Biological Health Hazard – Highly Infectious Streptococcus A (Outbreak – Fatal): Alaska, USA
STREPTOCOCCUS, GROUP A – USA: (ALASKA) FATAL, NEW STRAIN, HOMELESS, REQUEST FOR INFORMATION
Published Date: 2017-02-15 09:51:59
Subject: PRO/EDR> Streptococcus, group A – USA: (AK) fatal, new strain, homeless, RFI
Archive Number: 20170215.4840076
Date: Mon 13 Feb 2017
Source: Alaska Public Media [edited]
There’s an outbreak of a newly identified, rare strain of group A streptococcus bacteria [GAS or _Streptococcus pyogenes_] in Anchorage that’s mostly impacting people who are experiencing homelessness. Public health workers will be visiting Brother Francis Shelter, Beans’ Cafe, and other services this week to distribute antibiotics and antiseptics to try to stop the spread of the disease.
State epidemiologist Joe McLaughlin said the bacterium is fairly common. Most healthy people don’t show any symptoms or just have mild skin or throat infections. But if a person’s immune system is already compromised, then the bacteria can enter into a small cut and lead to major infections, toxic shock syndrome, or amputations.
“The homeless population is more at risk in general for these types of invasive diseases because they’re at higher likelihood to have other chronic conditions,” he explained during a phone interview. “They might also have decreased access to care and decreased opportunities for self care and personal hygiene.”
The outbreak started in Fairbanks over the summer  then died down. It spread to Anchorage in the fall. There have been 7 to 10 severe cases per month since October . 90 percent of the patients were homeless. 4 people have died.
Epidemic Intelligence Service Officer Emily Mosites, who is with the Center for Disease Control in Anchorage, said this outbreak has been hard to stop. The bacteria spread through human contact, like coughing near someone or touching, and it’s impacting a very mobile population. But she stressed that most people should not worry. “The main thing to keep in mind here is the risk in the general population is very low,” she said. “Right now we’re still seeing it in the homeless population, and we’re taking as many steps as we can to try to control it there.”
The newest step is going to different service providers this week to hand out single-dose antibiotics and antiseptic washes, to kill the bacterium before it causes more severe infections. Mosites said the epidemiologists have been working with the clinic at Brother Francis Shelter since November  to identify and treat cases early on, and to contact people who could be at risk for infection.
[Byline: Anne Hillman]
ProMED-mail from HealthMap Alerts
[Crowding in shelters likely facilitated person-to-person transmission.
ProMED-mail previously reported that a new “strain” of GAS had been identified as causing an outbreak of invasive GAS infections in Fairbanks in 2016, that subsequently spread to Anchorage, in mostly middle-aged Alaska Native men who had stayed in homeless shelters (Streptococcus, group A – USA: (AK) fatal, new strain, homeless native men, RFI 20161130.4664201). During February through November 2016, there were 28 confirmed cases of invasive infections identified — 10 in the Fairbanks area and 18 in Anchorage; 14 of these cases occurred during October and November 2016; 4 of 28 patients with invasive GAS died (2 in Fairbanks, 2 in Anchorage); and the strain that caused these infections was a novel genotype, _emm_-type 26 (http://dhss.alaska.gov/dph/epi/documents/phan/gas%20phan_nov_29_2016.pdf).
However, the news report above does not mention if Alaskan Native men are involved and does not indicate if the genotype of the “new” strain is also _emm_-type 26. Further information in this regard from knowledgeable sources would be appreciated. – Mod.ML
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/3238.]
Streptococcus group A, scarlet fever – USA: (KS) 20120113.1009102
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Notes from the Field: Fatal Infection Associated with Equine Exposure — King County, Washington, 2016
UK study identifies odd new Streptococcus variant – 2015/06/14
Emergence of a New Highly Successful Acapsular Group A Streptococcus Clade of Genotype emm89 in the United Kingdom