Abstract
Over a period of 2 months, 23 of 53 (43%) children attending a day care center and 15 of 104 (14%) household contacts developed diarrhea. Stool specimens from the children, their household contacts and personnel were cultured for Salmonella. Shiaella. Yersinia. Campylobacter, Aeromonas and Vibrio spp. organisms. Viral cultures were performed and presence of Rotavirus RNA was determined. Each specimen was tested for the presence of protozoal cysts and for helminth ova. The rapid dimethyl sulfoxide modified acid fast stain was used to detect Cryptosporidium oocysts. Cryptosporidium cocysts were identified in 13 of 2ΓΈ (65%) symptomatic children tested, compared to 3 of 27 (11%) asymptomatic children (P<0.001). The prevalence of Cryptosporidium oocysts in parents with diarrhea (15%) was not significantly different from the prevalence in parents without diarrhea (3%). Enteropathogenic bacteria, rotavirus and other protozoan parasites were ruled out as the cause of the diarrhea. Enteroviruses were cultured from 40% of the symptomatic children and 37% of the asymptomatic children.
The pattern of appearance of new cases suggested human to human transmission. Diarrhea in family members was strongly associated with the presence of an ill child and especially a child with proven cryptosporidiosis. The present report shows that Cryptosporidium should be added to the list of organisms that can cause outbreaks of diarrhea in day care centers.
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Alpert, G., Bell, I., Kirkpatrick, C. et al. 1049 An outbreak of cryptosporidiosis in a day care center. Pediatr Res 19, 285 (1985). https://doi.org/10.1203/00006450-198504000-01079
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DOI: https://doi.org/10.1203/00006450-198504000-01079