Child/Adolescent Health

Strep throat in children carries significant societal costs

When children are infected with strep throat, they need medical care and antibiotics. Parents usually miss work and incur transportation costs to take their child for care. When these costs are extrapolated, the burden of strep throat in the United States falls between $224 and $539 million each year, a study finds.

Researchers in the Boston area conducted telephone surveys with 135 parents whose children had strep throat (group A streptococcal pharyngitis) and were seen in 2 pediatric practices between October 1, 2005, and January 25, 2006. On average, children with strep missed nearly two days of school and shared their strep with at least one other family member in 29 percent of families. Forty-two percent of parents missed an average of 1.8 days of work to care for their sick children; 80 percent of the caregivers were women. Medical costs, including outpatient visits, antibiotics, and testing, averaged $118 for a child's strep. Nonmedical costs for missed work and personal time averaged $87.

The authors claim that the extrapolated totals that approach nearly $540 million justify pursuing a vaccine for strep throat. One multivalent candidate for group A streptococcus that wards off pharyngitis, invasive disease, and rheumatic fever is currently in phase I/II clinical trials in the United States and Canada. A vaccine could reduce the prevalence of strep not only in school-aged children, who tend to be sources of strep, but also in the larger community. By reducing annual cases of strep, antibiotic overuse and resistance may also decline. This study was funded in part by the Agency for Healthcare Research and Quality (HS13808).

See "Burden and economic cost of group A streptococcal pharyngitis," by Elizabeth Pfoh, B.A., Michael R. Wessels, M.D., Donald Goldmann, M.D., and Grace M. Lee, M.D., M.P.H., in the February 2008 Pediatrics 121(2) pp. 229-234.

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