A community outbreak of conjunctivitis caused by nontypeable Streptococcus pneumoniae in Minnesota.
BACKGROUND
The Minnesota Department of Health (MDH) was notified of an outbreak of conjunctivitis in city A with cultures positive for Streptococcus pneumoniae.


METHODS
MDH staff contacted clinics and schools in city A and city B regarding conjunctivitis cases, reviewed clinical findings of conjunctivitis cases in city A and collected isolates for subtyping.


RESULTS
Between September 1 and December 12, 2003, cities A and B reported 735 conjunctivitis cases. Fifty-one percent of the cases were reported from schools, childcare centers and colleges. Adults were more likely to report itching, burning or swelling of the eye(s); children were more likely to report crusty eyes (P < 0.05). Forty-nine percent of conjunctival cultures (71 of 144) were positive for S. pneumoniae. All isolates were nontypeable by serotyping. Pulsed field gel electrophoresis identified 3 clonal groups with 84% of isolates belonging to one clonal group. Multilocus sequence typing revealed that isolates had the same multilocus sequence type as isolates from a 2002 outbreak at a New England college.


CONCLUSIONS
This outbreak was widespread in the community and conjunctivitis clinical presentation varied by age. The predominant strains in this outbreak were related to a pneumococcal strain implicated in prior conjunctivitis outbreaks, suggesting these strains have a predilection for causing conjunctivitis.
Buck
Jessica M
JM
Acute Disease Investigation and Control Section, Minnesota Department of Health, St. Paul, MN 55164-0975, USA. Jessica.buck@health.state.mn.us
Lexau
Catherine
C
Shapiro
Miriam
M
Glennen
Anita
A
Boxrud
David J
DJ
Koziol
Bonnie
B
Whitney
Cynthia G
CG
Beall
Bernard
B
Danila
Richard
R
Lynfield
Ruth
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D016000:Cluster Analysis; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D003234:Conjunctivitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007223:Infant; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D017720:Molecular Epidemiology; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D012574:Schools; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*
D004269:DNA, Bacterial