Public health response following an iGAS outbreak in a residential aged care facility in Queensland
DOI:
https://doi.org/10.33321/cdi.2022.46.35Keywords:
invasive group A streptococcal infection, mass chemoprophylaxis, outbreak, streptococcal disease, residential facility, aged careAbstract
During an 18-day period, beginning in April 2020, three residents with invasive group A streptococcal infections (iGAS) were reported at a single residential aged care facility (RACF) in Brisbane’s northern geographical region. All three cases were hospitalised with severe illness; two of the cases died as a result of the illness. The Metro North Public Health Unit (PHU) led the public health investigation and response, targeting infection control measures and offering chemoprophylaxis to all 142 staff and 119 residents at the facility. The outbreak was declared over in June, after 30 days of no new cases. Isolates from all three cases were shown to have identical strain typing, emm89. The benefits and challenges of implementing mass chemoprophylaxis in this setting are discussed.
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References
Queensland Health. Invasive Group A Streptococcal Disease. [Internet.] Brisbane: Queensland Government, Queensland Health; 9 November 2018. [Accessed in January 2021.] Available from: https://www.health.qld.gov.au/cdcg/index/igas.
Northern Territory Government Department of Health. Public health management of invasive group A streptococcal infection. [Internet.] Darwin: Northern Territory Government, Health Library Services ePublications; November 2015. [Accessed in February 2022.] Available from: https://hdl.handle.net/10137/1187.
Vasant BR, Jarvinen KAJ, Fang NX, Smith HV, Jennison AV. Mass prophylaxis in an outbreak of invasive group A streptococcal disease in a residential aged care facility. Commun Dis Intell (2018) . 2019;43. doi: https://doi.org/10.33321/cdi.2019.43.18.
Queensland Government: Queensland Legislation. Public Health Act 2005 . [Legislation.] Brisbane: Queensland Government, Queensland Legislation, 8 March 2021. [Accessed on 12 April 2021.] Available from: https://www.legislation.qld.gov.au/view/html/inforce/current/act-2005-048.
Gherardi G, Vitali LA, Creti R. Prevalent emm types among invasive GAS in Europe and North America since year 2000. Front Public Health . 2018;6:59. doi: https://doi.org/10.3389/fpubh.2018.00059.
Lee MH, Lee GA, Lee SH, Park YH. A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: back to basics of infection control. PLoS One . 2020;15(3):e0229911. doi: https://doi.org/10.1371/journal.pone.0229911.
Jordan HT, Richards CL, Burton DC, Thigpen MC, Van Beneden CA. Group A streptococcal disease in long-term care facilities: descriptive epidemiology and potential control measures. Clin Infect Dis . 2007;45(6):742–52. doi: https://doi.org/10.1086/520992.
Cummins A, Millership S, Lamagni T, Foster K. Control measures for invasive group A streptococci (iGAS) outbreaks in care homes. J Infect . 2012;64(2):156–61. doi: https://doi.org/10.1016/j.jinf.2011.11.017.
Nanduri SA, Metcalf BJ, Arwady MA, Edens C, Lavin MA, Morgan J et al. Prolonged and large outbreak of invasive group A streptococcus disease within a nursing home: repeated intrafacility transmission of a single strain. Clin Microbiol Infect . 2019;25(2):248.e1–7. doi: https://doi.org/10.1016/j.cmi.2018.04.034.
Worthing KA, Werno A, Pink R, McIntyre L, Carter GP, Williamson DA et al. Biphasic outbreak of invasive group A streptococcus disease in eldercare facility, New Zealand. Emerg Infect Dis . 2020;26(5):841–8. doi: https://doi.org/10.3201/eid2605.190131.
Centers for Disease Control and Prevention (CDC). Invasive group A streptococcus in a skilled nursing facility – Pennsylvania 2009–2010. MMWR Morb Mortal Wkly Rep . 2011;60(42):1445–9.
Chalker VJ, Smith A, Al-Shahib A, Botchway S, Macdonald E, Daniel R et al. Integration of genomic and other epidemiologic data to investigate and control a cross-institutional outbreak of Streptococcus pyogenes . Emerg Infect Dis . 2016;22(6):973–80. https://doi.org/10.3201/eid2206.142050.
Mearkle R, Saavedra-Campos M, Lamagni T, Usdin M, Coelho J, Chalker V et al. Household transmission of invasive group A streptococcus infections in England: a population-based study, 2009, 2011 to 2013. Euro Surveill . 2017;22(3):30532. doi: https://doi.org/10.2807/15607917.ES.2017.22.19.30532.
Dooling KL, Crist MB, Nguyen DB, Bass J, Lorentzson L, Toews KA et al. Investigation of a prolonged group A streptococcal outbreak among residents of a skilled nursing facility, Georgia, 2009–2012. Clin Infect Dis . 2013;57(11):1562–7. doi: https://doi.org/10.1093/cid/cit558.
Kapatai G, Coelho J, Platt S, Chalker VJ. Whole genome sequencing of group A Streptococcus : development and evaluation of an automated pipeline for emm gene typing. PeerJ . 2017;5:e3226. doi: https://doi.org/10.7717/peerj.3226.
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