1423. Investigation of a Gonorrhea Outbreak in an Isolated Northern Alberta Community, 2015
Session: Poster Abstract Session: Public Health
Friday, October 28, 2016
Room: Poster Hall
  • ID Week Poster GC outbreak Oct14 2016.pdf (336.7 kB)
  • Background: In 2014, the rate of Neisseria gonorrhea(NG) in the North-Northwest subzone of Alberta (191/100,000) was four times higher than the provincial rate (46/100,000). Nearly one-third of cases in the subzone were reported from a small isolated community (population estimate: 2000- 2500 people). An investigation of cases was undertaken to determine transmission networks.

    Methods: A descriptive summary of all NG cases reported in 2015 from the community was conducted using routinely collected surveillance and partner data. During a two week period in the fall of 2015, cases and contacts were contacted to be re-interviewed to identify local exposure details. NG multiantigen sequence typing was determined and susceptibility to cephalosporins and ciprofloxacin was predicted by RT-PCR using the NAAT specimens. A social network analysis was completed using partner information.

    Results: In 2015, there were 84 NG cases reported in the community. All cases were heterosexual, 47.6% (n=40) were female, and 20% (n=8) were pregnant. The median age was 24 years (IQR: 20-30). Twenty-one clients were re-interviewed for local exposure details, representing a participation rate of 19.1% for the 110 gonorrhea cases and contacts. The majority of clients re-interviewed reported limited condom use (90.5%; n=19), being under the influence of alcohol or drugs during sexual encounters (61.1%; n=11), and meeting partners through local house parties (66.7%; n=12). An additional one-third (n=6) of participants met partners on-line. Eight unique STs were identified among 41 cases. 70% (n=29) of the sequence typed cases belong to sequence group ST-7576; one isolate in the province was available from this group and was resistant to erythromycin and tetracycline. SNP assay results were available for 19 specimens among 7 different ST; all were predicted to be susceptible to cephalosporins and ciprofloxacin. There were 21 sexual network components identified, with 33% (n=42) of individuals in network components of three or fewer people. The largest network represents 46.8% (n=59) of cases and contacts.

    Conclusion: Using the combination of routine surveillance data, with enhanced exposure details and in depth laboratory data, we were able to ascertain key aspects of the outbreak for local intervention.

    Jennifer Gratrix, RN, MSc1, Jonathan Edwin, MPH, BSc2, Joanna Foley, BScN3, Irene Martin, BSc4, Lindsay Bertholet, MN, RN1, Wadieh Yacoub, MD MSc FRCPC3 and Petra Smyczek, MD, PhD, FRCPC1,5, (1)Alberta Health Services-Centralized STI Services, Edmonton, AB, Canada, (2)Public Health Agency of Canada, Ottawa, ON, Canada, (3)Health Canada Alberta Region First Nations & Inuit Health, Edmonton, AB, Canada, (4)National Microbiology Laboratory, Winnipeg, MB, Canada, (5)University of Alberta-Department of Medicine, Edmonton, AB, Canada


    J. Gratrix, None

    J. Edwin, None

    J. Foley, None

    I. Martin, None

    L. Bertholet, None

    W. Yacoub, None

    P. Smyczek, None

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