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Edward L. Kaplan, Editorial Commentary: The Epidemiology of Group A Streptococci: A Need to Understand the Significance of the Fertile Fields, Clinical Infectious Diseases, Volume 55, Issue 4, 15 August 2012, Pages 488–490, https://doi.org/10.1093/cid/cis428
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(See the Major Article by Stockmann et al, on pages 479–87.)
Anyone who has lived on a farm understands the implications of fertile soil. Not only are there obvious advantages for the cultivated crops, but a favorable environment for unwanted weeds is a persistent and recurring thorn in the side of the farmer! If the field is fertile, almost any plant will colonize it and grow luxuriously.
Perhaps comparison of the epidemiology of group A streptococcal (Streptococcus pyogenes; GAS) colonization and infection in humans with that of unwanted weeds is stretching the point a little. But there are similarities. Since more than half a century ago, when the pioneering work by Rebecca Lancefield differentiated the various serologically distinct groups of beta-hemolytic streptococci [1], and a bit later, when it became obvious that GAS were important human pathogens [2], clinician-scientists, basic scientists, and public health authorities have sought to understand the epidemiology of this unique organism. There have been many enlightening attempts to understand the propensity of GAS to select “fertile fields” for infection. Yet, much remains to be learned. Where does the organism hide while waiting to “attack?” Why are humans (and perhaps only certain humans) its only recognized naturally occurring animal host? How do the answers to these questions impact not only its selection of when to attack the fertile “soil,” but also how do these variables affect strain virulence (ability to thrive in the field)? Our ultimate goal is to protect the host, and to accomplish that, we need this information.
