Infection with Streptococcus pyogenes (group A streptococcus, GAS) can lead to rheumatic fever (RF) and rheumatic heart disease (RHD), which are significant health concerns in the Indigenous populations of developed countries, including Australian Aboriginal people. The global burden of GAS diseases had been recently reviewed 1 and multiple studies have demonstrated the high burden of these diseases in Australia 2-4. RF and RHD are autoimmune type diseases, in which T-cells and antibodies targeting the bacteria may also cross-react with human tissues, therefore rendering a whole cell vaccine impractical.
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