Abstract
Group A Streptococcus (Strep A) is a common cause of sore throats and skin infections in children, and in rare cases, it can trigger acute rheumatic fever (ARF), an immune-mediated condition. The severe complication of ARF is rheumatic heart disease (RHD), that can lead to heart failure, stroke, and premature death. While the majority of the 46 million RHD cases are found in low- and middle-income countries, ARF/RHD remains a significant public health issue in Aotearoa New Zealand (NZ), a high-income nation.
During the height of the Covid-19 pandemic, measures like border closures, physical distancing, and mask mandates reduced transmission of many respiratory pathogens, including Strep A. In turn, many countries experienced dramatic reductions in invasive group A streptococcal infections (iGAS). However, as restrictions eased between 2022 and 2023 and social interactions returned to pre-pandemic levels, striking resurgences in iGAS were documented, including in NZ.