Between October 2013 and April 2014 five elderly patients living within a 2 square mile radius, were admitted to local hospitals with severe group A streptococcal cellulitis and septicaemia. Molecular typing confirmed four patients for whom typing results were available to have the same emm gene sequence type, emm st89. An outbreak investigation was launched and identified that each patient had received care interventions from a district nursing team at their home or local health clinic in the 7 days prior to onset of symptoms.
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