MMWR Morb Mortal Wkly Rep. 1997 Oct 10;46(40):944-8.
Group A Streptococcus (GAS) causes common childhood diseases such as streptococcal pharyngitis and impetigo and can cause severe, life-threatening invasive disease including streptococcal toxic-shock syndrome and necrotizing fasciitis. Invasive GAS disease occurs when GAS infects a normally sterile site. Clusters of invasive GAS infection previously had not been reported among children in school or childcare centers (CCCs). However, on February 13, 1997, the Boston Public Health Commission received reports of cases of concurrent invasive GAS and varicella infection among two of 14 children in the same CCC classroom. Because of the potential for further spread of invasive disease, the Boston Public Health Commission initiated an investigation of these cases. This report describes the findings of the investigation, including risk factors for infection, and recommended prevention measures. The findings indicate the potential for widespread GAS infection and carriage in CCCs and suggest that, in this outbreak, antecedent use of varicella vaccine would have prevented cases of invasive GAS.
A组链球菌（GAS）可引发常见的儿童疾病，如链球菌性咽炎和脓疱病，还可导致严重的、危及生命的侵袭性疾病，包括链球菌中毒性休克综合征和坏死性筋膜炎。当GAS感染通常无菌的部位时，就会发生侵袭性GAS疾病。此前尚未有在学校儿童或儿童保育中心（CCC）中出现侵袭性GAS感染聚集性病例的报告。然而，1997年2月13日，波士顿公共卫生委员会收到报告，称在同一CCC教室的14名儿童中有两名同时出现了侵袭性GAS感染和水痘感染病例。由于侵袭性疾病有进一步传播的可能性，波士顿公共卫生委员会对这些病例展开了调查。本报告描述了调查结果，包括感染的危险因素，并提出了推荐的预防措施。调查结果表明CCC中存在GAS广泛感染和传播的可能性，并提示在此次疫情中，预先接种水痘疫苗本可预防侵袭性GAS病例的发生。
