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Transmission dynamics of enteric bacteria in day-care centers
Abstract:
The role of fomites in the transmission of diarrhea in day-care centers was evaluated. During a nine-month period (December 1980-August 1981), inanimate objects and hands of children and staff in five Houston day-care centers were cultured monthly and again during outbreaks of diarrhea. Air was sampled from the classrooms and bathrooms using a single-stage sieve sampler. When a diarrhea outbreak occurred, stool specimens were collected from ill and well children and from staff in the affected rooms. Multiple pathogens accounted for 3 of 11 outbreaks. The rates of isolation of fecal coliforms from hands and classroom objects on routine sampling were 17% (22/131) and 13% (8/64), respectively. During outbreaks of diarrhea, fecal coliforms were recovered with significantly greater frequency from hands (32%; p less than 0.005) and from classroom objects (36%; p less than 0.005). There was no difference in the level of fecal contamination in the toilet areas during outbreak and nonoutbreak periods. Shigella was not isolated in the study; salmonella was isolated on one occasion from a table during an outbreak of salmonellosis. Contamination of hands, communal toys and other classroom objects appeared to play a role in the transmission of enteropathogens in day-care center diarrhea outbreaks and helped to explain the presence of multiple pathogens among those affected.
Insights
Fomites, or inanimate objects, and hands in day-care centers significantly contribute to diarrhea outbreaks. Increased fecal coliforms on hands and objects during outbreaks highlight their role in spreading enteropathogens.
Area of Science:
- Microbiology
- Public Health
- Epidemiology
Background:
- Diarrhea outbreaks are common in day-care settings.
- Understanding transmission routes is crucial for prevention.
Purpose of the Study:
- To evaluate the role of fomites (inanimate objects) and hands in the transmission of diarrhea in day-care centers.
- To identify specific contamination sources during outbreaks.
Main Methods:
- Monthly cultures of hands and objects from children and staff in five day-care centers over nine months.
- Air sampling and stool specimen collection during diarrhea outbreaks.
- Isolation and identification of fecal coliforms and other pathogens.
Main Results:
- Fecal coliforms were frequently isolated from hands (17%) and objects (13%) during routine sampling.
- Isolation rates significantly increased during diarrhea outbreaks: hands (32%) and objects (36%).
- Multiple pathogens were identified in 3 of 11 outbreaks; Salmonella was isolated once.
Conclusions:
- Contaminated hands and communal objects play a significant role in the transmission of enteropathogens during day-care diarrhea outbreaks.
- This contamination helps explain the presence of multiple pathogens among affected individuals.
- Toilet area contamination levels did not differ between outbreak and non-outbreak periods.