Aboriginal Australians in remote communities have high rates of rheumatic heart disease (RHD); yet pharyngitis is reportedly rare whilst pyoderma is common. Some strains of group A streptococci (GAS) have preference for the throat and others for the skin depending on M protein type. A study in three remote communities provided 350 GAS isolates for emm sequence typing, 244 were also emm pattern typed. There was 100% correlation between emm sequence and pattern type. Patterns D and E (non-throat tropic) made up 71% of throat and 87% of skin isolates although patterns A–C (throat tropic) were more common in the throat than the skin (RR 2·3, 95% CI 1·4–3·8) whilst the opposite was found for pattern D (RR 2·2, 95% CI 1·7–3·0). Pattern E favoured the throat (RR 1·4, 95% CI 1·1–1·8). Where environmental factors predispose to skin infection, emm pattern types D and E prevail, whatever the recovery site.

Due to an oversight the legend to Figure 1 appeared with errors in the key.

The figure, with its correct legend, is reproduced below.

Fig. 1.

Percentage survival on glass of all seven meningococcal strains by sampling time. □, NZ97/122; , Cu00162; ■, NZ03/280; , NZ98/254; , H44/76-SL; , NZ04/198; , NZ03/225.