[Group A streptococcus-induced diseases early in the 21st century: state of the problem and prospects of prevention].

The review presents the present state of the problem due to the diseases caused by group A streptococci. Greater interest in streptococcal infections is associated with a recent rise in the incidence of these diseases in many countries of the world, including Russia, with group cases of severe generalized forms and higher death rates being notified. Of priority significance in human diseases are serogroup A beta-hemolytic streptococci among which there are those that have returned into the circulation of defunct pathogen serotypes that are noteworthy for higher toxigenicity. The specific feature of a streptococcal infection is the cyclic character of an epidemic process: in parallel with 2-4-year periods there are also 40-50-year cycles. The undulation found is attended by the appearance and disappearance of particularly severe clinical forms of streptococcal infections. Immunodiagnostic techniques based on the determination of specific antibodies to streptococcal antigen has enjoyed the widest application in diagnosing streptococcal infections today. The therapeutical measures include the use of etiotropic and pathogenetic agents and direct toward eradication of the infecting organism and towards prevention of pyoinflammatory and autoimmune complications. Penicillin is the drug of choice in treating all forms of streptococcal infections. Despite progress in streptococcal vaccine design, there is no specific prophylaxis of streptococcal infection now, which determines the high value of antiepidemic measures.