Infectious diseases and infection control in infant-toddler daycare centers

This article provides an overview of the problem of infectious disease outbreaks in infant/toddler daycare centers. The economic costs incurred by the daycare center attendees' families and employers, and the center itself are presented as just one rationale for the implementation of effective infection control programs. A review of the daycare center infectious disease literature provides an overview of the most common pathogens encountered in these settings and the health implications for center children, their families, and the center staff. A model for understanding infectious disease transmission in a daycare center setting is presented to illustrate the discussion in the text. The article concludes with a review of infection control practices, research findings on the effectiveness of certain practices, and suggestions for the implementation of an effective infection control program.     

2008-2010年深圳市肠道传染病流行特征分析

目的 了解并掌握深圳市肠道传染病的发生、流行特征及变化趋势,探讨防治对策.方法 在国家疾病监测信息报告系统导出深圳市2008-2010年肠道传染病的数据,进行流行病学描述性分析.结果 2008-2010年深圳市肠道传染病共报告病例61 457例.伤寒、菌痢的发病高峰在夏秋季,其他感染性腹泻病的发病高峰在秋冬季.全市各区...     

Active and passive smoking during pregnancy and risk of central nervous system tumours in children

The effects of maternal active and passive smoking during pregnancy on childhood central nervous system (CNS) tumours were assessed in a population-based case-control study. The mothers of 244 children aged 0-15 years with CNS tumours and 502 control mothers were interviewed about their smoking habits. All families were resident in the region of Lombardy, Italy. Risk estimates were calculated by unconditional logistic regression, adjusted for age, sex and area of residence. Active smoking by the parents before pregnancy was not associated with increased risk of CNS tumours in the children. Active smoking by the mother during early pregnancy (approximately the first 5 weeks) was associated with a slightly increased risk of the child developing a CNS tumour (odds ratio [OR] 1.5 [95% CI 1.0, 2.3]). An increased risk of CNS tumours was found in the children of non-smoking mothers exposed regularly to tobacco smoke both in early pregnancy (OR 1.8 [95% CI 1.2, 2.6]) and in late pregnancy (OR 1.7 [95% CI 1.2, 2.5]). Although this study was retrospective, the results confirm our previous findings and suggest an association between the risk of developing CNS tumours in children and regular passive smoking by the mother during pregnancy.     

Advances and considerations in attention-deficit/hyperactivity disorder pharmacotherapy

Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neuropsychiatric disorder associated with significant impairments in occupational, academic, neuropsychological, and social functioning. Central nervous system (CNS) stimulants are recommended as first-line medication therapy for children. CNS stimulants include formulations of methylphenidate and amphetamine derivatives and are available in a large variety of immediate- and extended-release preparations. Extended-release preparations are often preferred to limit drug administration during school or work and may help to limit side effects associated with rapid fluctuations in serum concentration. Stimulant medication is by far the most commonly used treatment in managing children with ADHD, 10-20% of those who take such medication do now show clinically significant improvements in their primary ADHD symptom. Even when a favorable response is obtained, some children experience side effects that are of sufficient occurrence and severity to prevent continued use of stimulant medication. In such instances or when families are unwilling to consider a stimulant, non-stimulant medications may be appealing. This review focuses on etiology, assessment and treatment of ADHD with various stimulant and non-stimulant agents.     

Growth response to enteral feeding by children with cerebral palsy

This study evaluated the growth of 51 children with cerebral palsy after the initiation of enteral tube feedings. The children were divided into three groups according to how soon after their central nervous system (CNS) insult they were started on enteral feedings. Group 1 consisted of 14 children who were within a year of their CNS insult; they were underweight for age, but had normal length as well as weight for length. Within 6 months of initiating enteral tube feedings, most children in this group had normalized their weights. Group 2 consisted of 27 children who were within 8 years of their CNS insult; they were stunted and were underweight for both their age and their length. Within 6 months of initiating enteral feeds, the group increased both weight and weight for length to near normal, but their gains in length reached a plateau at 90% of ideal for age. Group 3 consisted of 10 children who were more than 8 years after their CNS insult. This group was severely malnourished but had some improvement in their weight for age and for length but, length for age showed no significant change. We conclude that the earlier adequate nutritional management of children with severe cerebral palsy is initiated, the more readily the nutritional deficits will reverse.     

