Cordell R L, Thor P M, Addiss D G, Theurer J, Lichterman R, Ziliak S R, Juranek D D, Davis J P
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Pediatr Infect Dis J. 1997 Jul;16(7):639-44. doi: 10.1097/00006454-199707000-00003.
We describe the impact of the 1993 waterborne cryptosporidiosis outbreak on metropolitan Milwaukee child care homes and centers.
Information on outbreak-related illness and changes in policies and practices was collected from directors of 117 facilities. Stool specimens from 129 diapered children from 11 centers were screened for Cryptosporidium.
Most (74%) facility directors reported children or staff with diarrhea during the outbreak; however, only 4 (3.4%) facilities closed because of illness among staff or children. During the outbreak child care homes were less likely to exclude children with diarrhea than were child care centers. Among diapered children attending centers the Cryptosporidium prevalence was 30%; 29% of infected children had no history of diarrhea associated with the Milwaukee outbreak.
Facilities continued to operate during the outbreak despite considerable illness among children and staff. The news media were effective means for providing public health information to child care facilities. Although secondary transmission undoubtedly took place in child care facilities, the presence of children with asymptomatic Cryptosporidium infections did not result in an increased risk of diarrhea in infant and toddler rooms.
我们描述了1993年水源性隐孢子虫病暴发对密尔沃基市大都会地区儿童保育院和中心的影响。
从117家机构的负责人那里收集了与暴发相关疾病以及政策和做法变化的信息。对来自11个中心的129名仍在使用尿布的儿童的粪便样本进行了隐孢子虫筛查。
大多数（74%）机构负责人报告在暴发期间有儿童或工作人员出现腹泻；然而，只有4家（3.4%）机构因工作人员或儿童患病而关闭。在暴发期间，儿童保育院比儿童保育中心更不可能排除腹泻儿童。在进入中心的仍在使用尿布的儿童中，隐孢子虫感染率为30%；29%的受感染儿童没有与密尔沃基暴发相关的腹泻病史。
尽管儿童和工作人员中出现了大量疾病，但各机构在暴发期间仍继续运营。新闻媒体是向儿童保育机构提供公共卫生信息的有效手段。虽然在儿童保育机构中无疑发生了二代传播，但有无症状隐孢子虫感染的儿童的存在并未导致婴儿和幼儿室腹泻风险增加。
