"FLESH-EATING BANANAS" > Page 1, 2
Food-Borne Group A Streptococcus: A Firsthand Account
In an earlier draft of my commentary on the "Flesh-Eating Bananas" hoax, I made the overly simplistic statement that "necrotizing fasciitis is not a food-borne illness." I owe a debt of gratitude to Wendy Bumgardner, About.com's Walking Guide and a trained microbiologist, for taking me to task on this.While the Centers for Disease Control in Atlanta confirm that "There is no evidence that necrotizing fasciitis is transmitted by food," it is known, as Wendy points out, that the bacteria associated with the illness can be transmitted via prepared food handled by infected people. This is uncommon and extremely unlikely to lead to necrotizing fasciitis, but Wendy can personally attest to the fact that the Group A Streptococcus bacteria can be passed on this way. She wrote:
In real life I am a microbiology technologist who, in 1981 at a convention for microbiologists at the Marriott Hotel in Portland, Oregon was infected, along with everyone else who ate the luncheon provided, by a food-borne epidemic of Group A Streptococcus.David Emery's contention in "Flesh-Eating Bananas" that Group A Strep cannot be food-borne is wrong, wrong, wrong. True, it is not the usual route, and it should not be a problem on the skin of intact fruit, etc. But it can be transmitted, as in our case, in prepared food.
The episode was written up in the CDC's Morbidity and Mortality Ward Report, sometime in the spring or summer of 1981. What occured was that two of the cooks in the kitchen had sores on their hands that were infected with Group A Strep. They prepared a very delicious cold salad sampler plate as the main course for the luncheon, which was included in the seminar fee. There was chicken salad, tuna, and another kind. With the preparation they inadverdantly seeded the salad with the bacteria from their hand sores. The salad had enough time between prep and service to allow at least some propagation of the bacteria. Strep is pretty hardy, it is a relative of bacteria commonly found on the skin. Skin infection from Group A Strep is common, although it usually doesn't progress to necrotizing fasciitis.
Within 24 hours of the luncheon, microbiologists all over northern Oregon were calling in sick, and many came to work, cultured their throats, and within 12 hours we knew we had a major epidemic of Strep infection on our hands, strangely affecting only those who went to the conference. Further investigation discovered the salads and the kitchen staff as the source, based on typing the strep.
I got a mild sore throat, was treated and was fine. The Marriott paid medical bills for everyone and if pressed they also paid a bit for pain and suffering. Group A Strep is a serious infection however it presents. If not treated, even if it goes away, the person can develop rheumatic fever and damage to their heart valves, or glomerulonephitis - a dangerous kidney infection.
To prevent complications, a person must receive antibiotic therapy and complete the full course of antibiotics, not stopping when they feel "well."
As this occured in my last months of medical technology internship, it was quite something to see us written up in the CDC MMWR.
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