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December 4, 1987, Vol 258, No. 21 >
ARTICLE | December 4, 1987

Group A β-Hemolytic Streptococcal Skin Infections in a US Meat-Packing Plant FREE

Laura J. Fehrs, MD; Kirby Flanagan, MD; Sharon Kline, RN; Richard R. Facklam, PhD; Karla Quackenbush, MS; Laurence R. Foster, MD
[+] Author Affiliations

Reprint requests to the Los Angeles County Health Department, 313 N Figueroa St, Los Angeles, CA 90012 (Dr Fehrs).


JAMA. 1987;258(21):3131-3134. doi:10.1001/jama.1987.03400210073028
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References

In 1985, the second reported outbreak of group A β-hemolytic streptococcal (GABHS) skin infections among US meat packers was recognized at an Oregon meat-packing plant. All 69 plant workers were interviewed and examined for the presence of pustular, draining, or inflamed lesions. During a three-month period, 44 episodes of skin infection occurred in 32 workers, all but four of whom worked in boning or killing areas. Acquiring infection was associated with job category (relative risk [RR], 5.7; 95% confidence intervals [CI], 2.9 to 11.3) and having at least two hand lacerations (RR adjusted for occupation, 6.2; 95% CI, 3.0 to 12.5). Group A β-hemolytic Streptococcus (18), Staphylococcus aureus (12), or both (20) were isolated from 70 lesions cultured. Meat is suspected as a vehicle of transmission because cultures of two meat specimens contained the same GABHS strain as did 24 isolates from patients. Increasing reports of GABHS skin infections in meat packers suggest that this occupational risk may be more common than is realized.

(JAMA 1987;258:3131-3134)

REFERENCES

1 +
Barnham M, Kerby J:  An outbreak of streptococcal infection in a chicken factory . J Hyg Cambridge 1981;;84:71-75.
2 +
Fraser CAM, Ball LC, Maxted WR, et al:  Streptococcal skin sepsis among meat handlers , in Parker MT (ed): Pathogenic Streptococci: Proceedings of the Seventh International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1979;, pp 115-116.
3 +
Mayon-White RT. Perks EM:  Skin infections in meat workers in the Oxford region . Environ Health 1982;;10:259-261.
4 +
Barnham M, Kerby J, Skillin J:  Streptococcal skin sepsis in chicken factory workers , in Holm SE, Christensen P (eds): Basic Concepts of Streptococci and Streptococcal Disease: Proceedings of the Eighth International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1982;, pp 26-27.
5 +
Barnham M, Kerby J:  A profile of skin sepsis in meat handlers . J Infect 1984;;84:43-50.
6 +
 Prevention of streptococcal sepsis in meat handlers . Communicable Dis Rep 1983;;84:3-4.
7 +
Working Group on Streptococcal Infection in Meat Handlers:  The epidemiology and control of streptococcal sepsis in meat handlers . Environ Health 1982;;10:256-258.
8 +
 Epidemiological Research Laboratory of the Public Health Laboratory Service: I. Skin infections in meat handlers . Br Med J 1975;;1:526.
9 +
Tsai TF, Watson WN, Hayes PS:  Mode of spread of group-A streptococci in an abattoir outbreak of wound sepsis , in Parker MT (ed): Pathogenic Streptococci: Proceedings of the Seventh International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1978;, pp 118-119.
10 +
Working Group on Streptococcal Infection in Meat Handlers:  A survey of streptococcal skin sepsis among meat handlers and other workers , in Parker MT (ed): Pathogenic Streptococci: Proceedings of the Seventh International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1978;, pp 117-118.
11 +
 Streptococcal skin infection in meat workers . Communicable Dis Rep 1981;;16:3-4.
12 +
Kolmel VK, Proksch E:  Rezidivierende Pyodermien als Berufskrankheit bei einem Schlachter . Dermatosen 1985;;33:223-224.
13 +
Rosef O, Bjorland J:  En epidemi med gruppe A-streptokokken ved Fellesslakteriet i Oslo . Norsk Veterinaertidsskrift 1981;;93:446.
14 +
Maxted WR, Widdowson JP, Fraser AM:  Antibody to streptococcal opacity factor in human sera . J Hyg Cambridge 1973;;71:35-42.
15 +
Perks EM, Mayon-White RT, Slack MPE, et al:  The epidemiology of Streptococcus pyogenes in Oxfordshire 1970-1980 , in Holm SE, Christensen P (eds): Basic Concepts of Streptococci and Streptococcal Disease: Proceedings of the Eighth International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1982;, pp 21-22.
16 +
Slack MPE, Saunders FC, Mayon-White RT:  Streptococcal skin infections in meat workers in Oxfordshire , in Holm SE, Christensen P (eds): Basic Concepts of Streptococci and Streptococcal Disease: Proceedings of the Eighth International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1982;, pp 28-29.
17 +
 Occupational injuries in the meatpacking industry, United States, 1976-1981 . MMWR 1985;;34: 29-32SS.
18 +
Barnham M, Kerby J:  Skin sepsis in meat handlers: Observations on the causes of injury with special reference to bone . J Hyg Cambridge 1981;;87:465-476.
19 +
Fraser AM, Ball LC, Morris CA:  Serological characterization of group-A streptococci associated with skin sepsis in meat handlers . J Hyg Cambridge 1977;;78:283-296.
20 +
 Foodborne outbreak of streptococcal pharyngitis—Portland, Oregon . MMWR 1982;;31:3-5.
21 +
Farber RE, Korff FA:  Foodborne epidemic of group A β-hemolytic Streptococcus . Public Health Rep 1958;;73:203-209.
22 +
Martin TA, Hoff GL, Gibson V, et al:  Foodborne streptococcal pharyngitis, Kansas City, Missouri . Am J Epidemiol 1985;;122:706-709.
23 +
Hill HR, Zimmerman RA, Reid GV, et al:  Foodborne epidemic of streptococcal pharyngitis at the United States Air Force Academy . N Engl J Med 1964;;280:917-921.
24 +
Decker MD, Lavely GB, Hutcheson RH, et al:  Foodborne streptococcal pharyngitis in a hospital pediatrics clinic . JAMA 1985;;253:679-681.
25 +
 Outbreak of foodborne streptococcal disease— Florida . MMWR 1974;;23:365-366.
26 +
McCormick JB, Kay D, Hayes P, et al:  Epidemic streptococcal sore throat following a community picnic . JAMA 1976;;236:1039-1041.

