TY - JOUR T1 - An outbreak of <em>Pseudomonas aeruginosa</em> infection linked to a “Black Friday” piercing event JF - bioRxiv DO - 10.1101/149914 SP - 149914 AU - Peter MacPherson AU - Katherine Valentine AU - Victoria Chadderton AU - Evdokia Dardamissis AU - Iain Doige AU - Andrew Fox AU - Sam Ghebrehewet AU - Tom Hampton AU - Ken Mutton AU - Claire Sherratt AU - Catherine M McCann Y1 - 2017/01/01 UR - http://biorxiv.org/content/early/2017/06/14/149914.abstract N2 - Background Outbreaks linked to cosmetic piercing are rare, but can cause significant illness. We report the investigation and management of a point-source outbreak that occurred during a “Black Friday” event in North West England.Methods Outbreak investigation was led by Public Health England, and included active case finding among individuals pierced at a piercing premises between 25/11/2016 (“Black Friday”) and 7/12/2016. Detailed epidemiological, environmental (including inspection and sampling), and microbiological investigation was undertaken.Results During the “Black Friday” event (25/11/2016), 45 people were pierced (13 by a newly-appointed practitioner). Eleven cases were identified (7 microbiologically-confirmed, 2 probable, and 2 possible). All cases had clinical signs of infection around piercing sites, and five required surgical intervention, with varying degrees of post-operative disfigurement. All confirmed and probable cases had a “scaffold piercing” placed with a guide bar by the newly-appointed practitioner. Pseudomonas aeruginosa, indistinguishable at nine-locus variable-number tandem repeat loci, was isolated from four of the confirmed cases, and from pre- and post-flush samples from five separate water taps (three sinks) in the premises. Water samples taken after remedial plumbing work confirmed elimination of Pseudomonas contamination.Conclusions Although high levels of Pseudomonas water contamination and some poor infection control procedures were identified, infection appeared to require additional exposure to an inexperienced practitioner, and the more invasive scaffold piercing. A proactive collaborative approach between piercers and health and environmental officials is required to reduce outbreak risk, particularly when unusually large events are planned. ER -