Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: Prospective study

Pickering, Larry K.; Evans, Dolores G.; DuPont, Herbert L.; Vollet, John J.; Evans, Doyle J.

doi:10.1016/s0022-3476(81)80956-0

Cited by 171 publications

(46 citation statements)

References 19 publications

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“…This concurs with reported outbreaks of rotavirus-positive diarrhea in day cares (22,60). Vomiting, watery diarrhea and the absence of blood in the stool have been previously associated with rotavirus (4,8,23,35,41,46,64).…”

Section: Discussionsupporting

confidence: 90%

“…Screening for the presence of rotavirus antigen through EIA had relatively high yield for NAD episodes as well. Based on these findings, it would appear that testing for C difficile toxin and rotavirus antigen by the use of EIA are the only tests indicated in NAD episodes other than in the setting of an outbreak, where bacterial culture, and ova and parasite screening may be useful (58)(59)(60). Our study may be limited by the lack of universal use of EM at our institution, which may pick up Norwalk, toroviruses and other gastrointestinal viruses.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community‐Acquired Paediatric Diarrhea

Deorari

McConnell

Tan

et al. 1999

Canadian Journal of Infectious Diseases and Medical Microbiolog

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OBJECTIVES:To evaluate the role of routine stool examination for all pathogens in paediatric nosocomial diarrhea (NAD) and community-acquired diarrhea (CAD) over a two-year period at Alberta Children's Hospital and current practices in other Canadian hospitals. A secondary objective was to characterize features that may predict NAD or CAD etiology. STUDY DESIGN: Retrospective cohort study and telephone survey. SETTING: Alberta Children's Hospital (retrospective review) and Canadian tertiary care paediatric centres (telephone survey). METHODS:The health and microbiological records of all children with an admission or discharge diagnosis of diarrhea were reviewed using a standardized data collection form. In addition, a telephone survey of laboratories serving all paediatric hospitals in Canada was conducted using a standard questionnaire to obtain information about practices for screening for pathogens related to NAD. RESULTS: Four hundred and thirty-four CAD episodes and 89 NAD episodes were identified. Overall, rotavirus and Clostridium difficile were the most commonly identified pathogens. Bacterial culture was positive in 10.6% CAD episodes tested, with Escherichia coli O157:H7 identified as the most common non-C difficile organism. In NAD, no bacteria were identified other than C difficile (toxin). Screening for ova and parasites had negligible yield. Viruses were more frequent in the winter months, while bacterial pathogens were more common in the summer and fall months. Over 50% of Canadian paediatric hospitals still routinely process NAD specimens similarly to CAD specimens. CONCLUSIONS: There is a need for the re-evaluation of routine ova and parasite screening, and bacterial culture in nonoutbreak episodes of NAD in children.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 98%

Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community‐Acquired Paediatric Diarrhea

Deorari

McConnell

Tan

et al. 1999

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…The acidic fractions with antirotaviral activity were pooled and subsequently designated as the acidic glycoprotein fraction of human milk. We found that this acidic glycoprotein fraction could inhibit the replication of the SA- 11 (38). We found that the affinity-purified milk mucin complex inhibits the replication of SA-11 virus at a concentration of 0.1 g/ml, or a 3,000-fold increase in specific activity (Fig.…”

Section: Resultsmentioning

confidence: 68%

“…Rotaviruses also have been implicated as causative agents of outbreaks of diarrhea occurring in nursing homes, travelers, day-care centers, and adult contacts of ill children. Additionally, rotaviruses have been identified as etiologic agents ofdiarrhea in patients undergoing bone marrow transplantation and suffering from a variety of immunodeficiency conditions (8)(9)(10)(11)(12). The recognition ofthe importance of rotaviral infections has led to a substantial effort directed at the prevention ofinfection by means ofactive immunization.…”

Section: Introductionmentioning

confidence: 99%

Human milk mucin inhibits rotavirus replication and prevents experimental gastroenteritis.

et al. 1992

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Acute gastrointestinal infections due to rotaviruses and other enteric pathogens are major causes of morbidity and mortality in infants and young children throughout the world. Breastfeeding can reduce the rate of serious gastroenteritis in infants; however, the degrees of protection offered against rotavirus infection vary in different populations. The mechanisms associated with milk-mediated protection against viral gastroenteritis have not been fully elucidated.We have isolated a macromolecular component of human milk that inhibits the replication of rotaviruses in tissue culture and prevents the development of gastroenteritis in an animal model system. Purification of the component indicates that the antiviral activity is associated with an acidic fraction (pI = 4.0-4.6), which is free of detectable immunoglobulins. Furthermore, high levels of antiviral activity are associated with an affinity-purified complex of human milk mucin. Deglycosylation of the mucin complex results in the loss of antiviral activity. Further purification indicated that rotavirus specifically binds to the milk mucin complex as well as to the 46-kD glycoprotein component ofthe complex. Binding to the 46-kD component was substantially reduced after chemical hydrolysis of sialic acid.We have documented that human milk mucin can bind to rotavirus and inhibit viral replication in vitro and in vivo. Variations in milk mucin glycoproteins may be associated with different levels of protection against infection with gastrointestinal pathogens. (J. Clin. Invest. 1992. 90:1984

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“…20 In its licensing regulations, the TDHR requires that all DCC meet certain specifications, including: no more than 17 children for each toilet and wash basin; available floor space (to include all child care areas) of at least 30 square feet per child; and various child/staff ratios not to be exceeded for different age groups. In our study, we followed all TDHR guidelines except that our measurements of floor space did not include rooms that were used only for communal activities of all children.…”

Section: Methodsmentioning

confidence: 99%

Longitudinal study of occurrence of diarrheal disease in day care centers.

Sullivan¹,

Woodward²,

Pickering³

et al. 1984

Am J Public Health

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Sixty day care centers (DCC) randomly selected from 736 licensed child care facilities in Harris County (Houston), Texas were surveyed for the incidence of diarrhea by periodic visits and weekly telephone calls over two years. A total of 2,708 episodes of diarrhea were reported in 3,800 children under 6 years of age, and 84 cases occurred in center staff. Overall incidence was 0.44 episodes/person/year among children and 0.14 among staff. Attack rates among the 60 DCC ranged from none to 3.64 cases/year in each child. The incidence for children under 36 months of age was 17 IntroductionThe increase in child care facilities in the United States and the recent recognition that they pose a significant reservoir of infectious diseases have called attention to the environment in which an estimated 11.4 million children spend a minimum of 10 hours per week.' Retrospective evaluations of epidemics of different diseases and of diarrheal illness of various and unknown etiologies2-'9 have been reported; however, few investigators have observed, by prospective design, the occurrence of day care center (DCC)-associated diseases. In October 1980, we undertook a two-year program of surveillance of diarrheal illness in DCC in Houston to determine the incidence, etiologic agents, child/staff characteristics, and mechanisms of enteropathogen transmission operative in this unique environment. We report here the results of one portion of our investigation which describe the incidence of diarrhea and its association with various characteristics of 60 randomly selected DCCs.

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Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: Prospective study

Cited by 171 publications

References 19 publications

Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community‐Acquired Paediatric Diarrhea

Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community‐Acquired Paediatric Diarrhea

Human milk mucin inhibits rotavirus replication and prevents experimental gastroenteritis.

Longitudinal study of occurrence of diarrheal disease in day care centers.

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