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Volume 23, Number 12—December 2017
CME ACTIVITY - Research

Group B Streptococcus Infections Caused by Improper Sourcing and Handling of Fish for Raw Consumption, Singapore, 2015–2016

Man L. Chau1, Swaine L. Chen1, Min Yap, Sri H.P. Hartantyo, Paul K.T. Chiew, Charlene J. Fernandez, Wai K. Wong, Rockey K. Fong, Wei L. Tan, Brian Z.Y. Tan, Youming Ng, Kyaw T. Aung, Kurosh S. Mehershahi, Christopher Goh, Joanne S.L. Kang, Timothy Barkham, Adeline O.K. Leong, Ramona A. Gutiérrez, and Lee C. NgComments to Author 
Author affiliations: National Environment Agency, Singapore (M.L. Chau, M. Yap, S.H.P. Hartantyo, Y. Ng, K.T. Aung, C. Goh, J.S.L. Kang, A.O.K. Leong, R.A. Gutiérrez, L.C. Ng); Genome Institute of Singapore, Singapore (S.L. Chen); National University of Singapore, Singapore (S.L. Chen, K.S. Mehershahi); Agri-Food and Veterinary Authority of Singapore, Singapore (P.K.T. Chiew, C.J. Fernandez, W.K. Wong, R.K. Fong, W.L. Tan, B.Z.Y. Tan); Nanyang Technological University, Singapore (P.K.T. Chiew, L.C. Ng); Tan Tock Seng Hospital, Singapore (T. Barkham)

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Figure 1

SPCs for sliced fish samples collected from various eating establishments during investigation of group B Streptococcus infections, Singapore, 2015–2016. Dashed horizontal line indicates regulatory limit of Singapore for SPCs for ready-to-eat foods (<5 log10 CFU/g) (14). Top and bottom of boxes in plots indicate 25th and 75th percentiles, horizontal lines indicate medians, and whiskers indicate minimum and maximum values. *p<0.05. †Food stalls housed within larger eating establishments tha

Figure 1. SPCs for sliced fish samples collected from various eating establishments during investigation of group B Streptococcus infections, Singapore, 2015–2016. Dashed horizontal line indicates regulatory limit of Singapore for SPCs for ready-to-eat foods (<5 log10 CFU/g) (14). Top and bottom of boxes in plots indicate 25th and 75th percentiles, horizontal lines indicate medians, and whiskers indicate minimum and maximum values. *p<0.05. †Food stalls housed within larger eating establishments that include hawker centers, coffee shops, and eating houses. Open circle indicates an outlier. NS, not significant (p>0.05); RTE, ready to eat; SG, Singapore government; SPCs, standard plate counts.

