Abstract
Background Streptococcus suis infection in humans has received increasing worldwide recognition.Methods and FindingsA prospective study of S. suis infection in humans was conducted in Phayao Province in northern Thailand to determine the incidence and the risk behaviors of the disease in this region in 2010. Thirty-one cases were confirmed. The case fatality rate was 16.1%, and the estimated incidence rate was 6.2 per 100,000 in the general population. The peak incidence occurred in May. The median age of the patients was 53 years and 64.5% were men. Consumption of raw pork products was confirmed in 22 cases and the median incubation period (range) was 2 days (0–11) after consumption of raw pork products. Isolates from 31 patients were confirmed as serotype 2 in 23 patients (74.2%) and serotype 14 in eight patients (25.8%). The major sequence types (STs) were ST1 (n = 20) for serotype 2 and ST105 (n = 8) for serotype 14. The epidemiological analysis suggested three possible clusters, which included 17 cases. In the largest possible cluster of 10 cases in Chiang Kham and its neighboring districts in May, the source of infection in four cases was identified as a raw pork dish served at the same restaurant in this district. Microbiological analysis confirmed that three of four cases associated with consumption of raw pork at this restaurant were attributable to an identical strain of serotype 2 with ST1 and pulsotype A2.ConclusionsOur data suggest a high incidence rate of S. suis infection in the general population in Phayao Province in 2010 and confirm a cluster of three cases in 31 human cases. Food safety control should be strengthened especially for raw pork products in northern Thailand.
Highlights
Streptococcus suis is a zoonotic pathogen that can cause invasive infection in humans who have close contact with infected pigs or contaminated pork-derived products
Bacteremic meningitis was defined as a positive result in both the cerebrospinal fluid (CSF) and blood cultures, confirmed meningitis was defined as a positive culture in the CSF only, and probable meningitis was defined as a positive blood culture
No case was found in the districts of Phu Sang, Phu Kamyoo, and Chiang Muan
Summary
Streptococcus suis is a zoonotic pathogen that can cause invasive infection in humans who have close contact with infected pigs or contaminated pork-derived products. The numbers of reported human cases, especially in Southeast Asian countries, have increased dramatically in the past few years [1,2,3]. In a retrospective study in 2006–2008 in Thailand, S. suis infection was confirmed in bacterial cultures of blood or cerebrospinal fluid (CSF) from 179 patients. These isolates were determined to be serotype 2 for 165 cases (92.2%), serotype 14 for 12 cases (6.7%), and one case each (0.6%) of serotypes 5 and 24 [4,5,6]. Streptococcus suis infection in humans has received increasing worldwide recognition
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