TY - JOUR AU - Watts, Vicky AU - Balasegaram, Sooria AU - Brown, Colin AU - Mathew, Suzanna AU - Mearkle, Rachel AU - Ready, Derren AU - Saliba, Vanessa AU - Lamagni, Theresa T1 - Increased Risk for Invasive Group A Streptococcus Disease for Household Contacts of Scarlet Fever Cases, England, 2011–2016 T2 - Emerging Infectious Disease journal PY - 2019 VL - 25 IS - 3 SP - 529 SN - 1080-6059 AB - The incidence of scarlet fever in England and Wales is at its highest in 50 years. We estimated secondary household risk for invasive group A Streptococcus (iGAS) disease within 60 days after onset of scarlet fever. Reports of scarlet fever in England during 2011–2016 were matched by residential address to persons with laboratory-confirmed iGAS infections. We identified 11 iGAS cases in ≈189,684 household contacts and a 60-day incidence rate of 35.3 cases/100,000 person-years, which was 12.2-fold higher than the background rate (2.89). Infants and contacts >75 years of age were at highest risk. Three cases were fatal; sepsis and cellulitis were the most common manifestations. Typing for 6 iGAS cases identified emm 1.0 (n = 4), emm 4.0 (n = 1), and emm 12.0 (n = 1). Although absolute risk in household contacts was low, clinicians assessing household contacts should be aware of the risk to expedite diagnosis and initiate life-saving treatment. KW - invasive group A streptococcal disease KW - iGAS disease KW - scarlet fever KW - streptococcal infections KW - Streptococcus pyogenes KW - bacteria KW - streptococci KW - respiratory infections KW - household contacts KW - incidence KW - risk KW - England KW - invasive group A Streptococcus disease DO - 10.3201/eid2503.181518 UR - https://wwwnc.cdc.gov/eid/article/25/3/18-1518_article ER - End of Reference