2012年深圳市光明新区儿童感染性腹泻流行病学特征及相关因素分析

目的了解深圳市光明新区儿童感染性腹泻流行特征及因素,为有效控制该类疾病提供科学依据。方法对深圳市光明新区疾病监测信息报告管理系统中上报的儿童感染性腹泻病例进行描述性流行病学分析,并采用病例对照研究,选取100例儿童感染性腹泻患者作为病例组,并进行1:1条件匹配作为对照;制作调查表进行调查;采用单因素和多因素条件Logistic回归分析筛选危险因素。结果 2012年深圳市光明新区共报告感染性腹泻病例2 558例,其中儿童病例(0~14岁)2 373例,年发病率为0.48%。5岁儿童占15岁儿童报告病例的95.7%,感染性腹泻发病时间主要在秋冬季。单因素分析差异有统计学意义(P0.05)的变量为户籍、居住环境、家庭收入、剪手指甲、奶瓶(餐具)消毒、剩饭菜加热、剩饭菜处置、室内有苍蝇;多因素分析进入模型有统计学意义(P0.05)的变量为奶瓶(餐具)消毒和室内有苍蝇,其OR值分别为9.790和24.355。结论深圳市光明新区2012年感染性腹泻报告病例主要集中在0~5岁的散居儿童,秋冬季是感染性腹泻的发病高峰,奶瓶(餐具)消毒和室内有苍蝇是儿童感染性腹泻发生的危险因素。     

广东省2004-2006年其他感染性腹泻流行特征分析

目的了解广东省其他感染性腹泻的流行病学特征,探索监测系统中可能存在的问题。方法对广东省2004-2006年疾病监测信息报告系统中上报的其他感染性腹泻病例进行描述性流行病学分析。结果2004-2006年广东省共报告其他感染性腹泻病例198 522例,年发病率的范围为64.0/10万~91.8/10万,发病呈逐年上升趋势。5岁以下年龄组占全部发病数的46.13%。8-9月开始其他感染性腹泻发病逐渐增加,2004-2005年的12月下旬出现发病高峰,2006年发病高峰提前到11月中旬。报告发病率居前5位的地级市有江门、珠海、中山、阳江、广州等市。实验室诊断病例占总报告病例数的12.7%,其中轮状病毒在实验室诊断病例中占34.5%。3年共报告其他感染性腹泻暴发疫情8起,主要为诺如病毒(5起)引起。结论广东省2004-2006年其他感染性腹泻流行主要集中在0~5岁散居和托幼儿童,秋冬季是其他感染性腹泻的好发季节,各地其他感染性腹泻的报告严重不均,轮状病毒可能是影响其他感染性腹泻分布的重要因素之一。     

Human parvovirus 4 as potential cause of encephalitis in children, India

To investigate whether uncharacterized infectious agents were associated with neurologic disease, we analyzed cerebrospinal fluid specimens from 12 children with acute central nervous system infection. A high-throughput pyrosequencing screen detected human parvovirus 4 DNA in cerebrospinal fluid of 2 children with encephalitis of unknown etiology.     

2004～2006年阿克苏地区儿童少年传染病报告分析

目的通过对阿克苏地区儿童少年人群2004～2006年的传染病疫情资料分析，以了解发病规律、流行趋势和特征，为制定传染病防治策略提供依据。方法采集《疾病监测信息报告管理系统》相应资料以及相关的人口等资料，应用描述流行病学方法进行分析。结果3年中，地区无甲类传染病报告。同期，5～19岁的儿少人群的地区总传染病发病率为455．75／10万，其中乙类传染病发病率为312．53／10万；丙类传染病发病率为143．22／10万。它们分别占相应的乙、丙类传染病报告数的14．13％和60．43％；儿少是丙类传染病发病的主体。儿少人群的前五种高发传染病是：病毒性肝炎、流行性腮腺炎、肺结核、细菌性痢疾、麻疹（或感染性腹泻），该五种疾病的报告数分别占当年的儿少人群传染病报告数的89．07％，92．35％，95．62％。结论 改善卫生条件和养成良好饮食卫生习惯仍然是预防肠道传染病的主要措施，并且需加强学校卫生工作的领导和管理，使校医和保健教师真正承担起学校传染病预防控制工作。     

