Oral Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

Public health response to an evolving Group A Streptococcal landscape in England (#116)

Theresa Lamagni 1 , R. Mearkle 2 , Laura Bubba 3 , V. Watts 2 , M. Saavedra-Campos 2 , R. Guy 1 , D. Ready 4 , V. Chalker 4 , Juliana Coelho 4 , A. Al-Shahib 5 , V. Saliba 6 , S. Balasegaram 2 , M. Chand 7 , A. Johnson 1
  1. Healthcare-Associated Infection & Antimicrobial Resistance Department, National Infection Service, Public Health England, London, LONDON, United Kingdom
  2. Field Epidemiology Service, National Infection Service, Public Health England, London, United Kingdom
  3. European Programme for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden
  4. Respiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, United Kingdom
  5. Infectious Disease Informatics, National Infection Service, Public Health England, London, United Kingdom
  6. Immunisation, Hepatitis & Blood Safety Department, National Infection Service, Public Health England, London, United Kingdom
  7. Reference Department Microbiology Services Division, National Infection Service, Public Health England, London, United Kingdom

The past three years have seen a succession of group A streptococcal (GAS) threats, challenging our public health response. The continuation of the scarlet fever epidemic, with each year seeing successive increases in incidence, has proven particularly demanding for local public health teams; over 17,000 notifications, 1000 hospital admissions and 600 outbreaks were recorded in England in 2016. Work continues to identify the drivers for the rise in England, the only country outside the Far East to report a resurgence to date, and to assess the wider impact and determinants of incidence. Reform of our guidelines for management of scarlet fever outbreaks in schools/nurseries is currently underway following feedback from local public health teams. Guidelines for management of community invasive GAS infection are also under review, stimulating new research to assess risk in care home residents and household contacts. Changes in the epidemiology of invasive disease were noted in 2016/2017. Two large outbreaks in homeless/drug injecting populations have been seen, with initially localised epicentres of transmission progressing to dissemination across the country. An overall elevation in incidence was observed during 2016, currently subject to further investigation.