[An outbreak of Streptococcus pyogenes infections in institutions for the mentally retarded in Greater Copenhagen 1995]. / Et udbrud af infektioner med Streptococcus pyogenes på institutioner for psykisk udviklingshaemmede i Storkøbenhavn 1995.

The largest reported outbreak of infections due to Streptococcus pyogenes, M-type 18, in recent years is described. Ninety persons at institutions for mentally retarded (73% residents) had infections due to the epidemic strain. Pharyngitis and scarlatina were the most common infections. Six patients died, five having a streptococcal toxic shock syndrome. During the outbreak an intensive surveillance was carried out together with improved infection control measures and prompt culturing of residents and employees before antimicrobial treatment. The primary outbreak was confined but a secondary outbreak could not be prevented. This was probably due to difficulties in implementing proper isolation precautions in this setting.

[Hepatitis A and a grill bar]. / Hepatitis A og grillbar.

A small outbreak of hepatitis A infection in October 1988 involving 11 patients is described, together with the history of the suspected index case. Six to eight weeks before the onset of disease, all patients had consumed one or several meals containing elements of uncooked food in a local grill bar in the Copenhagen county area. The virus had probably been imported from Egypt. Public sanitation authorities were alerted immediately after the first suspicion was raised.

[Occurrence of hepatitis B carriers in 2 immigrant families]. / Forekomst af hepatitis B smitte i to indvandrerfamilier.

The occurrence of Hepatitis B carriers in two immigrant families is described. In one family, consisting of parents and five children, three children were found to be carriers of HBsAg and HBe Ag, while the mother was carrier of HBs Ag only. The father and one child had Anti HBs and one child had neither antigen nor antibody. In the other family, consisting of parents and four children, the mother and all children were carriers of HBs Ag and HBe Ag while the father had Anti HBs. All of the children in both families were born in Denmark. The importance of examining pregnant women from Hepatitis B high-risk populations is stressed. The importance of proper information to HB carriers is also stressed.

Meningococcal disease in Scandinavia.

Scandinavia (Denmark, Finland, Iceland, Norway, and Sweden) comprises with mutual borders and 22.3 million inhabitants an area where the socioeconomic and cultural conditions are similar. Epidemic diseases, such as meningococcal infection, might therefore be expected to be uniformly distributed. An epidemiological study in the 10-year period 1970-9 shows, however, remarkable differences in the incidence, age, and serogroup and type distribution, as well as in the general dynamics of the disease. Three epidemics, two caused by different serotypes of group B (Norway and Iceland) and one by group A (Finland) occurred within the observation period. The annual overall incidence was generally around 3/100 000 but increased from fivefold (Finland) to eightfold (northern Norway) during epidemics. The epidemic strains caused infection in over 3000 patients and the loss of at least 250 lives. The overall case fatality rate was 8.6% (range 4.1-13.7%). Men were more susceptible and had a worse prognosis than women of the same age group. The group A epidemic in Finland was influenced by a large vaccination campaign, but this possibility was not feasible in the two other epidemics.