ABSTRACT
Group A beta hemolytic streptococci (GABHS) cause a wide variety of infectious and postinfectious diseases ranging from the relatively benign to the very serious. Tissue-invasive forms of the disease, such as necrotizing fasciitis have a high mortality but are relatively uncommon. Pyoderma and pharyngitis are very common and can be debilitating but, in themselves, are not of major concern. Nevertheless, strep pharyngitis has been estimated to cost the U.S. economy up to $2 billion per annum. However, these conditions can give rise to serious postinfectious diseases, rheumatic fever (RF), rheumatic heart disease (RHD), and glomerulonephritis. Untreated, between 0.3% and 3% of streptococcal pharyngitis can lead to RF and this figure can increase to up to 50% among individuals who have experienced a previous episode of RF/RHD [1]. World Health Organization (WHO) estimates that of the approximate 50 million people who die every year, 500,000 die as a result of RF/RHD [2]. This number may be an underestimate.
