Highest Strep A incidence has shifted to the second most affluent group

Measures introduced to reduce transmission of COVID-19 infections during 2020–2021 suppressed transmission of group A streptococcal (GAS) infections, particularly in children. Following the lifting of public health restrictions in the U.K. in February 2022, Group A Streptococcus presentations—including scarlet fever and invasive Group A Strep—rose significantly in England, although iGAS still remained very rare.
After a period of high incidence in December 2022, scarlet fever notifications are now in line with what is expected at this time of year. However, iGAS notifications remain slightly higher than normally seen at this point in the season.
New research by UKHSA presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15–18 April) shows that while no new strains emerged in 2022, emm1, which is more likely to cause severe disease, was more common than in previous years.
Analysis of the populations impacted by the increase in infections found that pre-pandemic, iGAS incidence was higher in the most deprived quintiles, but post-pandemic, the highest was in the second-most affluent quintile. Further research is needed to understand the reasons for this.
Provided by European Society of Clinical Microbiology and Infectious Diseases