ENT  |  Sore Throat Pathway - Swab Symptomatic Household Contacts




ENT

Sore Throat Pathway - Swab Symptomatic Household Contacts

  • Public Health do not have the resources to do this.   
  • Follow up of household contacts is a General Practice led service, the cost for which should be at the discretion of the practice. Those identified as meeting the criteria for swabbing should be contacted and offered throat swabs. 
  • In the WBOP the WBOPPHO Wellness Centre will carry out free throat swabbing but require laboratory forms to be completed by the GP who would also be responsible for followup of the results.  
  • School-based clinics may follow up their own Household Contacts on some occasions but this should not be assumed.



Reference: pg 46 New Zealand Guidelines for Rheumatic Fever; 2014 Update

How should symptomatic household contacts of GAS-culture positive pharyngitis patients be managed?

The likelihood of symptomatic householders, particularly school aged children, having GAS cultured positive pharyngitis is high. Within a household, the risk of secondary GAS infection was 1.8 times greater than that of a primary infection in the community. In households, more than half of secondary cases of serologically proven GAS pharyngitis were in five to 12 year old children. Danchin defined symptomatic as sore throat plus one of the Centor criteria: a history of fever, tender anterior cervical lymph nodes, pharyngeal exudate, or an absence of cough. Because these criteria were not developed for children, parents were encouraged to bring in their children with a broader set of symptoms, including headache, abdominal pain, vomiting, cough, coryza and hoarseness.  Falck et al followed 110 index GAS pharyngitis patients for a month and found at days six to ten, 20 out of 263 (8%) household contacts were symptomatic and cultured GAS, and 70 out of 263 (27%) were colonised (cultured GAS from their throats but were not symptomatic).



Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016


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