A community cluster of severe group A streptococcal skin infections occurred in Maui, Hawaii with 3 fatal cases of necrotizing fasciitis in 2002. emm types 1, 12, 58, 74, 85 and 109 were identified from 8 patients. emm types 74 and 109 have not been previously described in the United States according to the Centers for Disease Control and Prevention database. The identification of uncommon emm types suggested that group A streptococcal sero-types in Hawaii are different from those in the continental United States and can result in serious disease.
From the Departments of *Pediatrics and †Tropical Medicine and Microbiology, University of Hawaii, John A. Burns School of Medicine, and the ‡State of Hawaii Department of Health, Honolulu, Hawaii
Accepted for publication March 1, 2004.
Supported by grants from the American Heart Association, National Institutes of Health, Research Centers in Minority Institutions (P20RR11091-06) and the Geist Foundation-Hawaii Community Foundation.
Presented at the Eighth Research Centers in Minority Institutions International Symposium on Health Disparities, Honolulu, HI, December 2002.
Address for reprints: Guliz Erdem, MD, Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, Room 755, Honolulu, HI 96826. Fax 808-949-4232; E-mail firstname.lastname@example.org