The epidemiology and natural history of streptococcal pyoderma

An endemic disease of the rural Southern United States

Kenrad Edwin Nelson, Alan L. Bisno, Paul Waytz, Joel Brunt, Vijai K. Moses, Haque Riaz-ul

Research output: Contribution to journalArticle

Abstract

In order to study the natural history of endemic pyoderma. the host and environmental risk factors to infection, the immunologic response and the risk of acute glomerulonephritis (AGN) a prospective study was done between June 29 and December 13, 1970 in 444 black children aged 2-6 years attending project Headstart centers in Holmes County, Mississippi. The weekly prevalence of pyoderma was about 40-50% during July and August but decreased to 4% during the last week of the study. "Pyoderma-type" serotypes of group A streptococci were isolated from about 70% of the skin lesions and similar serotypes were also commonly isolated from the pharynx. The seasonal prevalence and T and M typing pattern of most of the pharyngeal isolates mirrored the skin isolates. Many of the streptococci appear to belong to previously unrecognized M-types and one strain has been designated provisional M type 67 by the International Subcommittee on Pneumococci and Streptococci. Staphylococci were also isolated commonly from the skin lesions, especially late in their evolution. Despite an 80% incidence of streptococcal pyoderma during the summer months, only 3 children (0.67%) developed AGN; all of these children had clinically mild disease. The risk of a major outbreak of AGN in populations like these is substantial. Surveillance for clusters of AGN is indicated and widespread benzathine penicillin prophylaxis should be used in the event of an outbreak. Also, further research to determine the long term prognosis of clinically mild AGN and to detect useful laboratory markers of nephritogenicity are indicated.

Original languageEnglish (US)
Pages (from-to)270-283
Number of pages14
JournalAmerican Journal of Epidemiology
Volume103
Issue number3
StatePublished - Mar 1976
Externally publishedYes

Fingerprint

Pyoderma
Endemic Diseases
Glomerulonephritis
Epidemiology
Streptococcus
Skin
Disease Outbreaks
Penicillin G Benzathine
Mississippi
Pharynx
Streptococcus pneumoniae
Staphylococcus
Biomarkers
Prospective Studies
Incidence
Infection
Research
Population

Keywords

  • Glomerulonephritis
  • Pyoderma
  • Skin diseases
  • Staphylococcal infections
  • Streptococcal infections
  • Streptococcus pyogenes

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Epidemiology

Cite this

The epidemiology and natural history of streptococcal pyoderma : An endemic disease of the rural Southern United States. / Nelson, Kenrad Edwin; Bisno, Alan L.; Waytz, Paul; Brunt, Joel; Moses, Vijai K.; Riaz-ul, Haque.

In: American Journal of Epidemiology, Vol. 103, No. 3, 03.1976, p. 270-283.

Research output: Contribution to journalArticle

Nelson, Kenrad Edwin ; Bisno, Alan L. ; Waytz, Paul ; Brunt, Joel ; Moses, Vijai K. ; Riaz-ul, Haque. / The epidemiology and natural history of streptococcal pyoderma : An endemic disease of the rural Southern United States. In: American Journal of Epidemiology. 1976 ; Vol. 103, No. 3. pp. 270-283.
@article{d8acda3b888844cc9089d4a3df922d7d,
title = "The epidemiology and natural history of streptococcal pyoderma: An endemic disease of the rural Southern United States",
abstract = "In order to study the natural history of endemic pyoderma. the host and environmental risk factors to infection, the immunologic response and the risk of acute glomerulonephritis (AGN) a prospective study was done between June 29 and December 13, 1970 in 444 black children aged 2-6 years attending project Headstart centers in Holmes County, Mississippi. The weekly prevalence of pyoderma was about 40-50{\%} during July and August but decreased to 4{\%} during the last week of the study. {"}Pyoderma-type{"} serotypes of group A streptococci were isolated from about 70{\%} of the skin lesions and similar serotypes were also commonly isolated from the pharynx. The seasonal prevalence and T and M typing pattern of most of the pharyngeal isolates mirrored the skin isolates. Many of the streptococci appear to belong to previously unrecognized M-types and one strain has been designated provisional M type 67 by the International Subcommittee on Pneumococci and Streptococci. Staphylococci were also isolated commonly from the skin lesions, especially late in their evolution. Despite an 80{\%} incidence of streptococcal pyoderma during the summer months, only 3 children (0.67{\%}) developed AGN; all of these children had clinically mild disease. The risk of a major outbreak of AGN in populations like these is substantial. Surveillance for clusters of AGN is indicated and widespread benzathine penicillin prophylaxis should be used in the event of an outbreak. Also, further research to determine the long term prognosis of clinically mild AGN and to detect useful laboratory markers of nephritogenicity are indicated.",
keywords = "Glomerulonephritis, Pyoderma, Skin diseases, Staphylococcal infections, Streptococcal infections, Streptococcus pyogenes",
author = "Nelson, {Kenrad Edwin} and Bisno, {Alan L.} and Paul Waytz and Joel Brunt and Moses, {Vijai K.} and Haque Riaz-ul",
year = "1976",
month = "3",
language = "English (US)",
volume = "103",
pages = "270--283",
journal = "American Journal of Epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - The epidemiology and natural history of streptococcal pyoderma

