Paediatric Active Enhanced Disease Surveillance (PAEDS) 2019: Prospective hospital-based surveillance for serious paediatric conditions

Introduction: The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is an Australian hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine preventable diseases and potential adverse events following immunisation (AEFI). This report presents surveillance data for 2019. Methods: Specialist nurses screened hospital admissions, emergency department records, laboratory and other data on a daily basis in seven paediatric tertiary referral hospitals across Australia, to identify children with the conditions under surveillance. Standardised protocols and case definitions were used across all sites. In 2019, the conditions under surveillance comprised: acute flaccid paralysis (AFP; a syndrome associated with poliovirus infection), acute childhood encephalitis (ACE), influenza, intussusception (IS; a potential AEFI with rotavirus vaccines), pertussis, varicella-zoster virus infection (varicella and herpes zoster), invasive meningococcal and invasive Group A streptococcus diseases and two new conditions, Kawasaki disease and gram-negative bloodstream infections. An additional social research component continued to evaluate parental attitudes to influenza vaccination. Results: PAEDS captured 2,701 cases for 2019 across all conditions under surveillance. Key outcomes of PAEDS included: contribution to national AFP surveillance to reach the World Health Organization reporting targets for detection of poliomyelitis cases; demonstration of high influenza activity in 2019 and influenza-associated deaths in ACE cases; identification of key barriers to influenza vaccination of children hospitalised for acute respiratory illness; reporting of all IS cases associated with vaccine receipt to relevant state health department; and showing a further reduction nationally in varicella cases. Enhanced pertussis surveillance continued to capture controls to support vaccine efficacy estimation. Invasive meningococcal disease surveillance showed predominance of serotype B and a reduction in cases nationally. Surveillance for invasive group A streptococcus captured severe cases in children. Monitoring of Kawasaki disease incidence and gram-negative bloodstream infections commenced. Conclusions: PAEDS continues to provide unique policy-relevant data on serious paediatric conditions using sentinel hospital-based enhanced surveillance.

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Paediatric Active Enhanced Disease Surveillance (PAEDS) 2017 and 2018: Prospective hospital-based surveillance for serious paediatric conditions

Communicable Diseases Intelligence ◽

10.33321/cdi.2020.44.49 ◽

2020 ◽

Vol 44 ◽

Cited By ~ 2

Author(s):

Jocelynne E McRae ◽

Helen E Quinn ◽

Gemma L Saravanos ◽

Samantha J Carlson ◽

Philip N Britton ◽

...

Keyword(s):

Herpes Zoster ◽

Disease Surveillance ◽

Hospital Admissions ◽

Group A Streptococcus ◽

Parental Attitudes ◽

Vaccine Uptake ◽

World Health ◽

Invasive Group ◽

Rotavirus Vaccines ◽

Group A

Introduction The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine-preventable diseases and potential adverse events following immunisation (AEFI). This report presents surveillance data for 2017 and 2018. Methods Specialist nurses screened hospital admissions, emergency department (ED) records, laboratory and other data on a daily basis in seven paediatric tertiary referral hospitals across Australia to identify children with the conditions under surveillance. In 2017 and 2018 these included acute flaccid paralysis (AFP; a syndrome associated with poliovirus infection), acute childhood encephalitis (ACE), influenza, intussusception (IS; a potential AEFI with rotavirus vaccines), pertussis, varicella-zoster virus infection (varicella and herpes zoster), invasive meningococcal, and invasive Group A streptococcus diseases. An additional social research component was added to evaluate parental attitudes to vaccination. Results PAEDS captured 1,580 and 925 cases for 2017 and 2018, respectively, across all conditions under surveillance. Key outcomes of PAEDS included: contribution to national AFP surveillance to reach the World Health Organization reporting targets; identification of a third human parechovirus outbreak among other infectious diseases linked to ACE; demonstration of variable influenza activity between 2017 and 2018, with vaccine effectiveness (VE) analysis demonstrating that the protection offered through vaccination is season-dependent. All IS cases associated with vaccine receipt were reported to the relevant state health department. Varicella and herpes zoster case numbers remained unchanged, with vaccine uptake found to be suboptimal among eligible children under the NIP. Enhanced pertussis surveillance continues to capture controls for VE estimation. Surveillance for invasive meningococcal disease showed predominance for serotype B at 57% over 2 years among 77 cases where serotyping was available, and surveillance for invasive group A streptococcus captured severe disease in children. Conclusions PAEDS continues to provide unique policy-relevant data on serious paediatric conditions using hospital-based sentinel surveillance.

