Investigation of scarlet fever outbreak in a kindergarten

Sukhyun Ryu, Byung-Chul Chun

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Scarlet fever is caused by a group A streptococcal (GAS) infection. On April 3, 2017, an outbreak among children in a kindergarten was reported to the local health department. An epidemiologic investigation was conducted to identify the possible transmission route of this outbreak and to recommend appropriate control measures. Materials and Methods: A retrospective cohort study was conducted using questionnaires including age, sex, the classroom attended at a kindergarten, and date and type of symptoms developed. A case-patient is defined as a child having sore throat, fever, skin rash, or strawberry tongue with or without laboratory confirmation of GAS infection between March 28 and April 28, 2017. Results: The index case-patients developed symptoms on March 28, 2017, and this outbreak persisted over a period of 16 days. The outbreak affected 21 out of 158 children (13.3%) in the kindergarten, with the mean age of 4.2 (range 3-5) years; 12 (57.1%) of them were boys. The common symptoms reported were fever (71.4%), sore throat (71.4%), reddened tonsil (57.1%), and skin rash (52.4%). The epidemiologic analysis showed that children attending one of the classrooms in the kindergarten were 14.12 times affected than the other classrooms (relative risk, 14.12; 95% confidence interval, 4.99-33.93; P < 0.01). All case-patients were recommended to stay away from the kindergarten and its social activities for > 24 hours after starting appropriate antibiotic treatment, and all the children in the kindergarten were instructed to keep strict personal hygiene practices. Conclusion: Our results suggest that the outbreak likely affected from the index case-patients who attended to one of the classrooms in the kindergarten. This highlights the importance of immediate notification of outbreak to prevent large number of patients.

Original languageEnglish
Pages (from-to)38-42
Number of pages5
JournalInfection and Chemotherapy
Volume50
Issue number1
DOIs
Publication statusPublished - 2018 Mar 1

Fingerprint

Scarlet Fever
Disease Outbreaks
Streptococcal Infections
Pharyngitis
Exanthema
Fever
Fragaria
Palatine Tonsil
Hygiene
Tongue
Cohort Studies
Retrospective Studies
Confidence Intervals
Anti-Bacterial Agents
Health

Keywords

  • Children
  • Kindergarten
  • Korea
  • Outbreak
  • Scarlet fever

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Investigation of scarlet fever outbreak in a kindergarten. / Ryu, Sukhyun; Chun, Byung-Chul.

In: Infection and Chemotherapy, Vol. 50, No. 1, 01.03.2018, p. 38-42.

Research output: Contribution to journalArticle

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abstract = "Background: Scarlet fever is caused by a group A streptococcal (GAS) infection. On April 3, 2017, an outbreak among children in a kindergarten was reported to the local health department. An epidemiologic investigation was conducted to identify the possible transmission route of this outbreak and to recommend appropriate control measures. Materials and Methods: A retrospective cohort study was conducted using questionnaires including age, sex, the classroom attended at a kindergarten, and date and type of symptoms developed. A case-patient is defined as a child having sore throat, fever, skin rash, or strawberry tongue with or without laboratory confirmation of GAS infection between March 28 and April 28, 2017. Results: The index case-patients developed symptoms on March 28, 2017, and this outbreak persisted over a period of 16 days. The outbreak affected 21 out of 158 children (13.3{\%}) in the kindergarten, with the mean age of 4.2 (range 3-5) years; 12 (57.1{\%}) of them were boys. The common symptoms reported were fever (71.4{\%}), sore throat (71.4{\%}), reddened tonsil (57.1{\%}), and skin rash (52.4{\%}). The epidemiologic analysis showed that children attending one of the classrooms in the kindergarten were 14.12 times affected than the other classrooms (relative risk, 14.12; 95{\%} confidence interval, 4.99-33.93; P < 0.01). All case-patients were recommended to stay away from the kindergarten and its social activities for > 24 hours after starting appropriate antibiotic treatment, and all the children in the kindergarten were instructed to keep strict personal hygiene practices. Conclusion: Our results suggest that the outbreak likely affected from the index case-patients who attended to one of the classrooms in the kindergarten. This highlights the importance of immediate notification of outbreak to prevent large number of patients.",
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