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.
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: R E Black; A C Dykes; K E Anderson; J G Wells; S P Sinclair; G W Gary; M H Hatch; E J Gangarosa Journal: Am J Epidemiol Date: 1981-04 Impact factor: 4.897
Authors: V Garrett; K Bornschlegel; D Lange; V Reddy; L Kornstein; J Kornblum; A Agasan; M Hoekstra; M Layton; J Sobel Journal: Epidemiol Infect Date: 2006-04-20 Impact factor: 2.451
Authors: Sumathi Sivapalasingam; Jennifer M Nelson; Kevin Joyce; Mike Hoekstra; Frederick J Angulo; Eric D Mintz Journal: Antimicrob Agents Chemother Date: 2006-01 Impact factor: 5.191
Authors: Myron M Levine; Karen L Kotloff; Eileen M Barry; Marcela F Pasetti; Marcelo B Sztein Journal: Nat Rev Microbiol Date: 2007-07 Impact factor: 60.633
Authors: Nicholas E Dickenson; Lingling Zhang; Chelsea R Epler; Philip R Adam; Wendy L Picking; William D Picking Journal: Biochemistry Date: 2010-12-15 Impact factor: 3.162
Authors: Kenneth F Stensrud; Philip R Adam; Cassandra D La Mar; Andrew J Olive; Gerald H Lushington; Raghavi Sudharsan; Naomi L Shelton; Richard S Givens; Wendy L Picking; William D Picking Journal: J Biol Chem Date: 2008-05-01 Impact factor: 5.157