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Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2016: Prospective hospital-based surveillance for serious paediatric conditions

Communicable Diseases Intelligence ◽

10.33321/cdi.2019.43.5 ◽

2019 ◽

Vol 43 ◽

Cited By ~ 3

Author(s):

Jocelynne.E McRae ◽

Helen.E Quinn ◽

Gemma.L Saravanos ◽

Alissa McMinn ◽

Philip N Britton ◽

...

Keyword(s):

Public Health ◽

Emergency Department ◽

Herpes Zoster ◽

Disease Surveillance ◽

Acute Flaccid Paralysis ◽

Group A Streptococcus ◽

Invasive Group ◽

Varicella Zoster ◽

Vaccine Preventable Diseases ◽

Group A

Introduction The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine preventable diseases and potential adverse events following immunisation (AEFI). PAEDS data is used to better understand these conditions, inform policy and practice under the National Immunisation Program, and enable rapid public health responses for certain conditions of public health importance. PAEDS enhances data available from other Australian surveillance systems by providing prospective, detailed clinical and laboratory information on children with selected conditions. This is the third annual PAEDS report, and presents surveillance data for 2016. Methods Specialist nurses screened hospital admissions, emergency department records, laboratory and other data, on a daily basis in 5 paediatric tertiary referral hospitals in New South Wales, Victoria, South Australia, Western Australia and Queensland to identify children with the conditions under surveillance. Retrospective data on some conditions was also captured by an additional hospital in the Northern Territory. Standardised protocols and case definitions were used across all sites. Conditions under surveillance in 2016 included acute flaccid paralysis (AFP) (a syndrome associated with poliovirus infection), acute childhood encephalitis (ACE), influenza, intussusception (IS; a potential AEFI with rotavirus vaccines), pertussis, varicella-zoster virus infection (varicella and herpes zoster), invasive meningococcal and invasive Group A streptococcus diseases. Most protocols restrict eligibility to hospitalisations; Emergency Department (ED) only presentations are also included for some conditions. Results In 2016, there were 673 cases identified across all conditions under surveillance. Key outcomes of PAEDS included: contribution to national AFP surveillance to reach World Health Organization (WHO) reporting targets; identification of the leading infectious causes of acute encephalitis which included human parechovirus, influenza, enteroviruses, Mycoplasma pneumoniae, and bacterial meningo-encephalitis; demonstration of high influenza activity with vaccine effectiveness (VE) analysis demonstrating some protection offered through vaccination. All IS cases associated with vaccine receipt were reported to the relevant state health department. Varicella and herpes zoster case numbers increased from previous years associated with suboptimal vaccination in up to 40% of cases identified. Pertussis surveillance continued in 2016 with the addition of test negative controls captured for estimating vaccine effectiveness. Surveillance for invasive meningococcal disease showed predominance for serotype B in absence of immunisation, and new invasive group A streptococcus surveillance captured severe disease in children. Conclusions PAEDS continues to provide unique policy-relevant data on serious paediatric conditions using hospital-based sentinel surveillance. Keywords: paediatric, surveillance, child, hospital, vaccine preventable diseases, adverse event following immunisation, acute flaccid paralysis, encephalitis, influenza, intussusception, pertussis, varicella zoster virus, meningococcal, group A streptococcus.

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Invasive group A Streptococcus disease in Australian children: 2016 to 2018 – a descriptive cohort study

BMC Public Health ◽

10.1186/s12889-019-8085-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Jane Oliver ◽

◽

Elise Thielemans ◽

Alissa McMinn ◽

Ciara Baker ◽

...

