207748 Active surveillance of invasive group A streptococcus and emm typing in New Mexico, 2004-2007

Tuesday, November 10, 2009: 3:35 PM

Kathy Angeles, MPH , Institute for Public Health, University of New Mexico, Las Cruces, NM
Joseph C. Bareta, MS , Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, NM
Melanie de Boer, PhD , Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, NM
Joan Baumbach, MD, MS, MPH , Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, NM
New Mexico began conducting active, laboratory, population-based surveillance for invasive group A streptococcus (GAS) in 2004 as part of the CDC's Emerging Infections Program (EIP). NM, which shares borders with 5 U.S. states and 2 Mexican states, has the highest percentage of Hispanics (43%) and the third highest of Native Americans in the U.S. From 2004 through 2007, 420 laboratory-confirmed cases of GAS were identified. Morbidity ranged from 4.8 cases per 100,000 population in 2004 to 5.3 per 100,000 population in 2007, slightly higher than reported nationally (3.3, 3.8). Rates were highest among individuals over the age of 64 years (12.3 per 100,000 population), American Indians (9.1 per 100,000 population), and Hispanics (3.9 per 100,000 population). The proportion of cases associated with necrotizing fasciitis was similar to national rates for the first 3 years, but almost doubled (12.9% vs. 6.2%) in 2007. Eighty-four percent of cases were hospitalized, with a median length of stay of 7 days (IQ25=4, IQ75=14). Seventeen percent of patients died from GAS disease. The 5 most common emm types (1, 76, 3, 12, and 28) accounted for 53% of isolates. This is comparable to national data with the exception of emm type 76. Emm type 76, not seen in 2004 or 2005 in NM, accounted for 3% of isolates in 2006 and 8% in 2007. Further analysis will be conducted to better understand the high incidence rates among the older age-group, Native Americans, Hispanics, and the emergence of emm type 76.

Learning Objectives:
Compare invasive group A streptococcus rates (GAS) and risk factors for New Mexico with other Active Bacterial Core Surveillance (ABCs) sites in the U.S. Describe emerging and commonly found (GAS) emm types found in New Mexico and their association with age, race, ethnicity, disease severity, and common clinical syndromes.

Keywords: Infectious Diseases, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Surveillance Officer for the New Mexico Emerging Infections Program, and have been conducting active surveillance and epidemiologic analysis for invasive group A streptococcus for the past 5 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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