Streptococcus agalactiae ST283 causing invasive sepsis in healthy adults is widespread in SE Asia

7/22/2019

Timothy Barkham, MBBS, MSc, FRCPath

Past presentations on GBS pathways from POGBSDvs

Timothy Barkham, MBBS, MSc, FRCPath
Dr. Barkham studied medicine and then specialised as a Microbiologist at St. Thomas' Hospital in London, UK. He worked at the Hammersmith Hospitals for 2 years before moving to Singapore in 1999. He enjoys clinical infectious diseases, epidemiology and outbreak investigation. He has a 20% teaching appointment at the National University of Singapore. He has developed diagnostic assays that are marketed in Singapore and elsewhere in Asia. He showed that ST283 was the cause of the outbreak in Singapore in 2015, and, with colleagues, pursued it’s epidemiology across Asia.

Marti Perhach

7/22/2019 09:23:51 pm

Thank you, Dr. Barkham, for all of the updates on your investigative work on ST238 -- fascinating topic! I enjoyed your and Swaine Chen's presentations on the same topic at our POGBSD symposium. https://www.groupbstrepinternational.org/presentations/category/pathways-of-infection for those of you who would like to learn more about the foodborne outbreak of GBS in SE Asia.

Swaine Chen

7/25/2019 04:19:25 am

Thanks, Marti!

This has been a remarkable story - the outbreak in 2015 in Singapore added a new dimension to our understanding of how GBS can cause disease: foodborne transmission.

This highlights several key points:
1. GBS caused by the ST283 clone seems to be occurring in Southeast Asia at a *higher* rate than all other previously known types of GBS infection (neonatal, elderly, immunocompromised, etc.).
2. We suspect there is lots of foodborne GBS throughout Southeast Asia - it definitely happened in Singapore due to contaminated raw fish. While Singapore banned the sale of these freshwater fish for raw consumption, there are lots of raw fish dishes in the region that are still being served. Be careful when you're doing food tourism!
3. The foodborne clone, ST283, is widely found in fish farms, which suggests how we had the outbreak in Singapore - contamination at the source. We need to watch out for bacteria and other viruses when we do high density aquaculture and farming of any kind!

Jonathan Pace

7/26/2019 08:19:31 am

Great information, it will be interesting to follow along and see how this outbreak spreads and colonizes species.

Marti Perhach

7/29/2019 10:27:44 am

Thank you! As to the caution about food tourism, do food tourism associations or public health agencies issue cautions that the average "foodie" would reasonably expect to see?

Swaine Chen

7/29/2019 12:34:44 pm

This is a great question - and I think unfortunately they can be hard to find. You kind of have to go looking for these types of cautions. Just recently seeing an example of dishes from Laos, there are some that are not necessarily recognizable as fish - or maybe the fish is cooked/fried but the sauce has drippings from the raw fish! It can be tricky out there for sure, which is why we're trying to solve the problem at the source with more research and understanding how to control and track contamination throughout the food supply.

Marti Perhach

7/29/2019 02:48:24 pm

Thank you and many thanks to you and your colleagues for all of the great work you are doing to help keep our food supply safe!

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