Strauss Barbara, Tepper Martin, Lu Diane, Gagnon François, Girard Eric, Demczuk Walter, Martin Irene, Massé Martine, Barnes Kirsten
Directorate Force Health Protection, Canadian Forces Health Services, Ottawa, ON.
41 Centre des Services de santé des Forces canadiennes, Richelain, QC.
Can Commun Dis Rep. 2020 Sep 3;46(9):256-263. doi: 10.14745/ccdr.v46i09a02.
Since December 2016, the basic military training (BMT) facility for the Canadian Armed Forces (CAF) has experienced repeated outbreaks of Group A (GAS). In 2018, a voluntary mass antibiotic prophylaxis (MAP) program was implemented to interrupt GAS transmission among recruits. The objective of this study was to describe the epidemiology of three GAS outbreaks and a period of increased pharyngitis infections at the CAF BMT facility in Québec over a two-year span, and to detail the prevention and control measures implemented to mitigate the risk to recruit health.
Descriptive data were collected on invasive and severe GAS cases along with laboratory data including genotyping of throat swabs from recruits presenting with pharyngitis. A laboratory-based acute respiratory infection surveillance system was used to aid in monitoring and decision-making. Close contacts of recruits were assessed for asymptomatic GAS carriage and MAP adverse events surveillance was conducted.
Three distinct GAS outbreaks occurred at the Canadian Forces Leadership and Recruit School totaling eight invasive (iGAS) and 13 severe (sGAS) cases over two years. All iGAS/sGAS cases, apart from one instructor, were among recruits. The predominant strain in all three outbreaks was type . A total of 11,293 recruits received MAP (penicillin G benzathine or azithromycin) between March 7, 2018 and November 18, 2019. There were eight reported serious adverse events related to penicillin administration.
The CAF BMT facility experienced three GAS outbreaks over the course of two years, and despite the use of enhanced hygiene measures, only MAP has been effective in quelling these outbreaks.
自2016年12月以来，加拿大武装部队（CAF）的基础军事训练（BMT）设施多次爆发A组链球菌（GAS）感染。2018年，实施了一项自愿性大规模抗生素预防（MAP）计划，以阻断新兵中GAS的传播。本研究的目的是描述魁北克省CAF BMT设施在两年时间内三次GAS爆发及咽炎感染增加时期的流行病学情况，并详细说明为降低新兵健康风险而实施的预防和控制措施。
收集侵袭性和严重GAS病例的描述性数据以及实验室数据，包括咽炎新兵咽拭子的基因分型。基于实验室的急性呼吸道感染监测系统用于协助监测和决策。评估新兵的密切接触者是否有无症状GAS携带情况，并进行MAP不良事件监测。
在加拿大部队领导力与新兵学校发生了三次不同的GAS爆发，两年内共有8例侵袭性（iGAS）和13例严重（sGAS）病例。除一名教员外，所有iGAS/sGAS病例均为新兵。三次爆发中的主要菌株均为 型。2018年3月7日至2019年11月18日期间，共有11,293名新兵接受了MAP（苄星青霉素或阿奇霉素）。报告了8例与青霉素给药相关的严重不良事件。
CAF BMT设施在两年内经历了三次GAS爆发，尽管采取了强化卫生措施，但只有MAP在平息这些爆发方面有效。
