A streptococcal epidemic in an isolated civilian population with institution of mass prophylaxis

Zimmerman, Robert A.; Cross, W. Michael; Miller, David; Sciple, George W.

doi:10.1016/s0022-3476(66)80359-1

Cited by 14 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zimmerman et al [27] have shown that there is an imminent risk of an epidemic when at least two of these three criteria are met: (1) prevalence of 30% or more of group A beta-hemolytic streptococci carriers in the population at possible risk; (2) a 50% greater preponderance of classified strains; (3) one single strain present in over a third of all the cultures of classified strains.…”

Section: Discussionmentioning

confidence: 99%

Post-streptococcal acute glomerulonephritis in Chile?20�years of experience

Berríos

Lagomarsino

Solar

et al. 2004

Pediatric Nephrology

View full text Add to dashboard Cite

In order to characterize the epidemiological and clinical picture of post-streptococcal acute glomerulonephritis (PSAGN), a prospective study was designed to investigate all admissions to a general hospital of a local health service in Chile. The protocol included the investigation of previous streptococcal infections (SI), clinical symptoms and signs, socioeconomic situation (SES), throat and skin swabs for the isolation of group A beta-hemolytic streptococci, sequential determination of serum antistreptolysin O (ASO) titer, anti-DNAase B antibodies, and C3. During the 20 years studied, 926 cases were admitted (56% males). Incidence showed an endemic period (EP) 1980-1983, an epidemic outbreak (EO) 1984-1989, and a late period (LP) 1990-1999, with a rate per 100,000 inhabitants of 6.2, 13.2, and 1.7, respectively. The clinical picture was similar in the three periods. SES was homogeneous, with 80% of the population in low and middle-low categories. The average size of the family was 6.9 compared with 4.8 in the general population. Pyoderma was more frequent than pharyngeal infection, and more so during the EO. The isolation rate of group A beta-hemolytic streptococci from the pharynx was 20% compared with 60% from skin swabs. During EP, the most prevalent serotypes were T14-M0 and T1-M1 from the pharynx and TImp19-M0 from the skin. During EO, T14-M0 was more prevalent (30%). M or T classification was possible in EP and EO in 80%-85% of all strains isolated from the two locations. Significant titers for ASO and anti-DNAase B were found on admission: 55% and 75%, respectively. Both tests allowed identification of 100% of previous SI. In conclusion, the incidence of PSAGN had an uneven trend during the observed period. EO was mainly due to skin infection and a predominance of one serotype, T14-MO, was observed. After the EO, the yearly rate gradually decreased from 13.2 in 1988 to 0.0 in 1999, a rate similar to that of industrialized nations.

show abstract

Section: Discussionmentioning

confidence: 99%

Post-streptococcal acute glomerulonephritis in Chile?20�years of experience

Berríos

Lagomarsino

Solar

et al. 2004

Pediatric Nephrology

View full text Add to dashboard Cite

show abstract

“…They are all due to group A streptococci and have also occurred in military populations (Coburn & Young, 1949;Rammelkamp, 1956;Schneider et al 1964). Prevalence of 30% or more group A streptococci in the population at risk, a 50 % or greater typability of the epidemic strain accounting for at least one third of cases and possible occurrence of streptococcal non-suppurative complications, are the main features of a streptococcal air-borne epidemic (Zimmerman, Cross & Miller, 1966). The streptococcal foodborne epidemics, which are still not widely recognized, are characterized by different features, such as abrupt onset and termination, appearance of most of the cases within only one incubation period and few complications (Horwitz, 1977).…”

Section: Discussionmentioning

confidence: 99%

Food-borne outbreak of group G streptococcal sore throat in an Israeli military base

et al. 1987

View full text Add to dashboard Cite

A food-borne outbreak of sore throat caused by Lancefield group G beta-haemolytic streptococci and involving 50 persons occurred in May 1983 in an Israeli military camp. All of the patients available for clinical examination had sore throat and difficulty in swallowing. Exudative tonsillitis occurred in 46% of the patients and the body temperature was above 37.5 degrees C in 81%. The pattern of attack was uniform over the base and 37 became ill during the night and morning of the 5 May. Thirty-two (84%) of the throat cultures taken from 37 patients grew group G beta-haemolytic streptococci. Eight of 29 contacts were positive for group G beta-haemolytic streptococci and 6 of the 28 foodhandlers examined had positive cultures of the same group. The organism was also isolated from one food sample. The epidemiological and laboratory investigations indicated that a food handler, a convalescent carrier of group G streptococci, might have been the source of infection. Assumptions on the potential of non-group A streptococci to cause epidemics are discussed.

show abstract

“…The sporadic variety of PSGN is almost always due to type 12 infection of the pharynx, whereas epidemics are associated with a variety of strains depending on throat or skin infection. Impet igo-associated PSGN epidemics are caused by types 49, 53, 55,56,57 and 60 [4], while types 1,4,6,12 and 25 have been identified in patients with throat infection during epidemic spread (5], Epidemics have been rare in the USA since 1965, but continue to be reported from under developed countries where they tend to occur in close communities with poor hygiene [6][7][8][9], The foregoing types are all group A |I hemolytic streptococci. Recently, non-group A streptococci such as group C have been associated with PSGN [10], Read et al [11] have more recently suggested that group G streptococci may also be responsible for PSGN.…”

mentioning

confidence: 99%