Keyword(s):

Disease Surveillance ◽

Vaccine Development ◽

Group A Streptococcus ◽

Invasive Disease ◽

Incidence Rates ◽

Surveillance Systems ◽

Invasive Group ◽

Australian State ◽

Life Threatening ◽

Group A

Abstract Objectives Invasive group A Streptococcus (iGAS) disease is serious and sometimes life-threatening. The Paediatric Active Enhanced Disease Surveillance (PAEDS) Network collects voluntary notifications from seven major Australian paediatric hospitals on patients with certain conditions, including iGAS disease. Our aims were to: 1) Describe the epidemiological distribution of paediatric iGAS disease in Australia and correlate this with influenza notifications, 2) Identify GAS strains commonly associated with invasive disease in children. Methods IGAS and influenza notification data were obtained (from the PAEDS Network and the Australian Institute of Health and Welfare, respectively, for the period 1 July 2016 to 30 June 2018). Included iGAS patients had GAS isolated from a normally sterile body site. Data were described according to selected clinical and demographic characteristics, including by age group and Australian State, with proportions and minimum incidence rates estimated. Results A total of 181 patients were identified, with most (115, 63.5%) <5 years old. The mean annual minimum incidence rate was 1.6 (95% confidence interval: 1.1–2.3) per 100,000 children across the study period. An epidemiological correlation with the seasonal burden of influenza was noted. Contact prophylaxis was not consistently offered. Of 96 patients with emm-typing results available, 72.9% showed emm-1, −4 or − 12. Conclusions Robust surveillance systems and cohesive patient management guidelines are needed. Making iGAS disease nationally notifiable would help facilitate this. Influenza vaccination may contribute to reducing seasonal increases in iGAS incidence. The burden of disease emphasises the need for ongoing progress in GAS vaccine development.

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A Cluster of Pediatric Invasive Group A Streptococcus Disease in Melbourne, Australia, Coinciding with a High-Burden Influenza Season

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1677456 ◽

2019 ◽

Vol 14 (04) ◽

pp. 213-218 ◽

Cited By ~ 2

Author(s):

Nicole X. Wong ◽

Nigel W. Crawford ◽

Jane Oliver ◽

Alissa McMinn ◽

Natasha S. Ching ◽

...

Keyword(s):

Disease Surveillance ◽

Group A Streptococcus ◽

Disease Incidence ◽

Surveillance Network ◽

Invasive Group ◽

Respiratory Tract Illnesses ◽

Group A ◽

Viral Testing ◽

Influenza Illness ◽

Prospective Monitoring

Background Invasive group A streptococcal disease (IGAS) carries significant morbidity and mortality in children. Fluctuations in disease incidence are well documented. However, the modulating factors that contribute to these changes remain unclear. Prospective monitoring of IGAS cases in Victoria, Australia, showed an increased number of cases in 2017, coinciding with a peak of influenza illness. Methods Children identified to have IGAS are prospectively monitored in Melbourne through a disease surveillance network. Data on their presentation, investigations, and clinical course are collected. An increased number of cases identified between June 1, 2017, and October 31, 2017, have been retrospectively analyzed. Results We identified 22 cases of pediatric IGAS during the study period. Increased case detection occurred during a period of increased influenza disease. Of 11 children in our cohort who underwent respiratory viral testing, 4 were confirmed to have concurrent respiratory tract illnesses, and 2 were confirmed to have influenza.

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Bilateral periorbital necrotising fasciitis associated with invasive group: a Streptococcus infection

BMJ Case Reports ◽

10.1136/bcr-2020-236800 ◽

2020 ◽

Vol 13 (12) ◽

pp. e236800

Author(s):

Grace Anne McCabe ◽

Thomas Hardy ◽

Thomas Gordon Campbell

Keyword(s):

Group A Streptococcus ◽

Early Recognition ◽

Skin Grafting ◽

Final Diagnosis ◽

Necrotising Fasciitis ◽

Invasive Group ◽

Group A ◽

Tissue Microscopy ◽

Periorbital Swelling ◽

Multidisciplinary Teamwork

A previously independent 56-year-old immunocompetent woman presented with septic shock in the setting of periorbital swelling and diffuse infiltrates on chest imaging. Blood cultures were positive for growth of group A Streptococcus (GAS). Broad spectrum antimicrobials were initiated with the inclusion of the antitoxin agent clindamycin. Necrosis of periorbital tissue was noted and surgical consultation was obtained. Débridement of both eyelids with skin grafting was performed. GAS was isolated from wound cultures and also observed on periorbital tissue microscopy. The final diagnosis was bilateral periorbital necrotising fasciitis (PONF) associated with invasive GAS infection. The patient had a prolonged intensive care unit course with input from multiple specialist teams. This case demonstrates the importance of early recognition and treatment of PONF, the profound systemic morbidity caused by these infections, and illustrates successful multidisciplinary teamwork.

