Sockett P N, Rodgers F G
Division of Enteric, Foodborne and Waterborne Diseases, Bureau of Infectious Diseases, Centre for Infectious Disease Prevention and Control, Health Canada, Ottawa, Ontario;
Paediatr Child Health. 2001 Apr;6(4):203-9. doi: 10.1093/pch/6.4.203.
Canadian statistics show that children from birth to four years of age are more likely to be reported with an infection from Campylobacter, Giardia, Salmonella and Shigella species, and verotoxigenic Escherichia coli than any other age group. A review of the Canadian and international literature, and an analysis of case and outbreak data suggest that the risk factors for infection in young children (ages birth to four years) are different from the risk factors for older children and adults. In children from birth to four years of age, infant formula, fast foods, snacks and candies have caused major outbreaks of enteric and foodborne diseases; however, the contamination of a child's environment or the presence of ill individuals in a household may be highly significant to disease expression. Contact with animals (including family pets) and contaminated surfaces, together with experimental touching and testing behaviours, are important routes of infection for infants and preschool children. Risk factors for enteric infections in children appear to be related, occasionally, to specific foods that are particularly attractive to all children (all age groups from infants up to and including elementary school-aged childen), to an infected person or pet in the same household, or to the contamination of a child's environment. Nonfood-related risk factors may be of particular significance in infection in infants and very young children. Contact with animals, particularly exotic pets and farm animals, or their environments should be considered to be a potential source of infection in children in situations in which there is an absence of other risk factors. The evidence presented in the current paper emphasizes the importance of personal and home hygiene practices in limiting children's exposure to enteric pathogens. Strict hand washing practices and restrictions on touching birds, reptiles and other animals at petting zoos or in nursery and primary school facilities are recommended to avoid widespread infection. Public health authorities should consider the development of guidelines on the provision of hand washing facilities and instruction notices in settings where the public may come into contact with farm or other animals in jurisdictions where such guidelines do not already exist.
加拿大的统计数据表明，与其他任何年龄组相比，出生至4岁的儿童感染弯曲杆菌、贾第虫、沙门氏菌、志贺氏菌属以及产志贺毒素大肠杆菌的报告更为常见。对加拿大及国际文献的综述以及病例和疫情数据的分析表明，幼儿（出生至4岁）感染的风险因素与大龄儿童及成人的风险因素不同。在出生至4岁的儿童中，婴儿配方奶粉、快餐、零食和糖果引发了多起肠道和食源性疾病的大规模暴发；然而，儿童所处环境的污染或家庭中患病个体的存在对疾病表现可能具有高度影响。与动物（包括家庭宠物）及受污染表面接触，以及试验性触摸和测试行为，是婴儿和学龄前儿童重要的感染途径。儿童肠道感染的风险因素似乎偶尔与所有儿童（从婴儿到包括小学年龄段儿童在内的所有年龄组）都特别喜爱的特定食物、同一家庭中的感染者或宠物，或儿童所处环境的污染有关。与食物无关的风险因素在婴儿和幼儿感染中可能具有特别重要的意义。在没有其他风险因素的情况下，与动物尤其是外来宠物和农场动物或其环境接触，应被视为儿童感染的潜在来源。本文所提供的证据强调了个人及家庭卫生习惯在限制儿童接触肠道病原体方面的重要性。建议严格洗手，并限制在宠物动物园或幼儿园及小学设施中触摸鸟类、爬行动物和其他动物，以避免感染的广泛传播。在尚无此类指南的司法管辖区，公共卫生当局应考虑制定关于在公众可能接触农场动物或其他动物的场所提供洗手设施及指示通知的指南。
