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A Cluster of Invasive Pneumococcal Disease in Young Children in Child Care
Thomas Cherian, MBBS, MD;
Mark C. Steinhoff, MD;
Lee H. Harrison, MD;
Dale Rohn, MPH;
Linda K. McDougal, MS;
James Dick, PhD
JAMA. 1994;271(9):695-697.
Abstract
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Objective.
—To investigate a cluster of invasive pneumococcal disease in children 8 to 26 months of age, using standard microbiological procedures and ribosomal DNA gene-restriction patterns to characterize the outbreak strain.
Design.
—Outbreak investigation.
Setting.
—A family child-care home with six children in Baltimore, Md.
Results.
—During an 8-day period, three of the six children in the family child-care home had febrile illnesses with pneumococcal bacteremia, and a fourth had purulent pneumococcal conjunctivitis. Type 12F Streptococcus pneumoniae was isolated from the four ill children and from the nasopharynges of the two healthy children. Ribotyping revealed all outbreak isolates had an identical ribotype pattern. Administration of rifampin to the children did not eradicate carriage of the organism.
Conclusions.
—Our data demonstrate that child care provides an opportunity for outbreak of invasive pneumococcal disease in young children. This observation suggests a need for increased alertness for clusters of pneumococcal disease in young children in child-care facilities and underscores the necessity for a pneumococcal vaccine that is effective in infants and young children.
(JAMA. 1994;271:695-697)
Author Affiliations
From the Departments of Pediatrics (Drs Cherian and Steinhoff), Medicine (Dr Harrison), and Laboratory Medicine (Dr Dick), School of Medicine, and the Departments of International Health (Drs Cherian, Steinhoff, and Harrison) and Epidemiology (Drs Steinhoff and Harrison), School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Md; the Maryland Department of Health and Mental Hygiene, Baltimore (Mr Rohn); and the Nosocomial Pathogens Laboratory Branch, Hospital Infections Program, National Center for Infectious Disease, Atlanta, Ga (Ms McDougal).
Footnotes
Reprint requests to Center for Immunization Research, School of Hygiene and Public Health, The Johns Hopkins University, 624 N Broadway, Room 125, Baltimore, MD 21205 (Dr Steinhoff).
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