T2 - An endemic disease of the rural Southern United States

AU - Nelson, Kenrad Edwin

AU - Bisno, Alan L.

AU - Waytz, Paul

AU - Brunt, Joel

AU - Moses, Vijai K.

AU - Riaz-ul, Haque

PY - 1976/3

Y1 - 1976/3

N2 - In order to study the natural history of endemic pyoderma. the host and environmental risk factors to infection, the immunologic response and the risk of acute glomerulonephritis (AGN) a prospective study was done between June 29 and December 13, 1970 in 444 black children aged 2-6 years attending project Headstart centers in Holmes County, Mississippi. The weekly prevalence of pyoderma was about 40-50% during July and August but decreased to 4% during the last week of the study. "Pyoderma-type" serotypes of group A streptococci were isolated from about 70% of the skin lesions and similar serotypes were also commonly isolated from the pharynx. The seasonal prevalence and T and M typing pattern of most of the pharyngeal isolates mirrored the skin isolates. Many of the streptococci appear to belong to previously unrecognized M-types and one strain has been designated provisional M type 67 by the International Subcommittee on Pneumococci and Streptococci. Staphylococci were also isolated commonly from the skin lesions, especially late in their evolution. Despite an 80% incidence of streptococcal pyoderma during the summer months, only 3 children (0.67%) developed AGN; all of these children had clinically mild disease. The risk of a major outbreak of AGN in populations like these is substantial. Surveillance for clusters of AGN is indicated and widespread benzathine penicillin prophylaxis should be used in the event of an outbreak. Also, further research to determine the long term prognosis of clinically mild AGN and to detect useful laboratory markers of nephritogenicity are indicated.

AB - In order to study the natural history of endemic pyoderma. the host and environmental risk factors to infection, the immunologic response and the risk of acute glomerulonephritis (AGN) a prospective study was done between June 29 and December 13, 1970 in 444 black children aged 2-6 years attending project Headstart centers in Holmes County, Mississippi. The weekly prevalence of pyoderma was about 40-50% during July and August but decreased to 4% during the last week of the study. "Pyoderma-type" serotypes of group A streptococci were isolated from about 70% of the skin lesions and similar serotypes were also commonly isolated from the pharynx. The seasonal prevalence and T and M typing pattern of most of the pharyngeal isolates mirrored the skin isolates. Many of the streptococci appear to belong to previously unrecognized M-types and one strain has been designated provisional M type 67 by the International Subcommittee on Pneumococci and Streptococci. Staphylococci were also isolated commonly from the skin lesions, especially late in their evolution. Despite an 80% incidence of streptococcal pyoderma during the summer months, only 3 children (0.67%) developed AGN; all of these children had clinically mild disease. The risk of a major outbreak of AGN in populations like these is substantial. Surveillance for clusters of AGN is indicated and widespread benzathine penicillin prophylaxis should be used in the event of an outbreak. Also, further research to determine the long term prognosis of clinically mild AGN and to detect useful laboratory markers of nephritogenicity are indicated.

KW - Glomerulonephritis

KW - Pyoderma

KW - Skin diseases

KW - Staphylococcal infections

KW - Streptococcal infections

KW - Streptococcus pyogenes

UR - http://www.scopus.com/inward/record.url?scp=0017289321&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017289321&partnerID=8YFLogxK

M3 - Article

VL - 103

SP - 270

EP - 283

JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

SN - 0002-9262

IS - 3

ER -