Skip to main content
×
Home
    • Aa
    • Aa

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)...
Abstract
SUMMARY

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.

Copyright
Corresponding author
*Author for correspondence: Dr L. Booth, Wessex PHEC, Unit 8 Fulcrum 2, Solent Way, Whiteley, Hampshire PO15 7FN, UK. (Email: linda.booth@phe.gov.uk)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3. J Tuttle , Lessons from a large outbreak of Escherichia coli O157:H7 infections: insights into the infectious dose and method of widespread contamination of hamburger patties. Epidemiology and Infection 1999; 122: 185192.

4. H Pennington . Escherichia coli O157. Lancet 2010; 376: 14281435.

13. S Shah , Prolonged fecal shedding of Escherichia coli O157:H7 during an outbreak at a day care center. Clinical Infectious Diseases 1996; 23: 835836.

14. GA Willshaw , Verocytotoxin-producing Escherichia coli (VTEC) O157 and other VTEC from human infections in England and Wales: 1995–1998. Journal of Medical Microbiology 2001; 50: 135142.

15. C Jenkins , Assessment of a real-time PCR for the detection and characterization of verocytotoxigenic Escherichia coli. Journal of Medical Microbiology 2012; 61: 10821085.

20. TG Boyce , DL Swerdlow , PM Griffin . Escherichia coli O157:H7 and the hemolytic-uremic syndrome. New England Journal of Medicine 1995; 333: 364368.

21. CH Pai , Epidemiology of sporadic diarrhea due to verocytotoxin-producing Escherichia coli: a two-year prospective study. Journal of Infectious Diseases 1988; 157: 10541057.

22. CS Wong , The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. New England Journal of Medicine 2000; 342: 19301936.

23. AT Pavia , Hemolytic-uremic syndrome during an outbreak of Escherichia coli O157:H7 infections in institutions for mentally retarded persons: clinical and epidemiologic observations. Journal of Pediatrics 1990; 116: 544551.

25. F Proulx , Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7 enteritis. Journal of Pediatrics 1992; 121: 299303.

27. M Nitschke , Association between azithromycin therapy and duration of bacterial shedding among patients with Shiga toxin-producing enteroaggregative Escherichia coli O104:H4. Journal of the American Medical Association 2012; 307: 10461052.

28. ME Seifert , PI Tarr . Therapy: azithromycin and decolonization after HUS. Nature Reviews Nephrology 2012; 8: 317318.

29. KG Snedeker , Primary and secondary cases in Escherichia coli O157 outbreaks: a statistical analysis. BMC Infectious Diseases 2009; 9: 144.

30. SM Parry , RL Salmon . Sporadic STEC O157 infection: secondary household transmission in Wales. Emerging Infectious Diseases 1998; 4: 657661.

31. L Al-Jader , Outbreak of Escherichia coli O157 in a nursery: lessons for prevention. Archives of Disease in Childhood 1999; 81: 6063.

33. P Reida , An outbreak due to enterohaemorrhagic Escherichia coli O157:H7 in a children day care centre characterized by person-to-person transmission and environmental contamination. Zentralblatt fur Bakteriologie 1994; 281: 534543.

35. CC Tam , Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut 2012; 61: 6977.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 4
Total number of PDF views: 25 *
Loading metrics...

Abstract views

Total abstract views: 114 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th March 2017. This data will be updated every 24 hours.