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2018 ; 50
(1
): 38-42
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Investigation of Scarlet Fever Outbreak in a Kindergarten
#MMPMID29637751
Ryu S
; Chun BC
Infect Chemother
2018[Mar]; 50
(1
): 38-42
PMID29637751
show ga
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.