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Volume 22, Number 4—April 2016

Hypervirulent emm59 Clone in Invasive Group A Streptococcus Outbreak, Southwestern United States

David M. Engelthaler1Comments to Author , Michael Valentine1, Jolene Bowers, Jennifer Pistole, Elizabeth M. Driebe, Joel Terriquez, Linus Nienstadt, Mark Carroll, Mare Schumacher, Mary Ellen Ormsby, Shane Brady, Eugene Livar, Del Yazzie, Victor Waddell, Marie Peoples, Kenneth Komatsu, and Paul Keim
Author affiliations: Translational Genomics Research Institute, Flagstaff, Arizona, USA (D. Engelthaler, M. Valentine, J. Bowers, E.M. Driebe, P. Keim); Arizona Department of Health Services, Phoenix, Arizona, USA (J. Pistole, S. Brady, E. Livar, V. Waddell, K. Komatsu); Northern Arizona Healthcare, Flagstaff (J. Terriquez, L. Nienstadt, M. Carroll); Coconino County Public Health Services District, Flagstaff (M. Schumacher, M.E. Ormsby, M. Peoples); Navajo Division of Health, Window Rock, Arizona, USA (D. Yazzie); Northern Arizona University, Flagstaff (P. Keim)

Main Article


Epidemiologic data for 18 case-patients with invasive emm59 group A Streptococcus infection, Arizona, USA, 2015*

Category Value
American Indian or Alaskan Native 15 (83)
3 (7)
F 4 (22)
14 (88)
Mean age, y (range)
40 (26–79)
Clinical information
Cellulitis 7 (39)
Necrotizing fasciitis 5 (28)
9 (50)
Risk factors
Injury 7 (39)
Alcohol abuse 10 (56)
Homeless 8 (44)
Living in shelter 5 (28)
Local jail term within ≈1 mo. of diagnosis 6 (33)

*Values are no. (%) patients except as indicated. Epidemiologic data based on available information.

Main Article

1These authors contributed equally to this article.

Page created: March 16, 2016
Page updated: March 16, 2016
Page reviewed: March 16, 2016
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