Streptococcus agalactiae
(Group B) - Invasive Disease

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)

I. IDENTIFICATION

 A. CLINICAL DESCRIPTION: Invasive group B streptococcal infections in adults cause many clinical syndromes including bacteremia and meningitis, and are a major cause of perinatal infections, including bacteremia, endometritis, amnionitis, and urinary tract infections in pregnant women. Systemic and focal infections in infants occur in two stages: "Early-onset disease" comprises approximately 5-10% of cases and usually occurs within the first 24 hours of life (range, 0-6 days). It is characterized by respiratory distress, apnea, shock, pneumonia and less often meningitis. "Late-onset disease" usually occurs at 3-4 weeks (range, 7 days to 3 months) and frequently manifests as bacteremia, meningitis, or focal infections such as osteomyelitis, septic arthritis or cellulitis.

 B. REPORTING CRITERIA: Laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

• Isolation of group B Streptococcus (Streptococcus agalactiae) by culture from a normally sterile site (e.g., blood, cerebrospinal fluid, joint, pleural or pericardial fluid).

 D. WISCONSIN CASE DEFINITION: A case that is laboratory confirmed.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: REPORT TO THE LOCAL HEALTH OFFICER within 72 hours of identification of a case or suspected case.

B. EPIDEMIOLOGY REPORTS REQUESTED

• Acute and Communicable Disease Case Report (DPH 4151)

C. PUBLIC HEALTH INTERVENTIONS:

• Immediate treatment is recommended.
• Notifiable at national level.

III. CONTACTS FOR CONSULTATION

A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 261-6955.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

C. WSLH / BACTERIOLOGY: (608) 263-3421.

IV. RELATED REFERENCES

1. Heymann DL, ed. GROUP B STREPTOCOCCAL SEPSIS OF THE NEWBORN. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:514-515.

2. Pickering LK, ed. Group A Streptococcal Infections. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:573-584.

 
V. DISEASE TRENDS