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Abstract

We report a national outbreak from a common source following piercings between July and September 2016 in England. The multi-agency outbreak investigation included active case finding, microbiological testing of environmental samples and case specimens including Variable Number Tandem Repeat (VNTR) typing and a retrospective cohort study. Overall, 162 outbreak cases (29 confirmed, 14 probable and 119 possible) and 14 non-outbreak cases were identified; all confirmed cases had ear piercings (93% cartilage). Outbreak cases were predominantly female (95%) and had a median age of 18 years (interquartile range: 13–56 years). Nineteen outbreak cases required surgery under general anaesthetic The same outbreak VNTR type (11,3,5,3,3,3,6,4,7) was isolated from bottles of an aftercare solution from a single manufacturer and in specimens from confirmed cases who attended eight different piercing studios supplied with this product. In the cohort study, use of aftercare solution was associated with becoming a case (aOR: 4.60, 95% confidence interval: 1.65–12.90). Environmental, microbiological and epidemiological investigations confirmed that contamination during production of aftercare solution was the source of this national outbreak; highlighting challenges in the regulation of a cosmetic products used in the piercing industry and that guidance on piercing aftercare may need to be reviewed.

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/content/10.2807/1560-7917.ES.2018.23.37.1700795
2018-09-13
2019-10-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.37.1700795
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National outbreak of Pseudomonas aeruginosa associated with an aftercare solution following piercings, July to September 2016, England
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Hannah+Evans&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Evans Hannah</a>, <a href="/search?value1=Hikaru+Bolt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bolt Hikaru</a>, <a href="/search?value1=Ellen+Heinsbroek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Heinsbroek Ellen</a>, <a href="/search?value1=Bryony+Lloyd&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lloyd Bryony</a>, <a href="/search?value1=Peter+English&option1=author&noRedirect=true" class="nonDisambigAuthorLink">English Peter</a>, <a href="/search?value1=Samia+Latif&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Latif Samia</a>, <a href="/search?value1=Nicola+Elviss&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Elviss Nicola</a>, <a href="/search?value1=Jane+Turton&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Turton Jane</a>, <a href="/search?value1=Peter+Hoffman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoffman Peter</a>, <a href="/search?value1=Paul+Crook&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Crook Paul</a>, <a href="/search?value1=Richard+Puleston&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Puleston Richard</a>, <a href="/search?value1=on+behalf+of+the+Outbreak+Control+Team&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Outbreak Control Team</a></span>. National outbreak of Pseudomonas aeruginosa associated with an aftercare solution following piercings, July to September 2016, England. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(37):pii=1700795. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.37.1700795" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.37.1700795</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 30 Nov 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 May 2018 </span> </p>
/content/10.2807/1560-7917.ES.2018.23.37.1700795
/content/10.2807/1560-7917.ES.2018.23.37.1700795
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