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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
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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.

Keywords:
Streptococcus pyogenesCanadaDNA sequence analysisInfectious disease outbreaksmilitary personnel

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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.