2024 Yes https://doi.org/10.1016/j.idh.2024.12.001 Enkel, Stephanie Australia Experimental Observational Exposure Study Students Elementary (K-5) Bacteria Respiratory symptoms Other Streptococcus pyogenes Aboriginal and Torres Strait Islander health Infection prevention and control Transmission Using settle plates and swabs in 12 classrooms, this study found only 2% of surfaces positive and no Strep A in air, despite pharyngitis and impetigo cases. Results suggest limited environmental evidence for fomite, droplet, or airborne transmission in these settings.