Re-Emerging Diseases- Group a Streptococcal (Gas)

Re-emerging diseases, despite all advances in modern medicine and treatment, still remain the leading cause of death worldwide (National Institute of Allergy and Infectious diseases (NIAID) 2014). Group A Streptococcal (GAS) infections are classified as re-emerging as there has been a recent increase in incidence from this once controlled disease. Due to resurging prevalence, the causing bacteria, associated diseases, transmission modes including specific reference to the paramedic field and global health risks will be reviewed to determine if current control measures are best practise.

GAS infection arise from the Streptococcus pyogenes group A bacteria, a Gram-positive bacteria, which characteristically infects the nose and throat of the human host and can cause a number of different moderate infections including; strep throat, strep infection, scarlet fever, impetigo, tonsillitis, rheumatic fever and cellulitis (1). In more severe cases, GAS bacteria has been shown to become invasive, that is move to areas of the body it is not usually naturally found including deep tissue, muscles and the bloodstream. Invasive GAS infections are rare but cause severe and life-threatening illnesses namely necrotizing fasciitis, streptococcal toxic shock syndrome, meningitis and pneumonia. In 2013 a scarlet fever epidemic in Hong Kong resulted in the infection of four hundred patients and resulted in two fatalities (NIAID 2014) and the United Kingdom is at present dealing with a twenty four year high in scarlet fever incidents. Although scarlet fever is not currently a common infectious disease in Australia, Morens (2004) has highlighted that such an infectious disease can spread globally within a very short time frame. For this reason, scarlet fever is the disease of choice for this review of GAS infection.

Historically, the GAS bacteria were first isolated and associated with the fatal scarlet fever pandemic of 1825-1885 which was the leading cause of childhood deaths...