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    MacDonald, Emily Dalane, Per Kjetil Aavitsland, Preben Brandal, Lin Thorstensen Wester, Astrid Louise and Vold, Line 2014. Implications of screening and childcare exclusion policies for children with Shiga-toxin producing Escherichia coli infections: lessons learned from an outbreak in a daycare centre, Norway, 2012. BMC Infectious Diseases, Vol. 14, Issue. 1,

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    HARRIES, M. DREESMAN, J. RETTENBACHER-RIEFLER, S. and MERTENS, E. 2016. Faecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae and Shiga toxin-producing Escherichia coli in asymptomatic nursery children in Lower Saxony (Germany), 2014. Epidemiology and Infection, p. 1.


Duration of shedding of Verocytotoxin-producing Escherichia coli in children and risk of transmission in childcare facilities in England

  • G. DABKE (a1), A. LE MENACH (a2) (a3), A. BLACK (a1), J. GAMBLIN (a1), M. PALMER (a1), N. BOXALL (a2) and L. BOOTH (a1)
  • DOI:
  • Published online: 15 May 2013

Exclusion of children with presumptive Verocytotoxin-producing Escherichia coli (VTEC) from childcare facilities until negative stool specimens are obtained is routine practice that disrupts families. We estimated the shedding and exclusion duration and transmission risk in such facilities. The study population comprised 225 children aged <6 years attending 201 childcare facilities in England with microbiologically confirmed VTEC in 2010–2011. We estimated the interval from onset to first negative specimen, and identified transmission events with secondary cases linked to facilities. The median duration of shedding was 31 days, and median period of exclusion was 39·5 days. Cases attending facilities while shedding VTEC did so for a median of 2 days before exclusion. Secondary cases occurred in 6/83 facilities (7%) attended by infectious cases. Despite evidence of VTEC shedding at facilities, transmission is relatively low. Revised control guidelines could consider supervised return for prolonged asymptomatic shedders.

Corresponding author
*Author for correspondence: Dr L. Booth, Wessex PHEC, Unit 8 Fulcrum 2, Solent Way, Whiteley, Hampshire PO15 7FN, UK. (Email:
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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