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U.S.
Food & Drug Administration Center for Food Safety & Applied Nutrition Foodborne Pathogenic Microorganisms and Natural Toxins Handbook |
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Streptococcus spp.
| 1. Name of the Organism:
Streptococcus spp. |
The genus Streptococcus is comprised of Gram-positive,
microaerophilic cocci (round), which are not motile and
occur in chains or pairs. The genus is defined by a
combination of antigenic, hemolytic, and physiological
characteristics into Groups A, B, C, D, F, and G. Groups
A and D can be transmitted to humans via food. Group A: one species with 40 antigenic types (S. pyogenes). Group D: five species (S. faecalis, S. faecium, S. durans, S. avium, and S. bovis). |
| 2. Nature of Acute Disease: | Group A: Cause septic sore throat and scarlet
fever as well as other pyogenic and septicemic
infections. Group D: May produce a clinical syndrome similar to staphylococcal intoxication. |
| 3. Nature of Disease: | Group A: Sore and red throat, pain on swallowing,
tonsilitis, high fever, headache, nausea, vomiting,
malaise, rhinorrhea; occasionally a rash occurs, onset
1-3 days; the infectious dose is probably quite low (less
than 1,000 organisms). Group D: Diarrhea, abdominal cramps, nausea, vomiting, fever, chills, dizziness in 2-36 hours. Following ingestion of suspect food, the infectious dose is probably high (greater than 107 organisms). |
| 4. Diagnosis of Human Illness: | Group A: Culturing of nasal and throat swabs, pus,
sputum, blood, suspect food, environmental samples. Group D: Culturing of stool samples, blood, and suspect food. |
| 5. Associated Foods: | Group A: Food sources include milk, ice cream, eggs,
steamed lobster, ground ham, potato salad, egg salad,
custard, rice pudding, and shrimp salad. In almost all
cases, the foodstuffs were allowed to stand at room
temperature for several hours between preparation and
consumption. Entrance into the food is the result of poor
hygiene, ill food handlers, or the use of unpasteurized
milk. Group D: Food sources include sausage, evaporated milk, cheese, meat croquettes, meat pie, pudding, raw milk, and pasteurized milk. Entrance into the food chain is due to underprocessing and/or poor and unsanitary food preparation. |
| 6. Relative Frequency of Disease: | Group A infections are low and may occur in any season, whereas Group D infections are variable. |
| 7. Course of Disease and Complications: | Group A: Streptococcal sore throat is very common,
especially in children. Usually it is successfully
treated with antibiotics. Complications are rare and the
fatality rate is low. Group D: Diarrheal illness is poorly characterized, but is acute and self-limiting. |
| 8. Target Populations: | All individuals are susceptible. No age or race susceptibilities have been found. |
| 9. Food Analysis: | Suspect food is examined microbiologically by selective enumeration techniques which can take up to 7 days. Group specificities are determined by Lancefield group-specific antisera. |
| 10. Selected Outbreaks: | Literature references can be found at the links below. |
| Group A: Outbreaks of septic sore throat and scarlet fever were numerous before the advent of milk pasteurization. Salad bars have been suggested as possible sources of infection. Most current outbreaks have involved complex foods (i.e., salads) which were infected by a food handler with septic sore throat. One ill food handler may subsequently infect hundreds of individuals. | |
| Group D: Outbreaks are not common and are usually the result of preparing, storing, or handling food in an unsanitary manner. | |
| MMWR 45(30):1996 | During December 1995-February 1996, four cases of a bacteremic illness (three accompanied by cellulitis and the fourth with infective endocarditis, meningitis, and probable septic arthritis) were identified among patients at a hospital in Ontario. Streptococcus iniae, a fish pathogen not previously reported as a cause of illness in humans (1-3), was isolated from all four patients. |
| MMWR 35(40):1986 | In the period October 17, 1985-January 9, 1986, 44 episodes of pyoderma occurred among 32 workers in an Oregon meat-packing plant. Most of the 44 reports involved impetigo-like lesions on the hand, wrist, and forearm, but six episodes of cellulitis and two of lymphangitis were also reported. The same epidemic strain of Group-A, -B hemolytic Streptococcus (GAS) isolated from skin lesions was also isolated from meat in the plant. |
| MMWR 33(47):1984 | Two large outbreaks of foodborne group A streptococcal pharyngitis have been reported to CDC during 1984. The Puerto Rico Department of Health was notified of the outbreak on August 8. Because of the high attack rate and the clustering of cases, the outbreak was presumed to be foodborne. Another outbreak occurred among participants from seven states at a meeting held at a Kansas City, Missouri, hotel from May 31, to June 1, 1984. Clustering of cases and a high attack rate suggested a foodborne source. |
| MMWR 32(39):1983 | Between July 25 and September 9, 1983, 16 cases of invasive group C streptococcal infection were identified in northern New Mexico. The group C streptococcus was isolated from the blood of 15 patients and the pericardial fluid of one patient. The organism isolated from 14 of the patients has been identified as a group C B-hemolytic streptococcus--species Streptococcus zooepidemicus; the species of the remaining two isolates have not yet been determined. Initial questionnaires identified eating "queso blanco," a homemade white cheese, as the only risk factor associated with illness. |
| Morbidity and Mortality Weekly Reports | For more information on recent outbreaks see the CDC. |
| 11. Education and Background Resources: | Literature references can be found at the links below. |
| Loci index for genome Streptococcus | Available from the GenBank Taxonomy database, which contains the names of all organisms that are represented in the genetic databases with at least one nucleotide or protein sequence. |
| Streptococcus A FAQ's from the CDC. | What is streptococcus A? What sort of germ is it? How can an infection be diagnosed? How can the infections be treated? |
| 12. Molecular Structural Data: | None currently available. |
mow@cfsan.fda.gov
January 1992 with periodic updates
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