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Shigella Outbreaks Linked with Daycare Centers &nb
« on: Jan 30th, 2004, 10:45am » |
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Shigella Outbreaks Linked with Daycare Centers
Thu Jan 29, 4:30 PM ET
NEW YORK (Reuters Health) - Between 2001 and 2003, six states experienced between 5 and 40 times the normal number of dysentery cases caused by the Shigella bacillus, public health officials report.
The prolonged outbreaks tended to start in daycare settings, and then spread from there throughout the communities.
More than 3000 laboratory-confirmed cases of diarrhea caused by Shigella sonnei were reported through the Public Health Laboratory Information System during the epidemic, Dr. Marci Drees and colleagues report in the Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention.
In Maryland, the number of cases was 10-fold higher than in previous years, while in New Jersey, the there was a 40-fold increase in cases.
States tend to have cyclical outbreaks every few years, Drees told Reuters Health. "This was the largest outbreak seen in Delaware in 20 years," added Drees, who is with the CDC and is stationed at the Delaware Department of Health.
The patients' median age ranged from 4 to 7 years, but the oldest patient was 101 years old.
"Most cases are self-limited and will get better regardless," Drees pointed out. However, children can continue to shed the bacillus for up to a month, so antibiotic treatment is often recommended to decrease this length of time.
Control measures include notification of daycare providers, parents and the medical community, and diligent hand-washing.
"If possible, the staff that change diapers should not be preparing food," Drees added.
"It only takes a small number of bacteria to give the disease to another," she explained. "It's not that people are being obviously messy or dirty, either. The standard of hygiene to prevent disease spread is so high that it's hard for anyone to maintain it 100 percent of the time."
Most health departments do not allow children to return to daycare until two negative stool cultures are documented. However, not allowing children to return to daycare can backfire, the authors point out, since parents may place their children in alternative childcare settings.
Another option is to keep infected children who don't have symptoms in daycare, but apart from uninfected kids.
SOURCE: Morbidity and Mortality Weekly Report, January 30, 2004.
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