Group A streptococcal skin infection outbreak in an abattoir: lessons for prevention

During a group A streptococcus (GAS) outbreak 21 abattoir workers developed skin infections. The unusual outbreak strain (emm 108.1) was cultured from five workers and four persons in the community with links to the abattoir. The attack rate was 26% in the lamb line. Communal nailbrushes were neithe...

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Bibliographic Details
Published in:Epidemiology and infection 2007-02, Vol.135 (2), p.321-327
Main Authors: HUMPHREYS, C. P., MORGAN, S. J., WALAPU, M., HARRISON, G. A. J., KEEN, A. P., EFSTRATIOU, A., NEAL, S. E., SALMON, R. L.
Format: Article
Language:English
Subjects:
Abattoirs
Animals
Bacteriology
Biological and medical sciences
Chi-Square Distribution
Cohort analysis
Cohort studies
Disease Outbreaks
Epidemics
Fundamental and applied biological sciences. Psychology
Health services
Humans
Hygiene
Infections
Infectious diseases
Meats
Microbiology
Miscellaneous
Occupational Exposure - adverse effects
Public health
Sepsis
Skin
Skin Diseases, Bacterial - drug therapy
Skin Diseases, Bacterial - epidemiology
Skin Diseases, Bacterial - transmission
Slaughterhouses
Staphylococcus infections
Streptococcal Infections - drug therapy
Streptococcal Infections - epidemiology
Streptococcal Infections - transmission
Streptococcus
United Kingdom - epidemiology
Workers
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Summary:During a group A streptococcus (GAS) outbreak 21 abattoir workers developed skin infections. The unusual outbreak strain (emm 108.1) was cultured from five workers and four persons in the community with links to the abattoir. The attack rate was 26% in the lamb line. Communal nailbrushes were neither routinely disinfected nor changed, and had high bacterial counts. A cohort study found a higher risk from working in the gutting area and getting cuts on hands more than weekly. Despite high bacterial counts daily nailbrush use had a lower risk, as did always wearing disposable gloves. Working in the gutting area (OR 11·44) and nailbrush use at least once a day (OR 0·04) were significant in the multivariate model. Transmission of infection is likely to have occurred on carcasses. GAS infection among abattoir workers was once common. Simple hygiene measures, such as nailbrush use, may reduce the impact of future outbreaks.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268806006819