title: An outbreak of noninvasive group A streptococcal disease in a facility for the developmentally disabled.
abstract: BACKGROUND
  Reports of outbreaks of group A streptococcal disease in long-term care facilities are uncommon.
  
  
  METHODS
  An outbreak of noninvasive group A streptococcal disease was investigated in a large facility for the developmentally disabled. The antistreptolysin O test was used to supplement the case finding.
  
  
  RESULTS
  Sixty-seven cases of streptococcal pharyngitis were diagnosed among residents and staff of the facility. Interventions based on enhanced infection control practices were effective, but maintaining them for several months was challenging because of the large number of staff, cognitive deficits of the residents, inconveniently placed areas for hand sanitation for the staff, and occurrence of a simultaneous outbreak of impetigo in the same population. After 4 months, the outbreak was successfully managed without chemoprophylaxis of the entire residential population and staff.
  
  
  CONCLUSIONS
  Outbreaks of group A streptococcal disease in centers for persons with developmental disabilities have unique challenges superimposed on routine outbreak response measures.
authors.affiliation: Division of Infectious Diseases, Illinois Department of Public Health, Chicago, 60601, USA. mdworkin@idph.state.il.us
authors.forename: Mark S
authors.initials: MS
authors.lastname: Dworkin
authors.forename: Lee
authors.initials: L
authors.lastname: Park
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Barringer
authors.forename: Rod
authors.initials: R
authors.lastname: Curtis
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D019989:Persons with Intellectual Disabilities; D010612:Pharyngitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013297:Streptococcus pyogenes / Q000472:pathogenicity*
chemical_list: D000900:Anti-Bacterial Agents