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1 +
Barnham M, Kerby J:  An outbreak of streptococcal infection in a chicken factory . J Hyg Cambridge 1981;;84:71-75.
2 +
Fraser CAM, Ball LC, Maxted WR, et al:  Streptococcal skin sepsis among meat handlers , in Parker MT (ed): Pathogenic Streptococci: Proceedings of the Seventh International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1979;, pp 115-116.
3 +
Mayon-White RT. Perks EM:  Skin infections in meat workers in the Oxford region . Environ Health 1982;;10:259-261.
4 +
Barnham M, Kerby J, Skillin J:  Streptococcal skin sepsis in chicken factory workers , in Holm SE, Christensen P (eds): Basic Concepts of Streptococci and Streptococcal Disease: Proceedings of the Eighth International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1982;, pp 26-27.
5 +
Barnham M, Kerby J:  A profile of skin sepsis in meat handlers . J Infect 1984;;84:43-50.
6 +
 Prevention of streptococcal sepsis in meat handlers . Communicable Dis Rep 1983;;84:3-4.
7 +
Working Group on Streptococcal Infection in Meat Handlers:  The epidemiology and control of streptococcal sepsis in meat handlers . Environ Health 1982;;10:256-258.
8 +
 Epidemiological Research Laboratory of the Public Health Laboratory Service: I. Skin infections in meat handlers . Br Med J 1975;;1:526.
9 +
Tsai TF, Watson WN, Hayes PS:  Mode of spread of group-A streptococci in an abattoir outbreak of wound sepsis , in Parker MT (ed): Pathogenic Streptococci: Proceedings of the Seventh International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1978;, pp 118-119.
10 +
Working Group on Streptococcal Infection in Meat Handlers:  A survey of streptococcal skin sepsis among meat handlers and other workers , in Parker MT (ed): Pathogenic Streptococci: Proceedings of the Seventh International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1978;, pp 117-118.
11 +
 Streptococcal skin infection in meat workers . Communicable Dis Rep 1981;;16:3-4.
12 +
Kolmel VK, Proksch E:  Rezidivierende Pyodermien als Berufskrankheit bei einem Schlachter . Dermatosen 1985;;33:223-224.
13 +
Rosef O, Bjorland J:  En epidemi med gruppe A-streptokokken ved Fellesslakteriet i Oslo . Norsk Veterinaertidsskrift 1981;;93:446.
14 +
Maxted WR, Widdowson JP, Fraser AM:  Antibody to streptococcal opacity factor in human sera . J Hyg Cambridge 1973;;71:35-42.
15 +
Perks EM, Mayon-White RT, Slack MPE, et al:  The epidemiology of Streptococcus pyogenes in Oxfordshire 1970-1980 , in Holm SE, Christensen P (eds): Basic Concepts of Streptococci and Streptococcal Disease: Proceedings of the Eighth International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1982;, pp 21-22.
16 +
Slack MPE, Saunders FC, Mayon-White RT:  Streptococcal skin infections in meat workers in Oxfordshire , in Holm SE, Christensen P (eds): Basic Concepts of Streptococci and Streptococcal Disease: Proceedings of the Eighth International Symposium on Streptococci and Streptococcal Disease . Chertsey, England, Reedbooks, 1982;, pp 28-29.
17 +
 Occupational injuries in the meatpacking industry, United States, 1976-1981 . MMWR 1985;;34: 29-32SS.
18 +
Barnham M, Kerby J:  Skin sepsis in meat handlers: Observations on the causes of injury with special reference to bone . J Hyg Cambridge 1981;;87:465-476.
19 +
Fraser AM, Ball LC, Morris CA:  Serological characterization of group-A streptococci associated with skin sepsis in meat handlers . J Hyg Cambridge 1977;;78:283-296.
20 +
 Foodborne outbreak of streptococcal pharyngitis—Portland, Oregon . MMWR 1982;;31:3-5.
21 +
Farber RE, Korff FA:  Foodborne epidemic of group A β-hemolytic Streptococcus . Public Health Rep 1958;;73:203-209.
22 +
Martin TA, Hoff GL, Gibson V, et al:  Foodborne streptococcal pharyngitis, Kansas City, Missouri . Am J Epidemiol 1985;;122:706-709.
23 +
Hill HR, Zimmerman RA, Reid GV, et al:  Foodborne epidemic of streptococcal pharyngitis at the United States Air Force Academy . N Engl J Med 1964;;280:917-921.
24 +
Decker MD, Lavely GB, Hutcheson RH, et al:  Foodborne streptococcal pharyngitis in a hospital pediatrics clinic . JAMA 1985;;253:679-681.
25 +
 Outbreak of foodborne streptococcal disease— Florida . MMWR 1974;;23:365-366.
26 +
McCormick JB, Kay D, Hayes P, et al:  Epidemic streptococcal sore throat following a community picnic . JAMA 1976;;236:1039-1041.

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