Group A Streptococcus

The Group A Streptococcal (GAS) research group focuses on disease caused by “strep”, that is, Streptococcus pyogenes, as well as neglected tropical infections such as scabies. Through a combination of laboratory and field-based investigation, the team aims to investigate and test new diagnostic, treatment and control strategies, and to better understand the immunology and epidemiology of GAS and neglected tropical diseases with a focus on the disease burden in developing countries, especially in the Asia-Pacific region. The group is working toward the development of a global GAS vaccine in collaboration with national and international partners.

GAS causes a wide range of clinical disease, from sore throat and skin sores, to serious invasive infections including toxic shock syndrome, to post-infectious complications such as rheumatic fever / rheumatic heart disease and post-streptococcal glomerulonephritis. Taken together, the diseases caused by GAS are a major cause of death and disability globally, especially in developing countries, leading to more than 500,000 premature deaths each year. Scabies is an important driver of GAS skin infection in tropical settings, and affects over 100 million people worldwide. Scabies was recently added to the World Health Organizations list of Neglected Tropical Diseases.

The group’s broad program of GAS research spans a variety of disciplines including epidemiology, public health, clinical science, and laboratory-based science.

The team is led by Associate Professor Andrew Steer, Theme Director of Infection and Immunity at the Murdoch Children’s Research Institute, Group Leader of the Group A Streptococcal Research Group at the Murdoch Children’s Research Institute, a principal research fellow at the Centre for International Child Health at the University of Melbourne, and paediatric infectious diseases physician in the Department of General Medicine at the Royal Children’s Hospital Melbourne. He is also a founding committee member and current Chair of the International Alliance for the Control of Scabies.

Group Leaders: 
Professor Pierre Smeesters
Role: 
Senior Research Fellow
Dr Samantha Colquhoun
Role: 
Postdoctoral Research Candidate
Dr Daniel Engelman
Role: 
Honorary Research Fellow / PhD Candidate
Ciara Baker
Role: 
Research Assistant
Frances Oppedisano
Role: 
Laboratory Manager
Myra Hardy
Role: 
PhD Candidate
Kristy Azzopardi
Role: 
Research Assistant
Hannah Frost
Role: 
PhD Candidate
Delphine Laho
Role: 
Research Assistant
Sanjeewani Pathirage
Role: 
Research Administration Assistant
Dr Joshua Osowicki
Role: 
PhD Candidate

Mass Drug Administration (MDA) for Scabies and Impetigo in Fiji (NHMRC)
Scabies is a major cause of morbidity in many developing countries and leads to economic disadvantage and reduced quality of life. This study addresses the problem of scabies control in high prevalence countries, through the investigation of the efficacy of two alternative mass drug administration (MDA) regimens in Fiji compared to the current standard of care, which centres on treatment of symptomatic cases and their direct contacts.

Immune Correlates of Protein and cross protection for GAS Vaccines (NHMRC)
New evidence in vaccine research suggests the potential for cross-protection between different strains of GAS, which could lead to development of a vaccine candidate with broader coverage. A correlate of protection is an indication of the level of immunity of an individual, and in this case could be used to determine whether a vaccine has produced immunity in the subject and whether cross-protection is present. This study involves an in-depth look at immune protection from GAS, including the development of new techniques.

Molecular and Clinical Epidemiology of GAS disease in Pacific, Asian and local areas
The streptococcal M protein that is used as the substrate for epidemiological typing is the major virulence factor of Streptococcus pyogenes and is a key vaccine target. There are over 220 variants of this protein described. This project involves collecting data from areas such as Fiji, New Caledonia, Laos and Cambodia with the aim of providing relevant information for vaccine development.

Fiji Islands Rheumatic Heart Disease Control and Prevention (collaboration with Fiji Ministry of Health, Cure Kids New Zealand, Auckland District Health Board)
This project will facilitate the expansion and strengthening of the existing Fiji Rheumatic Heart Disease (RHD) ControlProgram; providing Fiji with new models of Acute Rheumatic Fever (ARF)/RHD care and prevention. It will provide local health professionals and wider stakeholders with the strategies, expertise and tools needed to significantly reduce RHD morbidity and mortality.

Genetic susceptibility of Rheumatic Heart Disease in Fiji and New Caledonia, and in ATSI communities in northern Australia
It is widely believed that three to six per cent of any population is susceptible to developing Acute Rheumatic Fever and RHD. However, the basis of this genetic susceptibility is not known. Funded under separate schemes and with different leading institutions and partners, these projects are evaluating genetic susceptibility to RHD in three endemic settings, Fiji, New Caledonia and northern Australia, using genome wide sequencing methodology.

Screening for Rheumatic Heart Disease
Detection of RHD during the phase of the disease before patients develop symptoms may allow early institution of antibiotic preventative thereby halting the progression of the disease and avoiding serious complications. This project investigates screening for rheumatic heart disease using an abbreviated echocardiogram protocol, and

Collaborations: 

University of Melbourne Centre for International Child Health CICH

Fiji Islands Rheumatic Heart Disease Control and Prevention Fiji Ministry of Health

  • CureKids New Zealand
  • Fiji Ministry of Health
  • Auckland District Health Board

MDA for scabies and impetigo Fiji

  • Fiji Ministry of Health
  • University of New South Wales (UNSW)
  • Kirby Institute

Evaluating the genetic contribution to RHD in ATSI communities

  • Telethon Kids Institute
  • Menzies School of Health Research

Immune correlates of protein and cross protection for GAS vaccine

  • University of Wollongong (UOW)
  • University of Tennessee (UTK)

Genetic susceptibility of rheumatic heart disease in Fiji and New Caledonia

  • Government of New Caledonia
  • Fiji Ministry of Health
  • University of Oxford
  • Jenner Institute
  • French Institute of Health and Medical Research INSERM France

Economic evaluation of RHD in Fiji

  • Fiji Ministry of Health
  • Harvard School of Public Health

Molecular and clinical epidemiology of GAS disease in Pacific, Asia and local areas

Screening for rheumatic heart disease

  • Fiji Ministry of Health
  • CureKids New Zealand
  • Makere University, Uganda
  • Children’s National Medical Centre, Washington DC, USA

GAS Group Affiliates at Murdoch Children's

  • Dr Margie Danchin – Senior Research Fellow
  • Dr Eileen Dunne - Postdoctoral Scientist
  • Dr Tom Parks - Research Fellow / PhD student
  • Dr Joseph Kado - Consultant Paediatrician
  • Ms Lucia Romani - Research Coordinator / PhD student
  • Mr Amini Koroi - Study Coordinator
  • Ms Laisiana Matatolu – Study Coordinator
  • Ms Frances Matanatabu – Research Nurse
  • Ms Maureen AhKee – Research Assistant