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

Background: General practitioners and the microbiologist serving north Hack ney in north east London formed the impression, that of throat swabs sent t o the laboratory, a disproportionate number of those positive for group A s treptococcus appeared to come from Orthodox Jewish patients. Aim: To confirm the clinical impression that the pharyngeal carriage of gro up A streptococci uas higher in the Orthodox Jewish population than in othe r members of the population in the same locality. Design of study: A general practice questionnaire survey of all patients ag ed three years or over attending two practices that are about one kilometre apart, over a five-week period Setting live general practices in north Lon don, 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% respective ly in the 'others' group. The proportion of children with group A streptoco cci with and without sore throats was 17.4% and 5.9% respectively and 3.4% and 0% respectively in the others. These differences were nor explained by the larger family size and domestic overcrowding in the Orthodox Jewish gro up. Conclusions. Orthodox Jews in north London have a higher Pharyngeal carriag e rate of group A streptococci than the neighbouring population. These resu lts may have implications for the diagnosis and treatment of acute sore thr oat in Orthodox Jewish patients, especially children.