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Synopses of Research Articles Streptococcus suis Outbreak with Symptoms of Toxic Shock Syndrome in China DOI: 10.1371/journal.pmed.0030218 Streptococcus suis is a pathogen with serious economic effects of the cases had been caused by human-to-human transmission. on the pig industry worldwide. The disease is endemic in adult They also showed that S. suis isolated from the human patients pigs in most countries where pig farming is common. Infections caused typical S. suis disease in newborn piglets. in adult pigs are usually asymptomatic, but infant piglets that Were there other unusual characteristics among the Chinese get infected through contact with colonized adult females isolates that could explain their ability to cause STSS? STSS can develop fatal sepsis. Transmission to humans is rare and is thought to be caused by bacterial superantigens that generally restricted to individuals with occupational exposure overstimulate the human immune system. Gao and colleagues to live or dead pigs. The fi rst human case of S. suis infection tested the S. suis isolates associated with STSS for superantigen was reported in Denmark in 1968. Most of the approximately production, but were unable to detect any. 200 previously reported human cases were characterized by One of the key questions that arose when the recent outbreak meningitis and septicemia, and associated with a mortality of was fi rst reported was whether a new and more virulent strain less than 10%. of S. suis has emerged in China. Gao and colleagues performed Now George Gao and colleagues from the Chinese Academy an initial genomic survey of the isolates from the Chinese of Sciences, the Chine