Pneumococcal Disease Outbreak at a State Prison, Alabama, USA, September 1–October 10, 2018

Guillermo V. Sanchez; Constance L. Bourne; Sherri L. Davidson; Mark Ellis; Leora R. Feldstein; Katherine Fay; Nicole E. Brown; Evelyn F. Geeter; Lytasha L. Foster; Charlotte Gilmore; Mary G. McIntyre; Burnestine Taylor; Srinivasan Velusamy; Sopio Chochua; Almea M. Matanock

Disclosures

Emerging Infectious Diseases. 2021;27(7):1949-1952. 

In This Article

Abstract and Introduction

Abstract

A pneumococcal disease outbreak caused by Streptococcus pneumoniae serotype 12F occurred in a state prison in Alabama, USA. Among 1,276 inmates, 40 cases were identified (3 confirmed, 2 probable, 35 suspected). Close living quarters, substance use, and underlying conditions likely contributed to disease risk. Prophylaxis for close contacts included azithromycin and 23-valent pneumococcal polysaccharide vaccine.

Introduction

Streptococcus pneumoniae (pneumococcus) causes a spectrum of disease ranging from mild respiratory infections to severe disease, including meningitis, sepsis, and pneumonia.[1] Invasive pneumococcal disease (IPD) occurs when pneumococcus invades normally sterile sites. Pneumococcus is transmitted person-to-person primarily through respiratory droplets and is a leading cause of vaccine-preventable illness and death.[2] Pneumococcal colonization is a precursor to disease but does not always result in disease.[3] Pneumococcal conjugate vaccine (PCV) is highly effective in preventing pneumonia in adults,[4] and pneumococcal disease incidence has declined since the introduction of PCV.[5] IPD outbreaks are rare but can occur in settings with close person-to-person contact, such as homeless shelters[6] and healthcare facilities, in which underlying conditions can increase disease risk.[7]

On September 19, 2018, the Alabama Department of Public Health (Montgomery, AL) was notified of an IPD case after identification of S. pneumoniae in a blood culture from an ill patient incarcerated at a state prison. On September 24, a second case of IPD was reported in another inmate who received a diagnosis of meningitis and sepsis and died that morning. We investigated this outbreak to determine its extent, identify cases among staff and inmates, and recommend prophylactic measures to reduce spread.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....