Background: Invasive group A streptococcal disease (iGAS) is caused by Streptococcus pyogenes group A bacteria. In 2022, multiple disease alerts for iGAS in the Island Health region, in the context of increased infections in the paediatric population in Europe and the United States, prompted further investigation into local trends. This surveillance study summarizes epidemiological trends of iGAS in the region covered by Island Health, a regional health authority in British Columbia, in 2022.
Methods: In British Columbia, iGAS is a reportable disease; all confirmed cases are reported to the regional authority and the provincial health authority (BC Centre for Disease Control). Island Health's iGAS surveillance system is passive and collects information on cases that are identified through laboratory testing. Surveillance data were summarized for 2022 and compared with historical data from 2017-2021.
Results: In 2022, the incidence rate was 11.4 cases per 100,000 population (n=101), the highest observed rate in the last six years. The median age of cases was 53 years, with a range of 0-96 years, and 64% of cases were male. The highest risk of infection was reported in men 40-59 years of age, with an incidence rate of 21.3 cases per 100,000 population. The most common emm types were emm92 (n=14), emm49 (n=13), and emm83 (n=12). Overall, 85% (n=86) of cases were hospitalized, 21% (n=21) were admitted to the intensive care unit, and 6% (n=6) died.
Conclusion: This study highlights that the incidence of iGAS in the Island Health region continued to increase throughout the coronavirus disease 2019 (COVID-19) pandemic, reaching its highest annual rate in 2022. In contrast to reports from Europe and the United States, there was no notable increase in infections in the paediatric population. Given the sustained increase in iGAS activity, continued monitoring and description of the epidemiology of these cases on a regular basis is imperative.
This research asks: 'were there any objectively identifiable signals in the words leaders used in the early stages of the Covid-19 pandemic that can be associated with ineffective management of the crisis?' We chose to focus on the leaders of the two English-speaking nations that fared worst and best in the pandemic, the United States and New Zealand. By way of background and in order to contextualise the research, we compared and contrasted Trump's and Ardern's leaderships using the toxic triangle framework of destructive leadership. We then focused on the leader behaviour element of the triangle by using computerised text analysis (CTA) to analyse Trump's and Ardern's public pronouncements during the critical early stages of the pandemic. Based on a similarity index (S), we identified linguistic markers associated with destructive leader behaviours and negative outcomes (Trump) and non-destructive leader behaviours and positive outcomes (Ardern). We discuss future applications of these linguistic markers for the diagnosis both of incumbent and potential leaders' responses to crises management.
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