Essex Strep A outbreak: Report identifies list of failings

The outbreak of Group A streptococcal infection began in Braintree

An investigation into an outbreak of streptococcus that killed 15 older people has found failings ranging from wound management to record keeping.

The outbreak, identified in February 2019, saw 39 patients in Mid-Essex contract Group A Streptoccocus iGAS.

An independent report made a total of 22 recommendations.

Director of Nursing at Mid and South Essex Clinic Commissioning Groups (CCGs), Rachel Hearn, said "swift action" had been taken.

The patients affected in the outbreak, which started in Braintree, were elderly and in all but one of the cases was receiving treatment for wounds.

Extra infection control measures had been put in place, the clinical commissioning groups said

In July last year, an independent investigation was commissioned.

The independent investigation report concluded a "single source of transmission" had not been found.

However, it added there was evidence "people receiving community care in mid Essex were at risk," with the bacteria "isolated in a small number of staff in the community nursing team, and from a piece of community equipment".

A number of those affected had contact with district nurses, mostly from the Provide Community Interest Company.

The report, published on Thursday, found there had been errors in wound management, identifying the clinical deterioration of patients, antibiotic therapy, infection prevention and control, and record keeping.

It also found there were instances of "incomplete or inaccurate" medical records and a lack of timely referrals when patients' wounds had not been improving.

Most people affected were "elderly and had been receiving care for chronic wounds"

What is strep A?

• Group A streptococcal (GAS) infection is caused by strains of the streptococcus pyogenes bacterium

• The bacteria can live on hands or the throat for long enough to allow easy spread between people through sneezing, kissing and skin contact

• Most infections cause mild illnesses such as "strep throat", scarlet fever or skin infections

• The bacteria rarely infects healthy people but if it does get into the rest of the body, causing serious and even life-threatening conditions, it is known as invasive GAS or iGAS

Source: Mid Essex Clinical Commissioning Group

The CCG said improvements had already been made, including reducing the number of staff in contact with each patient and carrying out deep cleaning of clinical areas.

Ms Hearn said: "I would like to express our deepest sympathies to the families of those patients who have passed away.

"We have taken swift action to ensure changes have been made quickly and safely."

Chief Nurse at Provide, Stephanie Dawe, said the route of transmission may never be fully understood, but added "there are clearly things we need to do differently".

She said: "We consistently strive to do our best by the people we serve and remain conscious our nurses worked extremely hard to contain the infection."

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