A large outbreak of streptococcal pyoderma in a military training establishment

Cruickshank, J. G.; Lightfoot, N. F.; Sugars, K. H.; Colman, G.; Simmons, M. D.; Tolliday, John; Oakley, E. H. N.

doi:10.1017/s0022172400070492

Cited by 20 publications

(12 citation statements)

References 26 publications

(26 reference statements)

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“…The most important supporting evidence is the isolation of only 1 clone of GAS in all 4 outbreaks, in contrast to the great variability of clones among the S. aureus isolates. The outbreaks caused by this single GAS clone were characterized by a severe form of lesions, unlike most common impetigo outbreaks that have been described elsewhere [10,18,19], and by an exceptionally high attack rate of skin lesions among those units in which early intervention was not applied. In addition, high rates of systemic morbidity and glomerulonephritis were observed in 1 of the units.…”

Section: Discussionmentioning

confidence: 81%

A Cluster of Ecthyma Outbreaks Caused by a Single Clone of Invasive and Highly InfectiveStreptococcus pyogenes

et al. 2009

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Section: Discussionmentioning

confidence: 81%

A Cluster of Ecthyma Outbreaks Caused by a Single Clone of Invasive and Highly InfectiveStreptococcus pyogenes

et al. 2009

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“…This may be due to the study period, because most of the previous studies had been done by using the dataset before 2010 [13,14,15,16]. Additionally, a previous outbreak investigation of streptococcal pyogen in military training centres established that environmental contamination with Streptococcus pyogenes was common, and contact with contaminated substances contributed to the transmission of the bacterium [59]. To reduce this transmission, disinfection measures can be applied.…”

Section: Discussionmentioning

confidence: 99%

The Association between Environmental Factors and Scarlet Fever Incidence in Beijing Region: Using GIS and Spatial Regression Models

Mahara

Wang

Yang

et al. 2016

IJERPH

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(1) Background: Evidence regarding scarlet fever and its relationship with meteorological, including air pollution factors, is not very available. This study aimed to examine the relationship between ambient air pollutants and meteorological factors with scarlet fever occurrence in Beijing, China. (2) Methods: A retrospective ecological study was carried out to distinguish the epidemic characteristics of scarlet fever incidence in Beijing districts from 2013 to 2014. Daily incidence and corresponding air pollutant and meteorological data were used to develop the model. Global Moran’s I statistic and Anselin’s local Moran’s I (LISA) were applied to detect the spatial autocorrelation (spatial dependency) and clusters of scarlet fever incidence. The spatial lag model (SLM) and spatial error model (SEM) including ordinary least squares (OLS) models were then applied to probe the association between scarlet fever incidence and meteorological including air pollution factors. (3) Results: Among the 5491 cases, more than half (62%) were male, and more than one-third (37.8%) were female, with the annual average incidence rate 14.64 per 100,000 population. Spatial autocorrelation analysis exhibited the existence of spatial dependence; therefore, we applied spatial regression models. After comparing the values of R-square, log-likelihood and the Akaike information criterion (AIC) among the three models, the OLS model (R2 = 0.0741, log likelihood = −1819.69, AIC = 3665.38), SLM (R2 = 0.0786, log likelihood = −1819.04, AIC = 3665.08) and SEM (R2 = 0.0743, log likelihood = −1819.67, AIC = 3665.36), identified that the spatial lag model (SLM) was best for model fit for the regression model. There was a positive significant association between nitrogen oxide (p = 0.027), rainfall (p = 0.036) and sunshine hour (p = 0.048), while the relative humidity (p = 0.034) had an adverse association with scarlet fever incidence in SLM. (4) Conclusions: Our findings indicated that meteorological, as well as air pollutant factors may increase the incidence of scarlet fever; these findings may help to guide scarlet fever control programs and targeting the intervention.

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“…Although streptococci are a relatively hardy organism and can survive in the environment, for example, in bedding17 and dust,18 they dry within hours and appear to be non-infectious for pharyngitis 19. However, environmental persistence is a factor in transmission of streptococcal pyoderma 20. In 2000, 21 cases of GABHS, including scarlet fever, pharyngitis and impetigo, occurred in a Dutch primary school over a 4-week period 8.…”

Section: Discussionmentioning

confidence: 99%

An outbreak of scarlet fever in a primary school

Lamden¹

2010

Archives of Disease in Childhood

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Scarlet fever, due to infection with an erythrogenic toxin-producing Group A streptococcus, is an uncommon and generally mild illness, although serious sequelae do occur. In March 2009, 57 of the 126 (45%) pupils in a primary school in Lancashire, UK developed scarlet fever over a 4-week period. Infection was transmitted via direct contact between pupils, particularly among the youngest pupils. A significant degree of transmission also occurred between siblings. The median number of days absent from school was 3 (range 1-10 days). No children were hospitalised. Control measures, including hygiene advice to the school and exclusion of pupils for 24h while initiating penicillin treatment, were ineffective. The outbreak occurred against a background of an unusually high incidence of invasive Group A streptococcal infection. While there are national guidelines for the control of invasive disease, none exist for the control of scarlet fever outbreaks. This prolonged outbreak of scarlet fever highlights the need for an evidence based approach to outbreak management.

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A large outbreak of streptococcal pyoderma in a military training establishment

Cited by 20 publications

References 26 publications

A Cluster of Ecthyma Outbreaks Caused by a Single Clone of Invasive and Highly InfectiveStreptococcus pyogenes

A Cluster of Ecthyma Outbreaks Caused by a Single Clone of Invasive and Highly InfectiveStreptococcus pyogenes

The Association between Environmental Factors and Scarlet Fever Incidence in Beijing Region: Using GIS and Spatial Regression Models

An outbreak of scarlet fever in a primary school

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