Streptococcal suis infection presents with sepsis and meningitis with hearing loss. Wear gloves when slaughtering pigs and processing pork because swine are the reservoir. As of 2008, more than 700 cases had been reported with most of the cases in Southeast Asia.
CASES/YEAR
10 (US); 200 (Global)
INCUBATION
3 hours to 14 days with a median of 2.2 days; [PMID 19191650]
INITIAL SYMPTOMS
Headache, fever, vomiting, and meningeal signs;
PRECAUTIONS
Wear gloves when slaughtering pigs and processing pork; Wash hands after handling raw pork and cook pork thoroughly; [PMID 19191650]
COMMENTS
As of 2008, more than 700 cases had been reported with most of the cases in Southeast Asia. Sepsis and meningitis with hearing loss are the most common findings. Skin effects in 6% to 31% of patients include petechiae, purpura, ecchymoses, and hemorrhagic bullae with skin necrosis. Less common are subacute endocarditis, pyogenic arthritis, endophthalmitis, uveitis, brain stem ophthalmoplegia, and epidural abscess. Other complications are septic shock, acute renal failure, ARDS, and consumptive coagulopathy. S. suis infects pigs worldwide; it can also be isolated from ruminants, cats, dogs, deer, and horses. [PMID 19191650] Causes meningitis, hearing loss, skin lesions and septicemia in pig farmers and others exposed to pork products, mainly in Southeast Asia. [ABX Guide: Streptococcus species]
DIAGNOSTIC
Culture blood or CSF (commonly misidentified as other species of Streptococcus); In a Vietnam series of 151 patients, 117 had positive cultures and 149 were detected by real-time PCR; [PMID 19191650]
SCOPE
Global; Most cases have been reported in Southeast Asia; [PMID 19191650]
SIGNS & SYMPTOMS
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>fever
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G nausea, vomiting
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H leukocytosis
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N headache
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N stiff neck
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S petechiae and ecchymoses
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S skin blister or vesicles
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*acute renal failure
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*ARDS
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*arthritis
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*bleeding tendency
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*cranial neuropathy
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*endocarditis
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*meningitis
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*sepsis
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*shock
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*uveitis
ENTRY
Ingestion, Skin or Mucous Membranes (Includes Conjunctiva)
SOURCE
Animal Tissue, Eating Contaminated Food, Eating Contaminated or Infected Meat
RISK FACTORS
- Eat undercooked meat or fish
- Handle animal carcasses or placentas
- Ingest infectious agents in food/water
- Touch infected meat or poultry
TREATMENT
Susceptible to penicillin, ceftriaxone, and vancomycin in Vietnam cases; Penicillin resistance reported in one human isolate and in some pig isolates; [PMID 19191650]
REFERENCES FOR CASES/YEAR
1. (US) Guesstimate: 1/20 of global cases/yr;
2. (Global) Only about 150 cases reported in the world literature; Cases reported in England & Wales: 3 (2010), 0 (2011) , 3 (2012); [Public Health England website] Guesstimate: 200 cases/year;