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Concurrent neonatal and maternal sepsis due to invasive group A Streptococcus infection within 48 hours of birth

Journal of Paediatrics and Child Health ◽

10.1111/jpc.15357 ◽

2021 ◽

Author(s):

Lindsey Ross ◽

James Tong

Keyword(s):

Group A Streptococcus ◽

Invasive Group ◽

Group A ◽

Maternal Sepsis

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Increased expression of ska gene in emm49-genotyped strains of Streptococcus pyogenes isolated from patients of severe invasive group A streptococcus infections

International Congress Series ◽

10.1016/j.ics.2005.08.053 ◽

2006 ◽

Vol 1289 ◽

pp. 203-206 ◽

Cited By ~ 1

Author(s):

Tadayoshi Ikebe ◽

Haruo Watanabe

Keyword(s):

Streptococcus Pyogenes ◽

Group A Streptococcus ◽

Invasive Group ◽

Group A

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Sequential Quadriplex Real-Time PCR for Identifying 20 Common emm Types of Group A Streptococcus

Journal of Clinical Microbiology ◽

10.1128/jcm.01764-20 ◽

2020 ◽

Vol 59 (1) ◽

pp. e01764-20

Author(s):

Srinivasan Velusamy ◽

Katherine Jordak ◽

Madeline Kupor ◽

Sopio Chochua ◽

Lesley McGee ◽

...

Keyword(s):

Real Time ◽

Real Time Pcr ◽

Group A Streptococcus ◽

High Specificity ◽

The United States ◽

Rapid Identification ◽

Invasive Group ◽

Outbreak Investigations ◽

Group A ◽

Culture Negative

ABSTRACTWe developed a sequential quadriplex real-time PCR-based method for rapid identification of 20 emm types commonly found in invasive group A Streptococcus (iGAS) strains recovered through the Centers for Disease Control and Prevention’s Active Bacterial Core surveillance. Each emm real-time PCR assay showed high specificity and accurately identified the respective target emm type, including emm subtypes in the United States. Furthermore, this method is useful for rapid typing of GAS isolates and culture-negative specimens during outbreak investigations.

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The Path to Group A Streptococcus Vaccines: World Health Organization Research and Development Technology Roadmap and Preferred Product Characteristics

Clinical Infectious Diseases ◽

10.1093/cid/ciy1143 ◽

2019 ◽

Vol 69 (5) ◽

pp. 877-883 ◽

Cited By ~ 37

Author(s):

Johan Vekemans ◽

Fernando Gouvea-Reis ◽

Jerome H Kim ◽

Jean-Louis Excler ◽

Pierre R Smeesters ◽

...

Keyword(s):

Research And Development ◽

World Health Organization ◽

Vaccine Efficacy ◽

Group A Streptococcus ◽

World Health ◽

Product Characteristics ◽

Technology Roadmap ◽

Development Technology ◽

Group A ◽

Health Organization

Abstract Group A Streptococcus (GAS) infections result in a considerable underappreciated burden of acute and chronic disease globally. A 2018 World Health Assembly resolution calls for better control and prevention. Providing guidance on global health research needs is an important World Health Organization (WHO) activity, influencing prioritization of investments. Here, the role, status, and directions in GAS vaccines research are discussed. WHO preferred product characteristics and a research and development technology roadmap, briefly presented, offer an actionable framework for vaccine development to regulatory and policy decision making, availability, and use. GAS vaccines should be considered for global prevention of the range of clinical manifestations and associated antibiotic use. Impediments related to antigen diversity, safety concerns, and the difficulty to establish vaccine efficacy against rheumatic heart disease are discussed. Demonstration of vaccine efficacy against pharyngitis and skin infections constitutes a key near-term strategic goal. Investments and collaborative partnerships to diversify and advance vaccine candidates are needed.

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