Successive outbreaks of Group A streptococcus (GAS) in care of the elderly settings;lessons learned

Abstract

Group A streptococcal (GAS) outbreaks in care of the elderly settings are rare. We describe two successive outbreaks involving care of the elderly patients. The first outbreak involved 18 patients and the second involved six patients and two healthcare workers. We describe the difficulties encountered controlling GAS outbreaks in care of the elderly settings and how the lessons learned from the first outbreak influenced management of the second incident. Stringent infection control measures including isolation until completion of treatment and re-screening for evidence of eradication were required to bring outbreak one under control. These measures were adopted early in outbreak two and we suspect that these measures and the rapid identification of carriers brought this second outbreak under control quickly.

Keywords

Group A streptococcus outbreak

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References

Health Protection Agency. (2010) Guidelines for the investigation, control and prevention of group A streptococcal (GAS) infection in acute healthcare settings in the United Kingdom. Document for consultation. HPA: London.

Jordan

Richards

Burton

Thigpen

Van Beneden

. (2007) Group A Streptococcal disease in long term care facilities: descriptive epidemiology and potential control measures. Clinical Infectious Diseases 45: 742–52.

Nolan

Shertzberg

Wilson-Clark

Mcgeer

Pellizzari

Steingart

. (2003) Outbreaks of invasive group A streptococcal disease in two hospitals, Ontario, 2003. Canada Communicable Disease Report 34: 8–19.

Rahman

. (1981) Outbreak of Streptococcus pyogenes infections in a geriatric hospital and control by mass treatment. Journal of Hospital Infection 2: 63–9.

Reid

Briggs

Seal

Pearson

. (1983) Virulent streptococcus pyogenes: outbreak and spread within a geriatric unit. Journal of Infection 6: 219–25.

Sarangi

Roswell

. (1995) A nursing home outbreak of Group A streptococcal infection: case control study of environmental contamination. Journal of Hospital Infection 30: 162–4.

Smith

Tolomeo

Tyrell

Jamieson

Fisman

. (2003) Mass antibiotic treatment for group A streptococcus outbreaks in two long term care facilities. Emerging Infectious Diseases 9: 1260–5.

Van den Ende . (1941) Discussion on streptococcal cross-infection in wards. Proceedings of the Royal Society of Medicine, Nov 5.www.ncbi.nlm.nih.gov/pmc/articles/…/pdf/procrsmed00636-0013.pdf (accessed 5 October 2011).