Abstract
IntroductionOutbreaks linked to cosmetic piercing are rare, but can cause significant illness. We report the investigation and management of a point-source outbreak that occurred during a Black Friday promotional event in North West England.MethodsOutbreak investigation was led by Public Health England, and included active case finding among individuals pierced at a piercing premises between 25/11/2016 (Black Friday) and 7/12/2016. Detailed epidemiological, environmental (including inspection and sampling), and microbiological investigation was undertaken.ResultsDuring the Black Friday event (25/11/2016), 45 people were pierced (13 by a newly-appointed practitioner). Eleven cases were identified (7 microbiologically-confirmed, 2 probable, and 2 possible). All cases had clinical signs of infection around piercing sites, and five required surgical intervention, with varying degrees of post-operative disfigurement. All confirmed and probable cases had a scaffold piercing placed with a guide bar by the newly-appointed practitioner. Pseudomonas aeruginosa, indistinguishable at nine-locus variable-number tandem repeat loci, was isolated from four of the confirmed cases, and from pre- and post-flush samples from five separate water taps (three sinks) in the premises. Water samples taken after remedial plumbing work confirmed elimination of Pseudomonas contamination.DiscussionAlthough high levels of Pseudomonas water contamination and some poor infection control procedures were identified, infection appeared to require additional exposure to an inexperienced practitioner, and the more invasive scaffold piercing. A proactive collaborative approach between piercers and health and environmental officials is required to reduce outbreak risk, particularly when unusually large events are planned
Highlights
Outbreaks linked to cosmetic piercing are rare, but can cause significant illness
An Outbreak of Pseudomonas Aeruginosa Infection Linked to a “Black Friday” Pierci
A small number of case reports and point source outbreaks of Pseudomonas aeruginosa infection linked to conventional ear piercing have previously been reported[6,7,8]
Summary
Outbreaks linked to cosmetic piercing are rare, but can cause significant illness. Scaffold piercing is reported to be more painful than conventional ear piercing (as it involves the helix rather than the pinna) and may take longer to http://currents.plos.org/outbreaks/article/an-outbreak-of-pseudomonas-aeruginosa-infe... An Outbreak of Pseudomonas Aeruginosa Infection Linked to a “Black Friday” Pierci. Heal2,3,4 , we are unaware of previous reports of rates of infection or outbreaks associated with this relatively new cosmetic procedure[5 ]. A small number of case reports and point source outbreaks of Pseudomonas aeruginosa infection linked to conventional ear piercing have previously been reported. In England during 2016, a national outbreak of Pseudomonas infection linked to a contaminated aftercare cleaning solution resulted in a large number of cases[9 ]
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