Food-borne streptococcal pharyngitis in a hospital pediatrics clinic

Area of Science:

• Infectious Disease Epidemiology
• Public Health Microbiology
• Foodborne Illness Outbreaks

Background:

• Group A Streptococcus (GAS) is a common bacterial pathogen.
• Foodborne outbreaks are typically associated with commercially prepared foods or those containing dairy or eggs.
• Non-institutional food preparation settings can pose unique challenges for outbreak investigation.

Purpose of the Study:

• To investigate an unusual foodborne illness outbreak at a hospital pediatrics clinic.
• To identify the causative agent and vehicle of transmission.
• To understand the epidemiology of Group A Streptococcus transmission in a non-traditional setting.

Main Methods:

• Case finding among clinic staff following a potluck luncheon.
• Microbiological analysis of ill individuals to identify pathogens.
• Food consumption surveys and analysis to pinpoint the implicated food item.
• Epidemiological investigation linking the food vehicle to a symptomatic food handler.

Main Results:

• Over half of the clinic staff became ill.
• Group A Streptococcus was isolated from 12 of 20 ill individuals.
• Food-consumption analysis identified a homemade rice dressing as the likely source.
• The rice dressing was prepared by an employee with a history of pharyngitis.

Conclusions:

• This outbreak was caused by Group A Streptococcus transmitted via a homemade rice dressing.
• The source was an employee with pharyngitis, indicating person-to-person transmission to food.
• The findings underscore the potential for foodborne illness from non-commercially prepared foods, even those not typically high-risk.
• Public health awareness regarding safe food handling practices is crucial in all settings.