title: Viral meningitis in child care center staff and parents: an outbreak of echovirus 30 infections.
abstract: OBJECTIVE
  A report of five cases of viral meningitis among adults with children enrolled in a child care center prompted an investigation of risk factors for viral transmission from children to adult household members.
  
  
  METHODS
  To determine recent echovirus 30 (E30) infections, the authors conducted a serologic survey. To determine risk factors for infection among adult household members, they conducted a retrospective cohort study using written questionnaires.
  
  
  RESULTS
  Recent E30 infections were found in 84% of children tested, 57% of adult household members tested, and 47% of staff members tested. Infected adults were more likely than infected children to have clinical meningitis. Among adult household members, changing diapers was a risk factor for recent infection. Women who changed > or = 90 diapers per month had a higher infection rate than women who changed fewer diapers; in contrast, men who changed > or = 90 diapers per month had a lower infection rate than men who changed fewer diapers. Handwashing was protective: there was a negative correlation between handwashing after diaper changes and E30 infection among adults with infected children in diapers.
  
  
  CONCLUSIONS
  Because child care centers can be a source of enteroviral infections among adult household members, adults with viral meningitis should be questioned about their children's day care or preschool attendance. The importance of handwashing should be stressed to adults with children in day care.
authors.affiliation: Disease Investigations and Surveillance Branch, California Department of Health Services, Berkeley 94704, USA. jmohlebo@dhs.ca.gov
authors.forename: J C
authors.initials: JC
authors.lastname: Mohle-Boetani
authors.forename: C
authors.initials: C
authors.lastname: Matkin
authors.forename: M
authors.initials: M
authors.lastname: Pallansch
authors.forename: R
authors.initials: R
authors.lastname: Helfand
authors.forename: M
authors.initials: M
authors.lastname: Fenstersheib
authors.forename: J A
authors.initials: JA
authors.lastname: Blanding
authors.forename: S L
authors.initials: SL
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D002140:California / Q000453:epidemiology; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D015331:Cohort Studies; D004196:Disease Outbreaks; D004457:Echovirus Infections / Q000145:classification / Q000453:epidemiology* / Q000635:transmission; D029822:Enterovirus B, Human / Q000302:isolation & purification*; D005260:Female; D006235:Hand Disinfection; D006801:Humans; D007223:Infant; D007224:Infant Care; D008297:Male; D008587:Meningitis, Viral / Q000145:classification / Q000453:epidemiology* / Q000635:transmission; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index
chemical_list: D000914:Antibodies, Viral