Surveillance

CDC estimates that approximately 11,000 to 13,000 cases of invasive group A strep disease, like cellulitis with blood infection, pneumonia, and necrotizing fasciitis, occur each year in the United States. Each year between 1,100 and 1,600 people die due to invasive group A strep disease. In contrast, there are estimated to be several million cases of non-invasive group A strep illnesses, like strep throat and impetigo, each year. Some complications of group A strep infections, like post-streptococcal glomerulonephritis (PSGN) and acute rheumatic fever, are rare.

Globally, the burden from group A strep infections is even greater. For example, the World Health Organization estimates:

• 111 million children in the developing world have impetigo¹
• 470,000 new cases of acute rheumatic fever occur each year¹
• 282,000 new cases of rheumatic heart disease occur each year¹
• 15.6 million persons have rheumatic heart disease¹

Surveillance Systems

CDC does not track non-invasive group A strep infections.

CDC tracks invasive group A strep infections through Active Bacterial Core surveillance (ABCs), a population-based, active- and laboratory-based surveillance system. This means local and state health departments routinely contact laboratories to identify all cases, then report those cases to CDC.

Only streptococcal toxic shock syndrome is currently a nationally reported disease. Healthcare providers and laboratories should report cases to the appropriate health department. States then report these cases to CDC through the National Notifiable Diseases Surveillance System (NNDSS).

Disease Trends

Group A strep infections can occur any time during the year, but some infections are more common in the United States in certain seasons:

• Strep throat and scarlet fever are more common in the winter and spring.
• Impetigo is more common in the summer.

Anyone can get a group A strep infection, but some infections are more common in certain age groups:

• Strep throat and scarlet fever are most common in children between the ages of 5 and 15 years.
• Impetigo is most common in children between the ages of 2 and 5 years.

Reference

1. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5(11):685–94.

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