1 Fort Collins Laboratories, Fort Collins, Colorado
Streptococcal surveillance programs in areas of high endemicity are difficult to maintain due to the high economic costs and excessive laboratory demands based on total number of cultures taken.
Through retrospective analysis of data accumulated from five different surveillance studies carried out by the Streptococcal Disease Section in Colorado, we have been able to devise a new approach to streptococcal surveillance programs.
By utilizing the concept of familial susceptibility and employing crude criteria to define susceptible and nonsusceptible families, we found that S families accounted for 53% to 96% of all group A acquisitions and demonstrated a fourfold to sixfold higher mean prevalence when compared to NS families. Guidelines for setting up a streptococcal surveillance program utilizing these principles are presented. This applied approach can reduce economic costs and laboratory work by 50% to 60% and still maintain effective surveillance of the high-risk segment of the population being studied.