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Group A Streptococcus Outbreak in a Canadian Armed Forces Training Facility.
Karon Hammond-Collins1, Barbara Strauss2, Kirsten Barnes2
1Canadian Field Epidemiology Program, Public Health Agency of Canada, 100 Colonnade Drive, Ottawa, ON, Canada.
Military Medicine
|August 24, 2018
Summary
A Group A Streptococcus (GAS) outbreak in Canadian military trainees highlighted transmission risks and led to improved surveillance. Enhanced control measures successfully halted further invasive GAS infections.
Area of Science:
- Infectious Disease Epidemiology
- Microbiology
- Public Health
Background:
- Group A Streptococcus (GAS) infections can cause severe invasive disease.
- Military training facilities present unique challenges for infectious disease control due to close living quarters.
Purpose of the Study:
- To investigate an outbreak of invasive GAS infections at a Canadian military training facility.
- To characterize the outbreak, identify risk factors, and evaluate control measures.
Main Methods:
- Field investigation including throat cultures, case tracking, and interviews.
- Molecular typing using whole-genome sequencing to analyze GAS isolates.
- Evaluation of a rapid antigen detection test's performance.
Main Results:
- Four invasive and six non-invasive GAS cases were reported.
- GAS was detected in 35.2% of throat cultures from personnel.
- Low sensitivity was observed for the rapid antigen detection test (31.6%).
- Phylogenetic analysis revealed highly related outbreak isolates (emm6.4).
- Recruit behaviors like reluctance to seek care and poor antibiotic compliance were noted.
Conclusions:
- This was the first reported GAS outbreak among Canadian military trainees.
- Enhanced surveillance and control measures successfully contained the outbreak.
- Recommendations included improved antibiotic compliance and medical consultation support.
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