Acute post-streptococcal glomerulonephritis

Statutory notification

• Acute post-streptococcal glomerulonephritis (APSGN) is a notifiable condition in Western Australia (WA).
• Both confirmed cases AND probable cases should be notified. All suspected cases of APSGN including possible cases must be notified to the local Public Health Unit and should be reported to the regional paediatric team to ensure appropriate clinical assessment and management is undertaken.
• See notifiable communicable disease case definitions (Word 1.29MB).
• Notifications should be made using the communicable disease notification form for metropolitan residents (PDF 209KB) or regional residents (PDF 208KB).
• For notification of regional residents see contact details of public health units.
• See also description of statutory medical notifications in Western Australia.

Public health management

Important information

• Condition: APGSN is an immune-mediated condition characterised by glomerular inflammation and kidney dysfunction, occurring after streptococcal pharyngitis or skin infection e.g. impetigo.
• Infectious agent: Streptococcus pyogenes, also known as Group A Streptococcus (GAS), is the most common cause of streptococcal infections preceding onset of APSGN, however Group C and G streptococci have also been associated with glomerulonephritis.
• Transmission: APSGN cannot be transmitted to other people. The streptococcal bacteria that cause skin infections and sore throats can be passed from person to person through respiratory droplets, skin to skin contact or contaminated surfaces and objects e.g. towels and bedding.
• Incubation period: Onset is 7-10 days following streptococcal pharyngitis or 2-4 weeks following streptococcal skin infection.
• Infectious period: Streptococcal bacteria causing skin infections and sore throats may be transmitted from 7 days before symptom onset until symptoms have resolved or until 24 hours of effective antibiotic treatment.
• Case exclusion: Exclusions only apply to those cases with active skin sores or pharyngitis; exclude from school or childcare until 24 hours of effective antibiotic treatment.
• Contact exclusion/management: Do not exclude. Contact management will be coordinated by public health unit staff.
• Treatment: Antibiotic treatment and other clinical management as recommended by paediatrician/physician.
• Immunisation: None available.
• Case follow-up: Where appropriate, the relevant public health unit will coordinate the public health response.

Guidelines

• WA Country Health Service Public Health Management of Acute Post-Streptococcal Glomerulonephritis Guideline (external site)
• Kimberley Aboriginal Health Planning Forum APSGN – Acute Post-Streptococcal Glomerulonephritis guidelines (external site)
• Communicable Disease Guidelines, for teachers, child care workers, local government authorities and medical practitioners (PDF 386KB)

Notifiable disease data and reports

• General infectious disease reports
• Notifiable infectious disease dashboard