A cluster of acute rheumatic fever cases among Aboriginal Australians in a remote community with high baseline incidence

Autor: Anna P. Ralph, Bo Remenyi, Vicki Krause, Anthony Draper, Deborah C. Holt, Catherine Gargan, Kate Hardie, Jane E. Francis
Rok vydání: 2019
Předmět:
Adult
Male
Benzathine benzylpenicillin
medicine.medical_specialty
Native Hawaiian or Other Pacific Islander
Impetigo
Adolescent
030309 nutrition & dietetics
Prevalence
Disease cluster
Young Adult
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Streptococcal Infections
Internal medicine
medicine
Humans
public health response
030212 general & internal medicine
Child
cluster
Disease Notification
0303 health sciences
business.industry
Incidence
group A Streptococcus
lcsh:Public aspects of medicine
Incidence (epidemiology)
Public health
Australia
Public Health
Environmental and Occupational Health
Streptococcus
Outbreak
lcsh:RA1-1270
rheumatic heart disease
medicine.disease
acute rheumatic fever
Anti-Bacterial Agents
chemistry
Echocardiography
Child
Preschool
Population Surveillance
Acute Disease
Penicillin G Benzathine
Rheumatic fever
Female
Rheumatic Fever
business
Zdroj: Australian and New Zealand Journal of Public Health, Vol 43, Iss 3, Pp 288-293 (2019)
ISSN: 1326-0200
Popis: Objectives: We report a cluster of acute rheumatic fever (ARF) cases and the public health response in a high‐burden Australian setting. Methods: The public health unit was notified of an increase in ARF cases in a remote Australian Aboriginal community. A multi‐disciplinary group coordinated the response. Household contacts were screened for ARF or group A Streptococcus (GAS) infection by questionnaire and swab collection, offered an echocardiogram if aged 5–20 years, and intramuscular benzathine benzylpenicillin if aged over one year or if less than one year with impetigo. Results: Fifteen definite and seven probable ARF cases were diagnosed in the community in July–December 2014 (all‐age incidence of definite ARF: 1,473/100,000). The public health response identified two additional cases of ARF. A total of 81 contacts were screened; GAS was detected in 3/76 (4%) throat swabs and 11/24 (46%) skin swabs. Molecular typing revealed high GAS strain diversity. Conclusions: The incidence of ARF during this cluster was very high. Carriage and infection with GAS was observed, but no outbreak strain identified. Implications for public health: A national public health guideline has since been developed that includes advice on the investigation of an ARF outbreak/cluster. Sustained efforts with strong community engagement are required to tackle high ARF rates.
Databáze: OpenAIRE
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