Concentrated outbreak of streptococcal toxic shock

Abstract

Introduction: Toxic Shock Syndrome (TSS) is a self-inflammatory immune-mediated, infrequent, but, clinically very serious process. It is established abruptly and, commonly, progresses to death in a few hours. One of its triggers is infection by Streptococcus pyogenes. There are no reports of severe epidemics, but outbreaks occur and are increasing in frequency. This paper reports an experience related to an outbreak of streptococcal TSS, experienced by the Municipal Epidemiological Surveillance Service of São Carlos, SP, together with the Centre of Epidemiological Surveillance of State of Sao Paulo, Brazil. Case report: Facing the death of two persons residing in the same household, which occurred on the same day in unusual and identical conditions, descriptive epidemiological strategies allowed the immediate implementation of control measures and assistance. Ten days later there was confirmation that it was streptococcal TSS. Emerging and reemerging diseases has required of the services of health surveillance alertness and agility in dealing with unusual and acute problems. The most efficient tool available is, still, the descriptive epidemiology due to its potential to identify the means of control of aggravations even before their diagnosis. Conclusion: Outbreaks of streptococcal TSS is a reemerging problem that is increasing frequency, occur abruptly and have high lethality. It is necessary, therefore, special attention of the Health Surveillance Services in face of the possibility of circulation of infections by Staphylococcus or Streptococcus, or when deaths occur from events of rapid clinic progression in previously healthy people.