title: A food-borne streptococcal sore throat outbreak in a small community.
abstract: Beta-haemolytic group A streptococci (GAS) is a common cause of sore throat, usually spread person-to-person. Outbreaks related to infected food have more seldom been reported. The bacteria may originate from the throat or from wounds on the hands of persons handling the food. An outbreak in Sätila, Sweden, in April/May 2003 involving 153 individuals who fell ill after eating contaminated 'sandwich-layer cakes' was investigated in a descriptive, retrospective cohort study. Questionnaires were distributed, one immediately after the outbreak and one 3 months later. The average attack rate was 72%. 143 individuals sought medical care and 137 were treated with antibiotics. 76 individuals were ill for more than 4 days. GAS isolates of identical T-type were obtained from the throats of the patients, wounds on the caterer's fingers and also from the cakes. PFGE banding patterns of 14 representative isolates were identical, as well as the emm-sequence type, emm 89, of 3 chosen isolates. The study shows that GAS from a small wound on a finger can cause illness in a large number of individuals. To prevent further outbreaks, it is important to increase public awareness of this type of transmission.
authors.affiliation: Unit for Communicable Disease Control, Västra Götalandsregionen, Stockholm, Sweden. inger.asterberg@vgregion.se
authors.forename: Inger
authors.initials: I
authors.lastname: Asteberg
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Andersson
authors.forename: Leif
authors.initials: L
authors.lastname: Dotevall
authors.forename: Monika
authors.initials: M
authors.lastname: Ericsson
authors.forename: Jessica
authors.initials: J
authors.lastname: Darenberg
authors.forename: Birgitta
authors.initials: B
authors.lastname: Henriques-Nordmark
authors.forename: Ann
authors.initials: A
authors.lastname: Söderström
mesh_terms: D015331:Cohort Studies; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005511:Food Handling / Q000379:methods*; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000209:etiology*; D006801:Humans; D010612:Pharyngitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D013548:Sweden / Q000453:epidemiology