during the COVID-19 pandemic, when incidence fell by 73% among children younger than 18 and by 33% among adults 65 and older.

• #1 CDC study finds substantial US increase in invasive group A strep infections | CIDRAP

  https://www.cidrap.umn.edu/antimicrobial-stewardship/cdc-study-finds-substantial-us-increase-invasive-group-strep-infections

  „An increasing prevalence of underlying health conditions associated with invasive GAS likely contributed to rising incidence,” the study authors wrote. […] In the accompanying editorial, Osowicki and Theresa Lamagni, MSc, PhD, of the United Kingdom Health Security Agency note that increases in invasive GAS have also been reported in other high-income countries, particularly in the immediate wake of COVID-19. […] They also suggest that the increase in incidence might even be greater, since the ABC surveillance system doesn’t include 8 of the 10 poorest US states. […] „Overall, the theme of this US invasive GAS disease update looks to be a backward slide in the social determinants of invasive GAS, most evident in, but not limited to, disadvantaged and marginalized populations in the US,” Osowicki and Lamagni wrote. […] Whatever is driving the increase in invasive GAS incidence, the study authors say it requires urgent attention.

• #1 Scarlet Fever: A Deadly History and How it Prevails

  https://asm.org/articles/2023/january/scarlet-fever-a-deadly-history-and-how-it-prevails

  Since September 2022, there has been a significant outbreak of scarlet fever in children in Europe, and more recently, there have been documented increases in cases in the U.S. […] Importantly, antimicrobial susceptibility test results from routine laboratory surveillance in England did not demonstrate any increased antibiotic resistance among S. pyogenes organisms, indicating that drug resistance is not responsible for increased virulence or spread of the organism in the current outbreak. […] Expanded surveillance and research are needed to understand these outbreaks, but the pathogenesis and epidemiology of the disease provide additional context clues. […] The Centers for Disease Control (CDC) estimates that in the last 5 years, 14,000 to 25,000 cases of invasive group A strep disease have occurred in the U.S. and that 1,500-3,000 people die yearly from these infections. It is imperative that data on the prevalence of disease are reported to public health agencies regularly and surveillance is performed at the public health level. […] WHO recommends continued surveillance and advises healthcare providers to maintain a high level of suspicion for group A strep-related diseases, as identifying and treating these infections early may prevent invasive Streptococcal disease and other serious downstream outcomes.

• #1 2023 News Archive: Update on Group A streptococcus – Health Protection Surveillance Centre

  https://www.hpsc.ie/news/newsarchive/2023newsarchive/title-22663-en.html

  There has been an increase in notified invasive Group A Streptococcus (iGAS) infections in Ireland since October 2022. […] Between 2nd October 2022 and 10th June 2023, 384 cases of iGAS were notified in Ireland. […] Data from 2023 indicate that the number of iGAS cases continues to remain at higher levels than expected, with 305 cases notified in the first five months compared with an average of 67 cases during the pre-pandemic years 2017-2019. […] Since October 2022, there have been 12 deaths in children (10 in children aged under 10 years old and two in children aged 10-17 years) and 13 in adults (age range, 46-96 years). […] Whilst iGAS infections are still uncommon, there has been an increase in cases this year reported in Ireland since October 2022, particularly in children under 10 and sadly, a small number of deaths.

• #1 Incidence, causes, severity and treatment of throat discomfort: a four-region online questionnaire survey | BMC Ear, Nose and Throat Disorders | Full Text

  https://bmcearnosethroatdisord.biomedcentral.com/articles/10.1186/1472-6815-12-9

  The common cold/influenza was perceived to be the most common cause of throat discomfort across the countries surveyed although environmental and physical factors were also major perceived causes. […] Infections with bacteria/viruses and the common cold/influenza were classified as causing the highest degree of suffering across the countries. […] These data demonstrate that, in the mind of the consumer, throat irritation and discomfort may have a variety of perceived causes that can be broadly divided into three categories: the first category being caused by infections (e.g. caused by cold/influenza, bacterial/viral infection), the second being caused by environmental factors (e.g. allergy/hay fever, passive smoking, pollution, temperature, etc.), and the third a result of self-induced/physical factors (e.g. smoking, drinking, shouting, etc.).

• #1 Group A Streptococcus Treatment and Management

  https://www.uspharmacist.com/article/group-a-streptococcus-treatment-and-management

  Streptococcal pharyngitis, also referred to as strep throat, is one of the most common upper respiratory infections in school-age children and young adults. In the United States, strep throat accounts for approximately 12 million visits annually in outpatient care settings. […] GAS is the most common bacterial cause of streptococcal pharyngitis in children and young adults and peaks in winter and early to mid spring. GAS pharyngitis is also more common in children or in friends and families with a direct relation to school-age children. […] A recent meta-analysis showed that the prevalence of GAS pharyngitis in children aged younger than 5 years was 24%; in those aged younger than 18 years who presented to an outpatient center for treatment, it was 37%. […] Many regions of the world with low income and poor infrastructure continue to suffer a high burden of S pyogenes diseases, with millions of deaths annually.

