Recommendations for local
and state health agencies involved in public health investigations of GAS infections
Recommended steps in the
Confirm diagnoses and look for
additional invasive GAS cases.
Collect clinical and
demographic data on cases, e.g., age, sex, disease syndrome, setting
(community, hospital or other facility).
links among cases.
Determine if the cluster is
Discuss with local and state
public health authorities whether urgent public health action is needed.
Ask laboratories to save GAS
Review previous GAS
surveillance data in region.
Settings requiring urgent
public health action
Postpartum and post-surgical
GAS infections (see Prevention of Invasive Group A Streptococcal Disease
among Household Contacts of Case Patients and among Postpartum and
Postsurgical Patients: Recommendations from the Centers for Disease Control
and Prevention. Clinical Infectious Disease October 15, 2002, Vol. 35, Pages
Outbreaks of rheumatic fever
Clusters in military
Clusters in hospitals or
long-term care facilities
Outbreaks of invasive disease in child care
centers and other school settings
Outbreaks of invasive disease among young children
following varicella (Chicken pox) infections
These and other settings
requiring urgent public health action should be discussed with your state or
local public health partners. A single case of postpartum or post-surgical
GAS infection requires prompt epidemiologic investigation; assessment of
potential nosocomial spread from an asymptomatic carrier may be required. Close contact
facilitates disease transmission; special interventions and precautions
may be necessary to control disease spread in group settings.
Guidelines for invasive
group A streptococcal disease among household contacts
For household contacts
of persons with invasive GAS infection, routine screening for GAS
colonization and chemoprophylaxis is not recommended
Physicians and public health
officials may choose to offer chemoprophylaxis to household contacts who are
at increased risk of GAS disease.