High group A streptococcal carriage in the Orthodox Jewish community of north Hackney.

BACKGROUND

General practitioners and the microbiologist serving north Hackney in north east London formed the impression, that of throat swabs sent to the laboratory, a disproportionate number of those positive for group A streptococcus appeared to come from Orthodox Jewish patients.

AIM: To confirm the clinical impression that the pharyngeal carriage of group A streptococci was higher in the Orthodox Jewish population than in other members of the population in the same locality.

DESIGN OF STUDY: A general practice questionnaire survey of all patients aged three years or over attending two practices that are about one kilometre apart, over a five-week period.

SETTING

Two general practices in north London, one of which had a significant Orthodox Jewish patient list.

METHODS

Throat swabs were taken from eligible patients who were invited to participate by completing a questionnaire and having a throat swab taken.

RESULTS

Swabs were taken from 1223 people. After correction for age (child or adult) and history of recent sore throat, the Orthodox Jewish community had a significantly higher carriage rate of group A streptococci than the rest of the population (odds ratio = 5.0 [2.1 to 11.9]). The proportion of adults with group A streptococci with and without sore throats was 6.4% and 2.4% respectively in the Orthodox Jewish group and 0.45% and 1% respectively in the 'others' group. The proportion of children with group A streptococci with and without sore throats was 17.4% and 5.9% respectively and 3.4% and 0% respectively in the others. These differences were not explained by the larger family size and domestic overcrowding in the Orthodox Jewish group.

CONCLUSIONS

Orthodox Jews in north London have a higher pharyngeal carriage rate of group A streptococci than the neighbouring population. These results may have implications for the diagnosis and treatment of acute sore throat in Orthodox Jewish patients, especially children.