During November 2021–May 2022, we identified 37 clinical cases of Streptococcus equi subspecies zooepidemicus infections in central Italy. Epidemiologic investigations and whole-genome sequencing showed unpasteurized fresh dairy products were the outbreak source. Early diagnosis by using sequencing technology prevented the spread of life-threatening S. equi subsp. zooepidemicus infections.
Streptococcus equi subspecies zooepidemicus is a β-hemolytic streptococcus expressing Lancefield group C antigen and is 1 of 3 S. equi subspecies. S. equi subsp. zooepidemicus is an opportunistic pathogen that can infect domestic animals, pets, and wildlife (1–6). Sporadic human cases have been reported (7), characterized by clinical manifestations that vary from meningitis to sepsis. Human infection generally occurs through direct contact with infected animals or by consumption of contaminated unpasteurized milk or other dairy products (8–10). We report a large S. equi subsp. zooepidemicus outbreak in Italy.