453. High Burden of Invasive and Severe Group A Streptococcus Disease Among Native Americans on the White Mountain Apache Tribal Lands. - Sutcliffe, Catherine; Close, Ryan M; Davidson, Anne M; Reid, Angelina; Quay, Dianna; Nicolet, Katherine; Brown, Laura B; Grant, Lindsay; Weatherholtz, Robert; McAuley, James; Hammitt, Laura (Open Forum Infectious Diseases, 2019)