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References
  1. Joint news release between the Ministry of Health Singapore (MOH) and the Agri-Food and Veterinary Authority of Singapore (AVA) and the National Environment Agency (NEA). Update on investigation into group B Streptococcus cases. July 24, 2015 [cited 2016 Aug 10]. http://www.nea.gov.sg/corporate-functions/newsroom/news-releases/year/2015/month/7/category/food-hygiene/update-on-investigation-into-group-b-streptococcus-cases
  2. Tan  S, Lin  Y, Foo  K, Koh  HF, Tow  C, Zhang  Y, et al. Group B Streptococcus serotype III sequence type 283 bacteremia associated with consumption of raw fish, Singapore. Emerg Infect Dis. 2016;22:1970–3. DOIPubMedGoogle Scholar
  3. Rajendram  P, Mar Kyaw  W, Leo  YS, Ho  H, Chen  WK, Lin  R, et al. Group B Streptococcus sequence type 283 disease linked to consumption of raw fish, Singapore. Emerg Infect Dis. 2016;22:1974–7. DOIPubMedGoogle Scholar
  4. Tan  K, Wijaya  L, Chiew  HJ, Sitoh  YY, Shafi  H, Chen  RC, et al. Diffusion-weighted MRI abnormalities in an outbreak of Streptococcus agalactiae Serotype III, multilocus sequence type 283 meningitis. J Magn Reson Imaging. 2017;45:507–14. DOIPubMedGoogle Scholar
  5. Manning  SD, Neighbors  K, Tallman  PA, Gillespie  B, Marrs  CF, Borchardt  SM, et al. Prevalence of group B streptococcus colonization and potential for transmission by casual contact in healthy young men and women. Clin Infect Dis. 2004;39:380–8. DOIPubMedGoogle Scholar
  6. Public Health Agency of Canada. Streptococcus agalactiae: pathogen safety data sheet—infectious substances. April 30, 2012 [cited 2016 Aug 10]. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/streptococcus-agalactiae-eng.php
  7. Ballard  MS, Schønheyder  HC, Knudsen  JD, Lyytikäinen  O, Dryden  M, Kennedy  KJ, et al.; International Bacteremia Surveillance Collaborative. The changing epidemiology of group B streptococcus bloodstream infection: a multi-national population-based assessment. Infect Dis (Lond). 2016;48:386–91. DOIPubMedGoogle Scholar
  8. Phares  CR, Lynfield  R, Farley  MM, Mohle-Boetani  J, Harrison  LH, Petit  S, et al.; Active Bacterial Core surveillance/Emerging Infections Program Network. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. JAMA. 2008;299:2056–65. DOIPubMedGoogle Scholar
  9. Foxman  B, Gillespie  BW, Manning  SD, Marrs  CF. Risk factors for group B streptococcal colonization: potential for different transmission systems by capsular type. Ann Epidemiol. 2007;17:854–62. DOIPubMedGoogle Scholar
  10. Delannoy  CM, Crumlish  M, Fontaine  MC, Pollock  J, Foster  G, Dagleish  MP, et al. Human Streptococcus agalactiae strains in aquatic mammals and fish. BMC Microbiol. 2013;13:41. DOIPubMedGoogle Scholar
  11. Ip  M, Cheuk  ES, Tsui  MH, Kong  F, Leung  TN, Gilbert  GL. Identification of a Streptococcus agalactiae serotype III subtype 4 clone in association with adult invasive disease in Hong Kong. J Clin Microbiol. 2006;44:4252–4. DOIPubMedGoogle Scholar
  12. Kalimuddin  S, Chen  SL, Lim  CTK, Koh  TH, Tan  TY, Kam  M, et al. Singapore Group B Streptococcus Consortium. 2015 epidemic of severe Streptococcus agalactiae ST283 infections in Singapore associated with the consumption of raw freshwater fish: a detailed analysis of clinical, epidemiological and bacterial sequencing data. Clin Infect Dis. 2017;64(Suppl_2):S145–52.
  13. Joint news release between the Agri-Food and Veterinary Authority of Singapore (AVA) and the Ministry of Health Singapore (MOH) and the National Environment Agency (NEA). Freshwater fish banned from ready-to-eat raw fish dishes. December 5, 2015 [cited 2016 Aug 10]. http://www.nea.gov.sg/corporate-functions/newsroom/news-releases/freshwater-fish-banned-from-ready-to-eat-raw-fish-dishes
  14. Agri-Food and Veterinary Authority of Singapore. Sale of food act, chapter 283, section 56 (1), food regulations. December 20, 2016 [cited 2017 Jan 9]. http://www.ava.gov.sg/legislation
  15. British Columbia Centre for Disease Control. Food processing plants: guideline for live retail fish holding system. November 2013 [cited 2016 Aug 17]. http://www.bccdc.ca/resource-gallery/Documents/Educational%20Materials/EH/FPS/Food/RetailFishHoldingTankGuidelines_Nov2013trs.pdf
  16. Da Cunha  V, Davies  MR, Douarre  PE, Rosinski-Chupin  I, Margarit  I, Spinali  S, et al.; DEVANI Consortium. Streptococcus agalactiae clones infecting humans were selected and fixed through the extensive use of tetracycline. Nat Commun. 2014;5:4544. DOIPubMedGoogle Scholar
  17. Mehershahi  KS, Hsu  LY, Koh  TH, Chen  SL. Complete genome sequence of Streptococcus agalactiae serotype III, multilocus sequence type 283 strain SG-M1. Genome Announc. 2015;3:e01188–15.PubMedGoogle Scholar
  18. Abuseliana  AF, Daud  HH, Aziz  SA, Bejo  SK, Alsaid  M. Pathogenicity of Streptococcus agalactiae isolated from a fish farm in Selangor to juvenile red tilapia (Oreochromis sp.). J Anim Vet Adv. 2011;10:914–9. DOIGoogle Scholar
  19. Liu  G, Zhang  W, Lu  C. Complete genome sequence of Streptococcus agalactiae GD201008-001, isolated in China from tilapia with meningoencephalitis. J Bacteriol. 2012;194:6653. DOIPubMedGoogle Scholar
  20. Wang  R, Li  L, Huang  Y, Luo  F, Liang  W, Gan  X, et al. Comparative genome analysis identifies two large deletions in the genome of highly-passaged attenuated Streptococcus agalactiae strain YM001 compared to the parental pathogenic strain HN016. BMC Genomics. 2015;16:897. DOIPubMedGoogle Scholar
  21. Martins  C, Eding  EH, Verdegem  MC, Heinsbroek  LT, Schneider  O, Blancheton  J-P, et al. New developments in recirculating aquaculture systems in Europe: a perspective on environmental sustainability. Aquacult Eng. 2010;43:83–93. DOIGoogle Scholar
  22. Little  D, Edwards  P. Integrated livestock-fish farming systems. Rome: Food and Agriculture Organization of the United Nations; 2003 [cited 2017 Aug 15]. http://www.fao.org/docrep/006/y5098e/y5098e00.htm
  23. International Commission on Microbiological Specifications for Foods. Micro-organisms in foods 2: sampling for microbiological analysis; principles and specific applications. 2nd ed. 1986 [cited 2016 Aug 11]. http://www.icmsf.org/pdf/icmsf2.pdf
  24. Food and Drug Administration. Bad bug book: foodborne pathogenic microorganisms and natural toxins. 2nd ed. Silver Spring (MD): The Administration; 2012.
  25. Chau  ML, Aung  KT, Hapuarachchi  HC, Lee  PSV, Lim  PY, Kang  JSL, et al. Microbial survey of ready-to-eat salad ingredients sold at retail reveals the occurrence and the persistence of Listeria monocytogenes Sequence Types 2 and 87 in pre-packed smoked salmon. BMC Microbiol. 2017;17:46. DOIPubMedGoogle Scholar

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1These authors contributed equally to this article.

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