Prevention of secondary household transmission during Shiga toxin-producing Escherichia coli outbreaks.
Prevention of secondary household transmission of Shiga toxin-producing Escherichia coli (STEC) is important in outbreak settings. We examined factors contributing to secondary household transmission during STEC outbreaks in daycare centres in Japan. Suspected STEC outbreaks in daycare centres were identified by the National Epidemiological Surveillance of Infectious Diseases. Questionnaires were sent to local health centres that responded to outbreaks. Secondary household transmission rates were calculated, and factors affecting secondary household transmission rate were analysed by multilevel analysis. The secondary household transmission rates in 16 outbreaks ranged from 0% to 34·4% (median 4·4%). The highest rate (23·0%) was observed in siblings aged 6-9 years, and the infection rate was significantly higher for mothers than for fathers and grandparents (P < 0·05). Using multilevel analysis, the following variables were selected in the best model: information provided face-to-face (vs. letter or telephone) to families of children in daycare centres (at initial response), STEC type and lag time (days) between onset and providing information. Early response and hygiene education by visiting local health centre staff may be effective measures to prevent secondary household transmission in STEC outbreaks. Hygiene education should be emphasized for children aged 6-9 years, as well as for younger children.
Department of Infection Prevention and Control,Division of Medical and Environmental Safety,Kagoshima University Medical and Dental Hospital,Kagoshima,Japan.
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K
Tokuda
National Institute of Infectious Diseases,Shinjuku-ku,Tokyo,Japan.
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Y
Yahata
National Institute of Infectious Diseases,Shinjuku-ku,Tokyo,Japan.
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T
Sunagawa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D015331:Cohort Studies; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D005191:Family Characteristics; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D054323:Shiga-Toxigenic Escherichia coli / Q000502:physiology*; D055815:Young Adult
Incidence; Shiga-like toxin-producing E. coli
            ; outbreaks; transmission