Communitywide shigellosis: control of an outbreak and risk factors in child day-care centers.

Abstract

OBJECTIVES:

The study's objectives were to assess (1) control of a community outbreak of shigellosis through the promotion of handwashing, (2) risk factors in day-care centers, and (3) shigellosis attributable to attendance at a day-care center.

METHODS:

In 1991, an outbreak of Shigella sonnei infections occurred in Lexington-Fayette County, Ky; 14 licensed child day-care centers were involved. Communitywide promotion of hand washing was instituted along with diarrhea surveillance. A case-control study compared day-care centers that had confirmed cases of shigellosis with centers that had none. A family transmission study determined those cases attributable to attendance at day-care centers.

RESULTS:

The outbreak abated 3 weeks after the interventions' initiation. Day-care centers with outbreaks were more likely than those with no cases to have a food handler who changed diapers and to provide transportation for children from their homes to the center. These centers also had a higher toddler-to-toilet ratio than control centers (21 vs 12). In 58% of families with shigellosis, the first person with diarrhea during the outbreak was a child younger than 6 years; 92% of diarrheal illnesses among these children were attributable to day-care attendance.

CONCLUSIONS:

Community involvement in increasing hand washing most likely resulted in control of this shigellosis outbreak. Diarrhea prevention strategies in day-care centers could prevent substantial communitywide disease.

• Authors: J C Mohle-Boetani, M Stapleton, R Finger, N H Bean, J Poundstone, P A Blake, P M Griffin
• Journal: American journal of public health (Am J Public Health) Vol. 85 Issue 6 Pg. 812-6 (Jun 1995) ISSN: 0090-0036 [Print] United States
• PMID: 7762715 (Publication Type: Journal Article)

Topics

• Case-Control Studies
• Child Day Care Centers
• Child, Preschool
• Disease Outbreaks
• Dysentery, Bacillary (epidemiology, prevention & control, transmission)
• Family Health
• Humans
• Kentucky (epidemiology)
• Occupational Diseases (epidemiology, microbiology, prevention & control)
• Risk Factors
• Shigella sonnei