Changes in demography and lifestyle and various adverse events are major factors that enhance epidemics [
]. Yet microbes are not idle bystanders. They are constantly evolving. Microbial evolution is driven by mutations and underlying mechanisms of genetic exchange, which also play an important role in the emergence and re-emergence of infectious diseases. The re-emergence of streptococcal disease is considered within this context. Investigators are pursuing molecular studies to explore the possible genetic relationship between the recent re-emerging, virulent group A streptococci (GAS) and streptococci that caused widespread epidemics of severe scarlet fever in an earlier era.
Krause R.M. Emerging infections. Academic Press, New York1998
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