Epidemiology of severe Streptococcus pyogenes disease in Europe.

Research output: Contribution to journalArticle


The past two decades have brought worrying increases in severe Streptococcus pyogenes diseases globally. To investigate and compare the epidemiological patterns of these diseases within Europe, data on severe S. pyogenes infections were collected through an EU FP-5 funded programme (Strep-EURO). Prospective population-based surveillance of severe S. pyogenes infection diagnosed during 2003 and 2004 was undertaken in eleven countries across Europe (Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Italy, Romania, Sweden, UK) using a standardised case definition. A total of 5522 cases of severe S. pyogenes infection were identified across the eleven countries during this period. Rates of reported infection varied, reaching 3/100,000 population in the northern European countries. Seasonal patterns of infections showed remarkable congruence between countries. Risk of infection was highest among the elderly, with rates being higher in males than females in most countries. Skin lesions/wounds were the most common predisposing factor, reported in 25% of cases; 21% had no predisposing factors reported. Skin and soft tissue was the most common focus of infection, 32% of patients having cellulitis and 8% necrotizing fasciitis. The overall 7-day case fatality rate was 19%, 44% among cases who developed streptococcal toxic shock syndrome. Findings from Strep-EURO confirm a high incidence of severe S. pyogenes disease in Europe. Furthermore, these results have identified targets for public health intervention, as well as raising awareness of severe S. pyogenes disease across Europe.


  • Theresa L Lamagni
  • Jessica Darenberg
  • Bogdan Luca
  • Tuula Siljander
  • Androulla Efstratiou
  • Birgitta Henriques-Normark
  • Jaana Vuopio-Varkila
  • Anne Bouvet
  • Roberta Creti
  • Kim Ekelund
  • Maria Koliou
  • Ralf René Reinert
  • Angeliki Stathi
  • Lenka Strakova
  • Vasilica Ungureanu
  • Claës Schalén
  • Aftab Jasir
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Microbiology in the medical area
Original languageEnglish
Pages (from-to)2359-2367
JournalJournal of Clinical Microbiology
Issue number7
Publication statusPublished - 2008
Publication categoryResearch