SPREAD OF SERIOUS DISEASE-PRODUCING M3 CLONES OF GROUP-A STREPTOCOCCUS AMONG FAMILY MEMBERS AND HEALTH-CARE WORKERS

Streptococcus pyogenes causes a variety of diseases ranging from mild pharyngitis to severe toxic shock syndrome (TSS) and acute rheumatic f ever. Since 1987 there has been a resurgence of severe group A strepto coccus infections including TSS, necrotizing fasciitis, and myositis. Using molecular and serotyping procedures, we recently studied two clu sters of group A streptococcus disease that occurred within separate f amily units. The first cluster involved two family members (one with T SS and one with necrotizing fasciitis) and three health care workers w ho attended one of the index patients. The second cluster included a m other (with necrotizing fasciitis of the hand) and her three children. Group A streptococci isolated from individuals within both cluster gr oups were serotype M3;T3/13/B3264, and pulsed held gel electrophoresis revealed that all isolates except one had identical fingerprints of S mn I-digested chromosomal DNA. The findings demonstrate the potential for spread of serious group A streptococcus disease among individuals and the need for barrier protection when health care workers are expos ed to secretions from infected individuals.