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dc.contributor.authorVan den Boogaard, Jossy
dc.contributor.authorHahné, Susan Jm
dc.contributor.authorTe Wierik, Margreet Jm
dc.contributor.authorKnol, Mirjam J
dc.contributor.authorBalasegaram, Sooria
dc.contributor.authorde Gier, Brechje
dc.date.accessioned2020-10-13T07:27:06Z
dc.date.available2020-10-13T07:27:06Z
dc.date.issued2020-10-01
dc.identifier.issn1560-7917
dc.identifier.pmid33034283
dc.identifier.doi10.2807/1560-7917.ES.2020.25.40.1900589
dc.identifier.urihttp://hdl.handle.net/10029/624438
dc.description.abstractWe observed an increase in notifications of puerperal group A Streptococcus (GAS) infections in July and August 2018 throughout the Netherlands without evidence for common sources. General practitioners reported a simultaneous increase in impetigo. We hypothesised that the outbreak of puerperal GAS infections resulted from increased exposure via impetigo in the community.We conducted a case-control study to assess peripartum exposure to possible, non-invasive GAS infections using an online questionnaire. Confirmed cases were recruited through public health services while probable cases and controls were recruited through social media. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) with logistic regression analysis.We enrolled 22 confirmed and 23 probable cases, and 2,400 controls. Contact with persons with impetigo were reported by 8% of cases and 2% of controls (OR: 3.26, 95% CI: 0.98-10.88) and contact with possible GAS infections (impetigo, pharyngitis or scarlet fever) by 28% and 9%, respectively (OR: 4.12, 95% CI: 1.95-8.68). In multivariable analysis, contact with possible GAS infections remained an independent risk factor (aOR: 4.28, 95% CI: 2.02-9.09).We found an increased risk of puerperal fever after community contact with possible non-invasive GAS infections. Further study of this association is warranted.en_US
dc.language.isoenen_US
dc.subjectNetherlandsen_US
dc.subjectgroup A Streptococcusen_US
dc.subjectimpetigoen_US
dc.subjectpuerperal feveren_US
dc.titleOut-of-season increase of puerperal fever with group A infection: a case-control study, Netherlands, July to August 2018.en_US
dc.typeArticleen_US
dc.identifier.journalEuro Surveill 2020; 25(40):pii.1900589en_US
dc.source.journaltitleEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin


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