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Swine Flu has been making headlines all over the world, curtailing travel and
trade, and killing a small number of people in several countries. Eventually, it could
become a global menace or, like bird flu, continue to percolate in distant pockets of the
globe. No one knows what will happen or when, but this spring’s swine flu episode is
another reminder that many pathogens can make the leap from bird and animal to people.
Another pathogen that has made the leap is Streptococcus suis. It is not a virus,
but a bacterium whose natural host is the pig. Among the crowded pens of snorting,
slobbering porkers, the bacteria are readily exchanged orally and nasally. In piglets, the
bacteria sometimes will cause fatal infections such as sepsis, pneumonia and meningitis.
The first recognized case of S. suis in pigs was in 1954; the first case in humans was in
1969.
Since then, there have been more than 700 human cases. Most of them have
occurred in Southeast Asia where both the pig and the pig-eating populations have
million people and 5.2 million pigs in 1968. Today, they have 1.3 billion people and 508
million pigs. (The population of the U.S. is 300 million.) Perhaps it was no surprise then
that China recently had a large outbreak of S. suis infections. That 2005 outbreak
sickened 215 people and killed 38. Most of the deaths were due to meningitis.
fever, and vomiting. Hearing loss, endocarditis and arthritis may occur in some cases,
and a severe form of septic or toxic shock also has been seen. In Hong Kong, S. suis is
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Not surprisingly, most of the patients with S. suis infections tend to be older men
who work around pigs: farmers, veterinarians and butchers. That does not mean,
however, that many Asian women handling raw pork at home or in fresh meat markets
Infections from this bacterium usually are treated with penicillin, ceftriaxone,
vancomycin, and other common antibiotics. There is no vaccine for people or pigs, and it
is not clear just how useful one would be. S. suis is not transmitted person-to-person so
there is little fear of a contagious outbreak among people. (Unlike with swine flu.) Pigs
spread the bacteria among themselves and carry it naturally and asymptomatically. A
vaccine may not eliminate those carried bacteria or, worse, may eliminate the carried
People who work around pigs also may carry the bacteria. Among 132 studied
noses or throats. A 1999 study in the Netherlands found 6% of vets and 1% of pig
farmers had antibody to S. suis bacteria. They may not have been carriers, but they had
In the United States, the first human case of S. suis meningitis was reported in
February 2007. The patient was a 59-year-old farmer from upstate New York. He may
have been the first recognized patient, but he may not be the only patient. For example, a
2008 survey of Iowa hog-farm workers found seven of 73 who tested positive for prior
So the bacteria are present in U.S. pig populations and U.S. workers are being
exposed to the bacteria. Because millions of pigs are transported across the U.S. each
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year there are ample opportunities to spread the infection and expose farmers, truckers,
commercial farms where thousands of pigs and piglets may be crowded together.
“You could say that between 5 and 10 percent of [pig] workers in the U.S. might be
infected. I don’t know if it’s true, but the extrapolation is fair enough.”
the nasopharynx for years is unknown. But it’s clear that a normal pig pathogen can
evolutionary opportunity to emerge, evolve, and spread. S. suis is a new human pathogen