|
DENVER -
The Denver Department of Health says three more cases of E. coli have been
discovered in the past week in an outbreak believed to have started at the
National Western Stock Show.
The new cases bring the total number of cases to 23.
Many of the cases are in children along the Front Range,
from Boulder to El Paso County.
Several of the sick children go to day care and at least
two of the cases appear to have happened after ill children came into
contact with other sick children, according to the Colorado Department of
Health and Environment (CDPHE).
It is unclear how the E. coli first spread at the Stock
Show.
The CDPHE is recommending the following tips:
For child care centers:
• Report any cases of bloody diarrhea (even if there is
only one) to your local public health agency or to CDPHE at 303-692-2700
immediately.
• Report any increase in the number of children or staff
with diarrhea who attend your facility to your local health department or
to CDPHE at 303-692-2700 immediately.
• Children or staff must not attend child care while ill
with diarrhea.
o If it is known that a
child/staff member with diarrhea attended the stock show, or if the
facility took a trip to the stock show, the child/staff member should be
referred to his/her health care provider for follow up and stool testing
before returning to class. That stool test must be negative and the
diarrhea must have resolved before the child/staff member can return to
child care.
o Any child/staff member with bloody diarrhea, regardless
of whether he/she went to the stock show should be referred to his/her
health care provider for follow up and stool testing before returning to
class. That stool test must be negative and the diarrhea must have resolved
before the child/staff member can return to child care.
o If a child/staff member has
diarrhea that is not bloody and did not attend the stock show, then the
child/staff member is not required to provide a negative stool specimen,
however diarrhea must be resolved before returning to child care.
• Children and staff who are diagnosed with E. coli O157
must have two stool specimens that are negative for E. coli O157 or shiga toxin before returning to child care.
For schools:
• Report any cases of bloody diarrhea (even if there is
only one) to your local public health agency or to CDPHE at 303-692-2700
immediately.
• Report any increase in the number of children or staff
with diarrhea who attend you facility to your local health department or to
CDPHE at immediately.
• Children should not attend school while ill with diarrhea.
o If it is known that a child
with diarrhea has attended the stock show, or if the child has bloody
diarrhea, we strongly recommend the child be referred to his/her provider
for follow up and stool testing.
• Because transmission of E. coli O157 from one person to
another is rare in school settings, children who are diagnosed with E. coli
O157 are not required to have negative stool specimens before returning to
school. They should, however, be free of diarrhea before returning to
class.
• School staff who are diagnosed
with E. coli O157 are also not required to have negative stool specimens
before returning to work, unless the staff member handles food as part of
his/her job.
General control measures:
• Regular agents that are used for sanitizing and
disinfection, such as sodium hypochlorite and quaternary ammonia based
solutions, are effective against E. coli. No special disinfectants are
necessary to kill E. coli.
• Consider increasing cleaning frequency of sanitizing
and/or disinfection, particularly in restrooms and diaper changing areas.
• Meticulous hand hygiene following diaper changing is
extremely important in controlling the spread of many pathogens. Both the
child's and caregiver's hands should be washed immediately following diaper
changing and toileting.
• Handwashing is also extremely
important for food handlers and before eating meals. Caregivers should
supervise children during handwashing to ensure
that the process is adequate.
• Again, staff responsible for preparing meals in child
care facilities and in schools should not handle food if they have diarrhea
or have been diagnosed with E coli. Food handlers with diarrhea should not
return to work until their diarrhea has resolved and should be encouraged
to visit a physician to have their stool tested. Food handlers diagnosed
with E coli, should not return to work until they have had two negative
stool samples.
For your information, CDPHE has provided the following advice for health
care providers:
• Please obtain stool specimens from children presenting
with bloody diarrhea. Please ensure the laboratory will test for E. coli
O157 or for shiga toxin, as not all laboratories
do this routinely.
• Consider obtaining stool specimens from children with
non-bloody diarrhea if diarrhea has persisted for more than 2 days, or is
accompanied by fever, severe abdominal cramping or other symptoms.
• Report cases of bloody diarrhea in children to CDPHE at
303-692-2700 until further notice.
• Children should not attend child care while they have
diarrhea. Children who are diagnosed with E. coli O157 must have two stool specimens
that are negative for E. coli O157 or shiga toxin
before returning to child care. Please explain these exclusion policies to
parents of children who are ill and who attend child care.
• Antibiotics are generally not recommended for E. coli
O157 infection and may be associated with development of hemolytic uremic
syndrome (HUS).
If outbreaks or ill children are identified in your
facility, your local public health agency will work with you to determine
if additional control measures are necessary.
Please maintain this enhanced vigilance for illness and
the extra screening measures for some children with diarrhea from now to
Feb. 16.
For disease reporting or other questions please contact
the CDPHE Communicable Disease program at 303-692-2700.
|
16
