DHMH and Baltimore County Department of Health Investigating Cluster of Invasive Group A Streptococcus Associated with Cosmetic Surgery Center

 BALTIMORE (September 19, 2012) – The Maryland Department of Health and Mental Hygiene (DHMH) and the Baltimore County Department of Health are investigating a cluster of three severe invasive Group A Streptococcus (GAS) infections in persons who recently had liposuction at a cosmetic surgery center, Monarch Med Spa, in Timonium, Maryland.  The procedures occurred in mid-August to mid-September.  All three patients were hospitalized; one subsequently died.

DHMH and Baltimore County have ordered the facility closed while the investigation proceeds to determine possible sources of the infections and to limit further spread (the order is attached).  The facility has been cooperative in the course of the investigation.
Any individual who has had any procedure at this facility recently and has concerns about a subsequent infection should consult with his/her primary care provider and notify his/her local health department.  Symptoms may include:
  • Fever or influenza-like syndrome
  • Redness at a wound site
  • Abrupt onset of generalized or localized severe pain and swelling, often rapidly increasing
  • Progressive dizziness, weakness and confusion
Group A Streptococci are often found in the throat and on the skin.  These bacteria are spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin or by contact with contaminated surfaces. Sick individuals, such as those who have strep throat or skin infections (impetigo), are most likely to spread the infection.  Persons (also called “carriers”) who carry the bacteria but have no symptoms are much less contagious.
Most GAS infections are relatively mild; however, occasionally these bacteria can cause severe and even life-threatening diseases when they infect parts of the body where bacteria usually are not found, such as the blood, muscle, or the lungs.  These infections are termed "invasive GAS disease."
Persons with skin lesions (such as cuts, surgical wounds, chickenpox), the elderly, and adults with a history of alcohol abuse or injection drug use have a higher risk for developing invasive GAS disease.  Also, people with chronic illnesses like cancer, diabetes, and chronic heart or lung disease, and those who use medications such as steroids, have a higher risk.
Over the last five years, an average of 189 cases of invasive GAS were reported annually in Maryland.  About 9,000 to 11,500 cases of invasive GAS disease occur each year in the United States, resulting in 1,000 to 1,800 deaths annually. For more information, visit http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupastreptococcal_g.htm.
Cosmetic surgery centers in Maryland are not currently subject to state licensure. In the near future, DHMH will seek public comment on potential approaches to oversight of these facilities.
Media inquiries regarding this infection cluster will be handled by the Baltimore County Department of Health Public Information Office. Call Monique Lyle at 410-887-6092 or 443-463-3757.

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