Investigation of a human death from Streptococcus suis infection, Non Sung District, Nakhon Ratchasima Province, Thailand, July 2018

Abstract

Background: On 2 August 2018, the Office of Disease Prevention and Control 9, Nakhon Ratchasima detected a fatal case of Streptococcus suis (S. suis) infection from the R506 surveillance system. This deceased lived in Non Sung District, Nakhon Ratchasima Province. The investigation was conducted to confirm the diagnosis and outbreak, determine epidemiological characteristics of the case, find the source and transmission of the disease, and recommend control and prevention measures.
Methods: The investigation included reviewing medical records of this fatal patient from Nakhon Ratchasima and Non Sung hospitals, interviewing the patient’s relatives, and active case finding in the affected area. Environmental survey was conducted in the area. Fifty–one specimens of blood, tonsils and skin of pigs from the 4 registered slaughterhouses in the area were collected and examined for Streptococcus suis.
Results: The deceased was a 76–year–old male selling pork noodle and living in Lam Kho Hong Subdistrict, Non Sung District, Nakhon Ratchasima Province. He had hypertension and received regular treatment. He had history of daily alcoholic drinking and raw pork consumption. On 23 July 2018, he developed fever, diarrhea, vomiting, fatigue and dyspnea, with the diagnosis of septic shock and he died on the following day. Streptococcus suis serotype 2 was isolated from his blood. Of the pigs’ specimens from the 4 slaughterhouses, 2 collected from the tonsils were positive for Streptococcus suis serotype 2.
Conclusions: This fatal patient from Streptococcus suis serotype 2 might be infected from consumption of infectious raw pork. Being the aged and daily alcoholic drinking might worsen the infection in this patient.