An Outbreak of Invasive Group A Streptococcal Infection Among the Homeless in Alaska

A program of providing a single dose of azithromycin in homeless centers in Anchorage significantly reduced the number of new cases.

Invasive group A Streptococcus (GAS) infection due to strain type emm26.3 occurred in 43 patients at three hospitals in Anchorage, Alaska, from July 2016 through April 2017. The mean age of these patients was 52 years, 65% were male, 81% were homeless, 74% were Alaska natives, and 67% had a history of chronic alcohol use.

In response to this outbreak, investigators characterized the GAS strain based on the expression of M proteins produced by the emm gene and, in February 2017, implemented an antibiotic intervention in which 391 participants at six homeless service sites in Anchorage were given a single dose of oral azithromycin (1 g).

At baseline, 4% of 277 participants were colonized with the emm26.3 strain. Four weeks later, only 1% of 287…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

An Outbreak of Invasive Group A Streptococcal Infection Among the Homeless in Alaska

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Reviewing Author