A cluster of invasive pneumococcal disease in young children in child care
T. Cherian, M. C. Steinhoff, L. H. Harrison, D. Rohn, L. K. McDougal and J. Dick
Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD 21205.
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.
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