title: [Outbreak of skin infections due to Staphylococcus aureus carrying Panton-Valentine leukocidin genes in pupils and their relatives].
abstract: OBJECTIVE
  The study objectives were to describe an outbreak of skin infections in school settings, caused by Staphylococcus aureus carrying Panton-Valentine leukocidin genes (Sa PVL(+)), over a 2-year period. Nasal colonization prevalence was assessed in families where new skin infections occurred, despite a prevention and control strategy.
  
  
  METHODS
  A retrospective investigation of skin infections likely to be related to Sa and prospective monitoring and treatment of new infections occurring in pupils and their family members were implemented in October 2006, following the reporting of Sa PVL(+) abscesses and furuncles in a primary school. Additional nasal screening was performed in families where new skin infections occurred, after an initial systematic screening of Sa PVL(+) nasal carriers.
  
  
  RESULTS
  On October 31, 2008, 53 patients, accounting for 30 households, had developed 69 skin infections, in four decreasing outbreaks. The cumulative incidence of a first skin infection was 34.6% in primary classes, 21.3% in nursery schools, and 6.5% in the pupils' family households. Several skin infections were reported in 13 households, and in one of them, all of the seven family members had developed at least one skin infection during follow-up. The estimated frequency of nasal colonization ranged from 14.1% to 19.5% according to successive nasal screenings.
  
  
  CONCLUSIONS
  Early reporting of skin infection clusters is necessary to reinforce the effectiveness of hygiene and prevention measures, and thus limit the risk of a long-lasting outbreak.
authors: Cellule de l'InVS en région Île-de-France, 58-62 rue de Mouzaïa, Paris cedex 19, France. nicolas.carre@ars.sante.fr
authors: N
authors: N
authors: Carré
authors: N
authors: N
authors: Herbreteau
authors: N
authors: N
authors: Askeur
authors: J-P
authors: JP
authors: Dabas
authors: F
authors: F
authors: Sillam
authors: C
authors: C
authors: Pinchon
authors: M
authors: M
authors: Bes
authors: A
authors: A
authors: Tristan
authors: F
authors: F
authors: Vandenesch
mesh_terms: D000038:Abscess / Q000453:epidemiology / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000235:genetics*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D004196:Disease Outbreaks; D005098:Exotoxins / Q000235:genetics*; D005192:Family Health; D005260:Female; D005499:Folliculitis / Q000453:epidemiology / Q000382:microbiology; D005602:France / Q000453:epidemiology; D005667:Furunculosis / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D006920:Hygiene; D015994:Incidence; D007223:Infant; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology; D012189:Retrospective Studies; D012574:Schools; D012578:Schools, Nursery; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D013211:Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification; D013334:Students / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin