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APHA Scientific Session and Event Listing

Recorded presentation

Joan F. Walsh, PhD¹, Jonathan B. Kotch, MD, MPH², Jan Vinjé, PhD³, David Weber, MD, MPH⁴, Whitney Lyman, DVM, MPH¹, and Patricia Isbell, PhD². (1) Maternal and Child Health, University of North Carolina at Chapel Hill, 116-A Merritt Mill Road, Chapel Hill, NC 27599-8126, 919-843-7151, walshj@email.unc.edu, (2) Dept. of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, Campus Box # 7445, Chapel Hill, NC 27599-7445, (3) Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, 106 Rosenau Hall, CB#7341, Chapel Hill, NC 27599-7341, (4) Division of Infectious Diseases, Bioinformatics, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC 27599-7030

Incidence and etiology of infectious non-bacterial diarrhea in out-of-home child care

Gastrointestinal illnesses are common in child care centers most of which are likely caused by enteric viruses. Little data are available on the identity and distribution of viruses that cause acute gastroenteritis in child care settings. Outbreak investigations are only initiated when a reportable bacterial cause is found or suspected, but seldom otherwise. We are conducting a study on the incidence and etiology of outbreaks of acute infectious gastroenteritis in child care centers throughout North Carolina. Methods: Fecal specimens from infants and toddlers with diarrhea were collected and analyzed for the presence of norovirus, rotavirus gp A, sapovirus, adenovirus type 40/41 and astrovirus by (RT)-PCR methods, and for enteric bacteria by routine culture methods. Results: The study began in October 2005 and fecal specimens from 11 reported outbreaks have been analyzed as of this submission. Of these, 3 were positive for norovirus, 2 for rotavirus, 2 for astrovirus, and 2 for Shigella ssp. While at least one enteric virus was isolated in 6 of 11 outbreaks, only in 3 outbreaks were multiple specimens found to be positive for the same virus. We anticipate analysis of many more outbreaks over the next several months. Data from this study will be used to design a follow-up study that will assess alternate intervention measures to prevent or minimize transmission of viral agents of acute gastroenteritis in out-of-home child care to other children, staff, and household members.

Learning Objectives:

• Learners will assess the protocol used for determining the incidence of enteric viruses among young children in out-of-home care.
• Learners will identify the three viruses most commonly found by this study in child care centers in North Carolina.
• Learners will describe possible modes of viral transmission and potential interventions to reduce the incidence of viral disease in out-of-home care.

Keywords: Child Care, Infectious Diseases

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation