ABSTRACT
VTEC O157 outbreaks attributed to person-to-person transmission by the faecal-oral route have been reported in institutions where individuals cannot exercise a high level of personal hygiene. Outbreaks have been reported in psycho-geriatric wards, homes for the elderly and children’s day-care facilities. In children’s day-care centre outbreaks, 3 per cent to 38 per cent of children have been recognised as cases (with case definitions including bacterial confirmation, bloody diarrhoea or HUS). The introduction of VTEC O157 into a children’s day-care centre (pre-school age children) can transform a small community outbreak into a major incident. Infection is usually introduced by a sick child. Detailed record keeping of toileting, particularly in young children, facilitates early detection and control of such outbreaks. Attack rates were higher in younger ages. In some outbreaks, in such premises, the initial vehicle of infection was food with subsequent extensive person-to-person transmission.
