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Vaccine prevention of GAS infections and their immunological complications has been a goal of researchers for decades.
The desire for an effective vaccine arises from the large burden of disease caused by the bacterium, particularly rheumatic fever and rheumatic heart disease.
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) occur at very high rates among Aboriginal and Torres Strait Islander people.
We review GAS transmission characteristics and prevention strategies, historical and geographical trends and report on the estimated global burden disease...
Acute rheumatic fever (ARF) is an important cause of heart disease in Indigenous people of northern and central Australia.
In Australia, rheumatic heart disease (RHD) is almost exclusively restricted to Aboriginal Australian and Torres Strait Islander people with children being...
Globally, ARF and RHD cause more than a quarter of a million deaths and substantial disability each year.
Scabies is one of the world’s most prevalent diseases, with approximately 147 million cases at any one time and an estimated annual incidence of 455 million new episodes. Although Group A streptococcal (GAS) pharyngitis has long been implicated in the pathogenesis of acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD), impetigo caused by GAS has recently been postulated as a link between scabies and the pathogenesis of ARF.
Streptococcus pyogenes, also known as group A streptococcus (StrepA), is a bacterium that causes a range of human diseases, including pharyngitis, impetigo, invasive infections, and post-infection immune sequelae such as rheumatic fever and rheumatic heart disease. StrepA infections cause some of the highest burden of disease and death in mostly young populations in low-resource settings. Despite decades of effort, there is still no licensed StrepA vaccine, which if developed, could be a cost-effective way to reduce the incidence of disease.
Since 1955, the recommended strategy for rheumatic heart disease secondary prophylaxis has been benzathine penicillin G injections administered intramuscularly every 4 weeks. Due to dosing frequency, pain, and programmatic challenges, adherence is suboptimal. It has previously been demonstrated that BPG delivered subcutaneously at a standard dose is safe and tolerable and has favorable pharmacokinetics, setting the scene for improved regimens with less frequent administration.