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It is postulated that the surge in incidence and severity of group A streptococcus (GAS) infections since the 1980s is due to the emergence of strains of GAS with increased virulence. We used active, population-based surveillance of invasive GAS disease, serologically confirmed pharyngitis, and carriage to determine whether particular strains were associated with invasive disease.

Strain Prevalence, Rather than Innate Virulence Potential, Is the Major Factor Responsible for an Increase in Serious Group A Streptococcus Infections