Two of 3 people who contracted infection were in close contact

Two of the three patients who suffered severe Streptococcus A infections in Gillette were in close contact before they were infected, Wyoming Epidemiologist Dr. Tracy Murphy confirmed Wednesday morning.
But his investigators do not believe there is any connection between those two patients and a third patient that was treated earlier.
One of the three patients died, Murphy said.
None of the patients has been publicly identified.
Investigators also do not believe the cases constitute a public health threat, Murphy said.
“What we have here, so far, is that there have been three people in the Gillette area in the past month to month and a half who have had severe group A Strep infections,” Murphy said. “They have not all been the flesh-eating variety. One case seems to be totally unrelated to the other two. The other two do appear to be close contacts of each other.”
Strep A commonly occurs in every community and most often presents itself as strep throat. But once in a while in a small segment of cases, it can attack internal organs like the kidneys and in some cases it becomes necrotizing fasciitis, a condition commonly referred to as flesh-eating bacteria, Murphy said.
People at the highest risk for developing necrotizing fasciitis are those with immune deficiencies, skin conditions and diabetes. But studies indicate that caretakers of people who suffer from the infections also are at a higher risk of contracting the disease.
“We had received notification at the time of the first severe infection, around mid-August,” Murphy said.
His office took note of the report, but did not take more action because the illness is not a reportable disease and it was not presenting in that patient as the flesh-eating form, Murphy said. It was the form that attacked internal organs.
Since then, two more cases were reported, and both of them presented as necrotizing fasciitis, he said.
The Wyoming Health Department’s biggest concern is determining whether there is any source of the infections that poses a threat to public health in the community. Murphy declined to comment on specific circumstances of the three cases or what is the exact relationship between the pair that presented as necrotizing fasciitis.
His investigators now are looking at the cases, trying to determine if there is a chance that they came from a common source.
Because of how common the bacteria is in the community, it is almost impossible for investigators to determine the exact source of most Strep A infections unless they come from a common source, he said.
Those common sources his office looks for are things like inadequate infection control or contamination prevention procedures at hospitals, medical facilities or long-term care facilities, Murphy said. There is, however, no indication at this time that the infections came from such a source.
“Our main concern is to see if anything is going on that is a threat to public health,” he said. “It seems that it is unfortunate coincidence that three of these infections occurred in a short period of time.”
As of Wednesday, Murphy’s office did not have an investigator in Gillette and was working with Campbell County Memorial Hospital to get information about the three patients and the circumstances of their infections.
According to Murphy, because Strep A commonly occurs in the environment, the best way for people concerned about the disease to prevent infection is to simply practice good hygiene.
You should use good hygiene, stay home if you’re sick and avoid contact with people who are sick.
“In general, people should do things to perform good hygiene,” Murphy said. “It is not always clear who is at risk for those infections.”
Keeping schools clean
Schools in Campbell County aren’t taking any special precautions after reports of Strep A were reported by the hospital in Gillette earlier this week.
Kip Farnum, the school district’s director of student support services, said he contacted Campbell County’s Public Health Department when he saw news of the Strep A cases being discovered at the hospital.
“They told us it’s a pretty common bacteria and to just focus on the universal steps: good hygiene and washing, things we do all the time, especially this time of the year with flu season,” he said. “For us, it’s pretty much business as usual. ... We take our lead from Public Health.”
LuAnn Miller, the head nurse in the district, also plans to send a flier out to each school and principal emphasizing those steps.
“We typically do this at this time of the year,” Miller said Wednesday morning. “It’s just a generalized reminder about good health (practices).”
Miller said the schools are already seeing increased respiratory illnesses, including strep throats and coughs.
Similar precautions were being taken at Wright Junior-Senior High School, said Principal Hal Johnson.
“We always try to disinfect the common areas, like doorknobs, desks, countertops and everywhere,” he said. “We’re doing nothing special above and beyond that. We’re always a little more cautious this time of year.”