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Volume 22, Number 6—June 2016
Dispatch

Scarlet Fever Upsurge in England and Molecular-Genetic Analysis in North-West London, 2014

Claire E. Turner, Marta Pyzio, Bonita Song, Theresa Lamagni, Margie Meltzer, J. Yimmy Chow, Androulla Efstratiou, Sally Curtis1, and Shiranee SriskandanComments to Author 
Author affiliations: Imperial College London, London, UK (C.E. Turner, M. Pyzio, S. Sriskandan); Imperial College Healthcare NHS Trust, London (B. Song, S. Curtis); Public Health England, London (T. Lamagni, M. Meltzer, J.Y. Chow, A. Efstratiou)

Main Article

Figure

Increase in North-West London scarlet fever notifications and association with emm4 and emm3, 2014. A) Weekly scarlet fever notifications in North-West London during  2009–2014. During  weeks 10–20 (March–May) 2014, the number of notifications substantially increased. B) emm genotyping of 404 upper respiratory tract Streptococcus pyogenes isolates. Isolates were available from March 2009 through May 2014, inclusive; 308 isolates were from 2009–2013; however, of these, 134 were from 2009, and 174

Figure. Increase in North-West London scarlet fever notifications and association with emm4 and emm3, 2014. A) Weekly scarlet fever notifications in North-West London during 2009–2014. During weeks 10–20 (March–May) 2014, the number of notifications substantially increased. B) emm genotyping of 404 upper respiratory tract Streptococcus pyogenes isolates. Isolates were available from March 2009 through May 2014, inclusive. A total of 308 isolates were from 2009–2013; however, of these, 134 were from 2009, and 174 were from 2010–2013, reflecting a fall in submission rates and affecting the availability of strains for study. Thus, isolates from 2009–2013 were considered a single group (January–December) and the following emm-types were identified: emm12 20% (62/308), emm89 16% (48/308), emm1 15% (47/308), emm3 7% (22/308), emm28 6% (19/308), emm4 3% (10/308). A similar pattern was observed during March–May in 2009–2013 (n = 72). A total 96 isolates were available from 2014, all of which were from March–May, submitted following alerts to clinicians regarding scarlet fever activity. During March–May 2014, isolates typed as emm4 increased significantly, from 3% (2/72) to 17% (17/96), (χ2(1df) = 9.478. p = 0.0021). A borderline significant increase occurred in emm3, from 10% (7/72) in 2009–2013 to 20% (20/96) in 2014 (χ2(1df) = 3.766, p = 0.0523). This constituted a 3-fold increase in emm3 and emm4 combined, from 13% in 2009–2013 to 37% in 2014 (March–May).

Main Article

1Current affiliation: Royal Sussex County Hospital, Brighton, UK.

Page created: May 16, 2016
Page updated: May 16, 2016
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