Sunday, March 05, 2000

Strep outbreak has killed 2

Area seems magnet for virus

The Cincinnati Enquirer

        Since January, two Hamilton County residents have died and another 21 in Greater Cincinnati have become ill with a streptococcus bacterium that in rare cases causes toxic shock or a life-threating skin infection.

        Now, local, state and federal health experts are trying to figure out why there's been such a large cluster of cases in the area.

        The illness is called “invasive group A streptococcus.” Of 63 cases reported in Ohio in January and February, 36 percent have been in southwest Ohio: 16 cases in Hamilton County, four in Butler County and three in Clermont County. Warren County reported none.

        That's several times higher than the number of cases reported this time last year, but Cincinnati Health Commissioner Malcolm Adcock said there's still no reason for the public to be concerned.

        “It's still a very rare occurrence, and there's nothing we can tell people specifically to prevent the disease,” Mr. Adcock said Saturday.

        Strep A is a common bacterium that causes sore throats and scarlet fever and at any given time five to 10 percent of the population is carrying the disease. But in rare cases — experts are still unsure why — an invasive form of the infection spreads uncontrollably.

        Still, the more serious infection can be treated. Nationwide in 1998, there were 10,000 invasive Strep A cases reported to the Centers for Disease Control and Prevention. Of those people:

        • About 800 developed nec rotizing fasciitis, which the media has called “flesh-eating” bacteria because it destroys muscles, fat and skin. About 20 percent of these patients die.

        • About 600 developed streptococcal toxic shock syndrome (STSS) where blood pressure drops and organs such as the kidneys, liver and lungs fail. About half of these patients die.

        • Death also occurs in another 10 to 15 percent of patients with other forms of invasive group A strep diseases.

        In Greater Cincinnati, three of the cases have been diagnosed as necrotizing fasciitis, Dr. Adcock said. Toxic shock cases also have been seen, he said. It's unclear whether the two people who died had necrotizing fasciitis, STSS or something else.

        A doctor and medical student from the Centers for Disease Control have been in Cincinnati since last week to interview victims and their family members to see if there are any links among the cases, said Randy Hertzer, spokesman for the Ohio Department of Health.

        “Anytime you see a significant increase in cases like that you want to see what's going on,” he said.

        So far, they aren't aware of any connections between cases.

        Health officials also aren't sure whether the bacterium — which is most common in the late winter and early spring — is on the rise or if it is just being caught and reported more. Ohio has only kept records on the cases for a few years, Mr. Hertzer said.

        People with chronic diseases are more susceptible to the bacterium. Doctors say the best way to avoid the disease is to make sure open wounds from an injury or surgery stay clean and to see a doctor if infections occur.


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