• #1 Pharyngitis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/lecture/uriphyn.htm

  Pharyngitis (sore throat) is a common disease resulting in over 15 million physician office visits each year in the US. Most cases of pharyngitis are caused by viruses. […] Pharyngitis is common worldwide. […] Pharyngitis due to S pyogenes is usually a disorder of children aged 5-15 years. […] In temperate climates, it is most common during winter and early spring. […] Viruses are the most common cause of pharyngitis. […] With few exceptions (e.g., diphtheria) pharyngitis is benign and self-limiting. […] Viral pharyngitis is acquired by person-to-person contact and following contact with contaminated fomites. […] S pyogenes is transmitted by person-to-person contact. […] N gonorrhoeae is transmitted by oral sex with fellatio being a more common means of transmission than cunnilingus.

• #1 Streptococcal – Group A Infections | South Dakota Department of Health

  https://doh.sd.gov/diseases/streptococcal-group-a-infections/

  The most common clinical illness produced by GAS is sore throat („strep throat”). […] GAS pharyngitis and skin infections are more common in school-aged children than in adults except during epidemics. […] The incubation period of GAS pharyngitis is 2-5 days. […] Patients with uncomplicated GAS pharyngitis, who are not treated with antibiotics, can transmit the bacteria for weeks or months. […] During outbreaks, or if there is an indication of acute rheumatic fever, kidney infection, streptococcal toxic shock or other complication, asymptomatic household contacts should be cultured.

• #1 Epidemiology – ASAVI

  https://www.asavi.org.au/our-work/epidemiology/

  Thats why our Sore Throat Study is seeking to establish baseline epidemiology of Strep A pharyngeal infection (sore throats caused by bacteria). […] Our study aims to determine the incidence rates of bacterial sore throats in our community. Rates will be based on culture positive serologically proven Strep A infections. […] The point of care testing device will play a major role in the Sore Throat Study. […] The study offers a unique opportunity to participate in research and contribute to Strep A vaccine development.

• #1 Sore Throat (Clinical Resource)

  https://patient.info/doctor/sore-throat-pro

  Sore throat is a symptom rather than a diagnosis and so estimates of incidence vary. The symptom is in any case likely to be under-reported, as it is often self-limiting and a clinician may not be consulted. […] Sore throats are usually due to a viral infection. Viruses commonly implicated include rhinovirus, coronavirus, influenza and parainfluenza viruses and adenovirus. In many cases, a sore throat is associated with the common cold. It may also be a symptom of influenza, or of infectious mononucleosis (glandular fever). […] The most common bacterial agent is Group A beta-haemolytic streptococcus (GABS). In children, it accounts for 20-40% of cases of sore throats; in adults around 10%. Asymptomatic nasal carriage of Group A streptococci is very common, especially in very young children.

• #1 Factsheet – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/other/scarletfever/factsheet/

  Scarlet fever and the other milder infections caused by GAS bacteria are not notifiable in Ireland meaning that healthcare professional do not have to report cases to the national surveillance centre. Because of this the number of cases in Ireland is not known. […] More severe, iGAS diseases are notifiable in Ireland. As of June 2023, there has been an increase in notified iGAS infections in Ireland since October 2022, with data from 2023 suggesting that it continues to remain at a higher level than expected.

• #1 Missing Piece Study protocol: prospective surveillance to determine the epidemiology of group A streptococcal pharyngitis and impetigo in remote Western Australia | BMJ Open

  https://bmjopen.bmj.com/content/12/4/e057296

  To date, primary prevention strategies for ARF and efforts in GAS vaccine development have been based on the concept that ARF is caused solely by GAS pharyngitis. […] In light of these observed low rates of pharyngitis and high rates of impetigo in Aboriginal and Torres Strait Islander populations, primary prevention efforts have been redirected at reducing GAS impetigo. […] Without this prospective surveillance study, we remain at an impasse in our ability to inform the prioritisation of treatment for sore throats, skin sores or both, in remote-living Aboriginal and Torres Strait Islander children.

• #2 Evaluation of acute pharyngitis in adults – UpToDate

  https://www.uptodate.com/contents/evaluation-of-acute-pharyngitis-in-adults/print

  Acute pharyngitis accounts for approximately 12 million ambulatory care visits, or 1 to 2 percent of all ambulatory care visits, in the United States annually. The incidence peaks in childhood and adolescence with approximately 50 percent of all cases occurring before age 18. Among adults, most cases of acute pharyngitis occur by age 40 and incidence declines thereafter. […] The epidemiology, clinical features, and evaluation of acute pharyngitis in adults are reviewed here.

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