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Tonsillopharyngitis caused by foodborne group A streptococcus: a prison-based outbreak
Michael Levy1, Christine G Johnson, Ed Kraa
1Population Health, Corrections Health Service, Matraville, Australia.
Summary
A Streptococcus pyogenes outbreak infected 72 inmates in a correctional center. Curried egg rolls, contaminated by a food handler with infected hand wounds, were the likely source of this tonsillopharyngitis outbreak.
Area of Science:
- Infectious Disease Epidemiology
- Public Health Surveillance
- Microbiology
Background:
- Streptococcus pyogenes (group A Streptococcus) can cause tonsillopharyngitis.
- Outbreaks of S. pyogenes infections are documented in various congregate settings.
- Correctional facilities present unique challenges for infection control.
Purpose of the Study:
- To investigate an outbreak of tonsillopharyngitis in a correctional facility.
- To identify the causative agent and mode of transmission.
- To determine the source of the outbreak.
Main Methods:
- Retrospective cohort study design.
- Microbiological analysis of throat swabs and hand wounds.
- Case-finding through inmate illness reporting.
- Food history questionnaires to identify risk factors.
Main Results:
- 72 out of 256 inmates (28%) developed tonsillopharyngitis.
- Streptococcus pyogenes type M-75, T-25 (opacity factor positive) was isolated.
- Consumption of curried egg rolls was strongly associated with illness.
- A food handler with infected hand wounds was identified as the likely source.
Conclusions:
- Contaminated food, specifically curried egg rolls, was the probable vehicle for S. pyogenes transmission.
- Food handler hygiene is critical in preventing outbreaks in congregate settings.
- This highlights the risk of streptococcal pharyngitis outbreaks in correctional facilities.