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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.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 11, 2003
PubMed

Insights

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.

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