Tonsillopharyngitis Caused by Foodborne Group A Streptococcus: A Prison-Based Outbreak

An outbreak of tonsillopharyngitis due to Streptococcus pyogenes occurred among inmates of a rural correctional center in New South Wales, Australia. A total of 72 (28%) of 256 inmates became ill in December 1999. S. pyogenes type M-75, T-25, which was opacity factor positive, was isolated from throat swab specimens obtained from 5 of 57 inmates with primary cases and from 4 of 15 inmates with secondary cases, as well as from specimens obtained from the hand wounds and throat of one of the food handlers. The consumption of curried egg rolls (i.e., curried egg salad sandwiches) was the most likely association with this outbreak. The presumed source of the food contamination was the food handler who had infected hand wounds. There has been only one other outbreak of streptococcal pharyngitis reported from a prison. Other outbreaks have been reported from military bases, nursing homes, and community picnics.