Minnesota Department of Health (MDH) Bug Bytes
February 5, 2003
Vol. 4: No. 2
1. Prevention of Invasive Group A Streptococcal
In October, recommendations for the prevention of invasive group A streptococcal disease (GAS) among household contacts of patients and among postpartum and postsurgical patients were published in Clinical Infectious Diseases (abstract at: http://www.journals.uchicago.edu/CID/
020374. abstract.html). The recommendations for prevention of household contacts were partly based on data provided by us and other Emerging Infections Program sites from around the country from a study measuring the incidence of subsequent GAS disease among household contacts of patients with invasive GAS. Thank you EIP partners - clinicians, labs, and ICPs - and patients - for helping with this study that has helped shape these recommendations.
While this study and a similar study in Canada found that subsequent invasive GAS disease among household contacts is rare, the risk was found to be higher for household contacts than that of the general population. The recommendations state that "as a result, routine screening for colonization with GAS and routine administration of chemoprophylaxis against GAS are not recommended for household contacts of index patients. However, because of the increased risk of sporadic invasive GAS disease among certain groups and the risk of death among persons aged > 65 years who develop invasive GAS disease, health care providers may choose to offer chemoprophylaxis to members of the households of patients with invasive GAS infection that include persons > 65 years or other high-risk individuals." High-risk individuals would include those with HIV infection, diabetes, cancer, heart disease, injecting drug use, varicella, steroid use, and Native American race. You may call us at 651-201-5414 for assistance in determining whether chemoprophylaxis would be indicated in a particular situation.
2. 2001 Gastroenteritis Outbreak Summary
The 2001 MDH Gastroenteritis Outbreak Summary is now available at: http://www.health.state.mn.us/divs/dpc/
ades/fvzd/summaries.htm. The summary is an annual report from the Acute Disease Investigation and Control Section and includes information about foodborne, waterborne, and person-to-person outbreaks of gastroenteritis that were investigated in 2001. A total of 112 gastroenteritis outbreaks were documented that year involving at least 1,900 persons (since identified persons represent only a fraction of those actually ill). These included 39 confirmed foodborne; 21 probable foodborne; four confirmed waterborne; one probable waterborne; and 47 non-foodborne, non-waterborne gastroenteritis outbreaks. Of the 39 confirmed foodborne outbreaks, 25 (64%) were either laboratory-confirmed or epidemiologically defined as norovirus gastroenteritis. (Note: the International Committee on the Taxonomy of Viruses now designates Norwalk-like virus as norovirus). For more information, contact Ellen Swanson at 612-676-5639 or firstname.lastname@example.org.
On a related note, we continue to investigate clusters and outbreaks of norovirus. Since November, MDH or local health departments have investigated more than 60 such outbreaks. Widespread norovirus activity continues to be reported across North America and the United Kingdom.
3. Smallpox Vaccination
In the next few weeks we will begin to do something that has not been done for 30 years in Minnesota: vaccinate persons against smallpox (see past two issues of Bug Bytes for our plans at http://www.health.state.mn.us/
divs/idepc/bugbytes/). Vaccinations are scheduled mid-February for MDH and other staff, and then will quickly move throughout the state.
Bug Bytes is a combined effort of the Infectious Disease Epidemiology, Prevention and Control Division and the Public Health Laboratory Division of MDH. We provide Bug Bytes as a way to say THANK YOU to the infection control professionals, laboratorians, local public health professionals, and health care providers who assist us.
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