Investigation of an outbreak of group A Streptococcus in a Regina retirement residence and personal care home, 2018

Streptococcus pyogenes (group A Streptococcus) is a common bacterium that causes infections ranging from minor illnesses, like strep throat, to life-threatening invasive disease. The elderly are particularly at risk of invasive infection, with this risk compounded by living in communal settings, including long-term care facilities or personal care homes. Following the identification of five invasive group A streptococcal infections in residents of a Regina retirement residence and personal care home over a period of five months, an outbreak was declared on May 8, 2018. Over the 10 weeks the outbreak lasted, 10 cases were diagnosed, attributable to nine individuals: six residents and three staff. Five of the 10 cases (50%) were invasive, all of which required hospitalization. The predominant emm type was 92 – a type not common in Canada. Interventions, including onsite inspections, weekly surveillance, hand hygiene and environmental cleaning improvements, as well as mass screening for carriage of group A Streptococcus were carried out in collaboration with the personal-care home. Mitigating outbreak risks in private retirement residences and personal care homes requires that facilities establish robust infection control programs, including hand hygiene and effective environmental cleaning, and work collaboratively with Public Health officials to address outbreaks.