**China: Disease Outbreak in Humans Associated with an Outbreak of Streptococcus Suis in Pigs**

Released: August 5, 2005

The Public Health Agency of Canada is monitoring a disease outbreak in humans associated with an outbreak of Streptococcus suis infection among pigs in China.

As of August 03, 2005, the Department of Health in Sichuan province has reported 206 human cases of disease, including 38 deaths, and 18 critically ill patients. At this time, human cases have been reported in ten cities within the south-western province of Sichuan. Additionally, two cases of human infection have been reported in Hong Kong; it has not yet been determined if these cases are linked to the outbreak in Sichuan.

Initial epidemiological investigations in China suggested that the infections were limited to those occupationally exposed to pigs or pig products (i.e. those involved in the slaughtering or handling of infected pigs). This, however, does not necessarily eliminate concern to the broader population, in Sichuan, in terms of the potential for food-borne transmission related to improperly handled raw and cooked pork for market.

Chinese authorities are taking rigorous measures to investigate and contain this outbreak. Authorities have found no cases of human-to-human transmission. The World Health Organization is closely monitoring the situation as outbreaks of this size are not typically seen with Streptococcus suis.

Sources: World Health Organization: Regional Office for the Western Pacific, Chinese Department of Health

Streptococcus suis-

Streptococcus suis (S.suis) is a contagious bacterial infection found in pigs. Infection in pigs is usually asymptomatic; however, the bacterium is known to cause a number of severe conditions.

S. suis is a pig-borne disease and, although rare, transmission from pigs to humans can occur. While S.suis has 35 identified serotypes, two have been implicated in human infections; S. suis type 2, a recognized zoonotic agent, and more recently S. suis type 14. Human infection with the bacteria was first described in the 1960s.

Streptococcus suis is found worldwide where pigs are raised, including in Canada and the United States of America.

Recommendations

While the disease outbreak in humans has some unusual features, preliminary epidemiological findings indicate that the risk of infection is greatest in persons having had close contact with live and/or slaughtered pigs infected with S. suis. Transmission to humans is thought to occur mainly via cuts and other wounds of the skin, including minor abrasions, when handling infected carcasses; however, infection via ingestion or through mucous membranes has been suspected in some cases. Individuals who are immunosuppressed including those who have had their spleens removed, are also at increased risk.

Although the risk of transmission to humans is relatively low, the Public Health Agency of Canada recommends that it would be prudent for travellers to avoid unnecessary contact with live and/or slaughtered pigs in Sichuan province; this includes avoiding pig farms as well as markets where live and slaughtered animals such as pigs are sold.

Canadian travellers who may be at high risk due to occupational activities should, where appropriate, wear gloves, cover wounds with waterproof dressings to reduce the chance of infection, and follow personal hygiene precuaitons.

Normal precautions regarding food storage, handling and preparation should be followed. Maintain high standards of hygiene, including thorough hand washing, particularly after having contacted pigs, pork or pork products and avoid cross contamination from contaminated pork to other food products. The Agency reminds travellers that it is always advisable to avoid undercooked or raw meat dishes; pork should always be cooked to an internal temperature of at least 71°C (well-done).

As a reminder…

The Public Health Agency of Canada routinely recommends that Canadian international travellers seek the advice of their personal physician or travel clinic prior to international travel, regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.

The Public Health Agency of Canada recommends, as well, that travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician, without being asked, that they have been travelling or living outside of Canada, and where they have been.

Additional Information

For information on Streptococcus suis, visit the WHO fact sheet at: http://www.wpro.who.int/media_centre/fact_sheets/fs_20050802.htm.

For a map illustrating the prefectures in Sichuan reporting cases, click here!

For information on general health related travel advice, visit the PHAC information sheet, General Advice for Travellers at: http://www.phac-aspc.gc.ca/tmp-pmv/travel/advice_e.html

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	Last Updated: 2005-08-05		Important Notices