Prevention of secondary household transmission during Shiga toxin-producing Escherichia coli outbreaks

• Published in: Epidemiology and infection Vol. 144; no. 14; pp. 2931 - 2939
• Main Authors: TOKUDA, K., YAHATA, Y., SUNAGAWA, T.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2016
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child care; Child Day Care Centers; Child, Preschool; Children; Children & youth; Cohort Studies; Day care centers; Daycare; Disease Outbreaks; Disease prevention; Disease transmission; E Coli; Education; Epidemiology; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Escherichia coli Infections - transmission; Families & family life; Family Characteristics; Female; Health care facilities; Health surveillance; Hemolytic-Uremic Syndrome - epidemiology; Hemolytic-Uremic Syndrome - microbiology; Households; Humans; Hygiene; Infant; Infections; Infectious diseases; Japan - epidemiology; Lag time; Male; Middle Aged; Multilevel; Nosocomial infections; Original Papers; Outbreaks; Prevention; Public health; Retrospective Studies; Shiga toxin; Shiga-Toxigenic Escherichia coli - physiology; Siblings; Studies; Young Adult; Japan; transmission; outbreaks; Shiga-like toxin-producing E. coli; Incidence
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268816001199

Prevention of secondary household transmission of Shiga toxin-producing Escherichia coli (STEC) is important in outbreak settings. We examined factors contributing to secondary household transmission during STEC outbreaks in daycare centres in Japan. Suspected STEC outbreaks in daycare centres were identified by the National Epidemiological Surveillance of Infectious Diseases. Questionnaires were sent to local health centres that responded to outbreaks. Secondary household transmission rates were calculated, and factors affecting secondary household transmission rate were analysed by multilevel analysis. The secondary household transmission rates in 16 outbreaks ranged from 0% to 34·4% (median 4·4%). The highest rate (23·0%) was observed in siblings aged 6–9 years, and the infection rate was significantly higher for mothers than for fathers and grandparents (P < 0·05). Using multilevel analysis, the following variables were selected in the best model: information provided face-to-face (vs. letter or telephone) to families of children in daycare centres (at initial response), STEC type and lag time (days) between onset and providing information. Early response and hygiene education by visiting local health centre staff may be effective measures to prevent secondary household transmission in STEC outbreaks. Hygiene education should be emphasized for children aged 6–9 years, as well as for younger children.