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American Journal of Epidemiology Vol. 124, No. 6: 969-976
Copyright © 1986 by The Johns Hopkins University School of Hygiene and Public Health

research-article

AN OUTBREAK OF STAPHYLOCOCCAL SKIN INFECTIONS AMONG RIVER RAFTING GUIDES

MICHAEL D DECKER1,2,, JEFFREY A LYBARGER1,3, WILLIAM K. VAUGHN4, ROBERT H. HUTCHESON, JR.2 and WILLIAM SCHAFFNER2,4

1Division of Field Services, Epidemiology Program Office, Centers for Disease Control Atlanta, GA.
2Tennessee Department of Health and Environment Nashville, TN.
3South Carolina Department of Health and Environmental Control Columbia, SC.
4Department of Preventive Medicine, Vanderbilt University School of Medicine Nashville, TN.

Send reprint requests to the Division of Field Services, Epidemiology Program Office, Centers for Disease Control, Atlanta, GA 30333.

Outbreaks of staphylococcal skin infections among healthy adults are most unusual. The authors report an epidemic of skin infections due to Staphylococcus aureus that involved river rafting guides in Tennessee, South Carolina, and North Carolina in summer 1982. Infections occurred only among employees of the rafting companies that provided communal, on-site housing; carriage rates of S. aureus were as high as 89% at those companies. A casecontrol study found that having had an infected roommate was significantly associated with infection, as was working at the livery with the most crowded housing. This outbreak appeared to be due to two factors: frequent minor skin wounds acquired while rafting, and prolonged close contact among the perms with wounds. It is likety that crowding and exposure to infected wounds led to elevated S. aureus camage rates, whkh in turn increased the probability that wounds would become infected. Repeated immersion in water likely enhanced the development of infections.

abscess; cellulitis; disease outbreaks; furunculosis; staphylococcal infections; Staphylococcus aureus


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