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Abstract

We report an outbreak of invasive and non-invasive disease due to an unusual type of group A , 66) among a vulnerable, largely homeless population in southern England and Wales, detected in September 2016. Twenty-seven confirmed cases were subsequently identified between 5 January and 29 December 2016; 20 injected drugs and six reported problematic alcohol use. To date, we have ruled out drug-related vehicles of infection and identified few common risk factors.

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/content/10.2807/1560-7917.ES.2017.22.3.30446
2017-01-19
2017-12-16
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.3.30446
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References

  1. Health Protection Agency (HPA). Group A Streptococcus Working Group. Interim UK guidelines for management of close community contacts of invasive group A streptococcal disease. Commun Dis Public Health. 2004;7(4):354-61. PMID: 15786581 
  2. Steer JA, Lamagni T, Healy B, Morgan M, Dryden M, Rao B, et al. Guidelines for prevention and control of group A streptococcal infection in acute healthcare and maternity settings in the UK. J Infect. 2012;64(1):1-18.  https://doi.org/10.1016/j.jinf.2011.11.001  PMID: 22120112 
  3. Public Health England (PHE). Unlinked Anonymous Monitoring Survey of People Who Inject Drugs in contact with specialist services: data tables. Surveillance Update: July 2016. London: PHE. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/537598/UAM_Survey_of_PWID_2016_data_tables_with_2015_data_FINAL.pdf
  4. Facklam R, Beall B, Efstratiou A, Fischetti V, Johnson D, Kaplan E, et al. emm typing and validation of provisional M types for group A streptococci. Emerg Infect Dis. 1999;5(2):247-53.  https://doi.org/10.3201/eid0502.990209  PMID: 10221877 
  5. National Center for Biotechnology Information U.S. National Library of Medicine. Basic Local Alignment Search Tool Bethseda, MD, USA. [Accessed 15 Dec 2016]. Available from: https://blast.ncbi.nlm.nih.gov/Blast.cgi.
  6. 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.  https://doi.org/10.1016/j.jinf.2011.11.017  PMID: 22138601 
  7. Curtis SJ, Tanna A, Russell HH, Efstratiou A, Paul J, Cubbon M, et al. Invasive group A streptococcal infection in injecting drug users and non-drug users in a single UK city. J Infect. 2007;54(5):422-6.  https://doi.org/10.1016/j.jinf.2006.10.004  PMID: 17116332 
  8. Efstratiou A, Emery M, Lamagni TL, Tanna A, Warner M, George RC. Increasing incidence of group A streptococcal infections amongst injecting drug users in England and Wales. J Med Microbiol. 2003;52(Pt 6):525-6.  https://doi.org/10.1099/jmm.0.05167-0  PMID: 12748273 
  9. Lamagni TL, Neal S, Keshishian C, Hope V, George R, Duckworth G, et al. Epidemic of severe Streptococcus pyogenes infections in injecting drug users in the UK, 2003-2004. Clin Microbiol Infect. 2008;14(11):1002-9.  https://doi.org/10.1111/j.1469-0691.2008.02076.x  PMID: 19040471 
  10. Efstratiou ALT. Epidemiology of Streptococcus pyogenes. In: Ferretti JJ SD, Fischetti VA, editor. Streptococcus pyogenes: Basic Biology to Clinical Manifestations [Internet]. Oklahoma City (OK): University of Oklahoma Health Sciences Center; 2016-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK343616/.
  11. Luca-Harari B, Darenberg J, Neal S, Siljander T, Strakova L, Tanna A, et al. Strep-EURO Study Group. Clinical and microbiological characteristics of severe Streptococcus pyogenes disease in Europe. J Clin Microbiol. 2009;47(4):1155-65.  https://doi.org/10.1128/JCM.02155-08  PMID: 19158266 
  12. Steer AC, Law I, Matatolu L, Beall BW, Carapetis JR. Global emm type distribution of group A streptococci: systematic review and implications for vaccine development. Lancet Infect Dis. 2009;9(10):611-6.  https://doi.org/10.1016/S1473-3099(09)70178-1  PMID: 19778763 
  13. Krucsó B, Gacs M, Libisch B, Hunyadi ZV, Molnár K, Füzi M, et al. Molecular characterisation of invasive Streptococcus pyogenes isolates from Hungary obtained in 2004 and 2005. Eur J Clin Microbiol Infect Dis. 2007;26(11):807-11.  https://doi.org/10.1007/s10096-007-0359-4  PMID: 17665233 
  14. Meygret A, Vincent P, Moullec S, Nacazume J, Adnani Y, Lavenier D, et al. Genome Sequence of the Uncommon Streptococcus pyogenes M/emm66 Strain STAB13021, Isolated from Clonal Clustered Cases in French Brittany. Genome Announc. 2016;4(4):e00689-16.  https://doi.org/10.1128/genomeA.00689-16  PMID: 27445380 
  15. Athey TB, Teatero S, Sieswerda LE, Gubbay JB, Marchand-Austin A, Li A, et al. High Incidence of Invasive Group A Streptococcus Disease Caused by Strains of Uncommon emm Types in Thunder Bay, Ontario, Canada. J Clin Microbiol. 2016;54(1):83-92.  https://doi.org/10.1128/JCM.02201-15  PMID: 26491184 
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