重症手足口病早期识别实验室检查的研究进展

手足口病(HFMD)是多种肠道病毒感染引起的一种急性传染病,好发于3岁以下儿童。大部分患儿可自愈,但少部分患儿,尤其是EV71型感染的患儿可迅速进展为重症。并发神经系统损害和心肺功能损害,遗留严重后遗症,极少数患儿甚至死亡,给患儿家庭和社会带来严重负担。本文献复习对重症重型和重症危重型手足口病的临床表现、发病机制,特别是实验室检查中能提示病情进展的指标进行综述。早期识别和诊断重症手足口病,为临床救治重症手足口病提供可靠的科学理论依据。     

新生儿消化系统感染性疾病的临床诊断与治疗研究

目的监测新生儿消化系统感染性疾病的发生率、临床诊断与治疗方法,以建立预防机制、减少疾病的发生。方法选择我院于2010年2月至2012年1月期间患消化系统感染性疾病的新生儿的发病率及疾病特点进行分析。结果在1392例新生儿患儿当中,患消化系统感染性疾病患儿129例,鹅口疮患儿32例(24.8%),其中30例治愈,2例好转,无死亡患儿。其余97例均为感染性腹泻患儿(75.2%),其中89例治愈,7例好转,1例死亡。结论医护人员要密切观察新生儿变化,能早期发现异常情况,及时采取诊治措施,可减少消化系统感染性疾病的发生率及降低死亡率,提高人口素质。     

儿童细菌感染性腹泻分离菌株的分布和耐药性分析

目的 分析儿童细菌感染性腹泻分离菌株的构成和耐药情况,为临床诊断和合理用药提供依据。方法 回顾性分析2015年1月-2016年12月西宁市第一人民医院腹泻患儿的粪便培养和药敏结果,采用Microscan WalkAway-40全自动微生物分析对粪便标本中的菌株进行鉴定,采用K-B纸片扩散法进行药敏试验,结果参照美国临床实验室标准化研究所文件2006版的标准判读。结果 817份标本中检出112株致病菌和条件致病菌,检出率为13.71%。主要病原菌包括志贺菌属(44株)、致病性大肠埃希菌(29株)、沙门菌属(17株)、肠球菌属(10株)、变形杆菌属(6株)。主要的革兰阴性致病菌对亚胺培南、第三代头孢菌素和加酶抑制剂的抗生素具有较高的敏感性,革兰阳性致病菌对利奈唑胺和万古霉素具有较高敏感性。结论 儿童细菌感染性腹泻的病原菌仍以致病革兰阴性菌为主。在使用抗菌药物时应根据药敏试验结果合理选择抗生素。     

A review of outbreaks of infectious disease in schools in England and Wales 1979-88

In this review of 66 outbreaks of infectious disease in schools in England and Wales between 1979-88, 27 were reported from independent and 39 from maintained schools. Altogether, over 8000 children and nearly 500 adults were affected. Most of the outbreaks investigated were due to gastrointestinal infections which affected about 5000 children: respiratory infections affected a further 2000 children. Fifty-two children and seven adults were admitted to hospital and one child with measles died. Vaccination policies and use of immunoglobulin for control and prevention of outbreaks in schools have been discussed.     

2009—2013年南京市浦口区中小学生和幼托儿童传染病疫情分析

目的分析南京市浦口区中小学生和幼托儿童传染病疫情,为制定防控策略提供科学依据。方法对2009—2013年中国疾病预防控制系统传染病报告卡相关数据,用描述性流行病学方法进行分析。结果2009—2013年中小学生累计报告传染病1 195例,年均报告发病率为323.27/10万,报告发病数位居前5位的病种依次为手足口病、流腮、水痘、肺结核、梅毒,男女性别比为1.65∶1,疫情主要发生在5—7月。2009—2013年幼托儿童累计报告传染病3 163例,年均报告发病率为3 830.23/10万,报告发病数位居前5位的病种依次为手足口病、流腮、水痘、细菌性痢疾、猩红热,男女性别比为1.55∶1,疫情有2个高峰,分别发生在5—6月和11—12月。中小学生和幼托儿童呼吸道传染病报告数,均占总数的90%以上。结论当前浦口区中小学生和幼托儿童主要传染病是呼吸道传染病,控制呼吸道传染病是今后传染病防治工作重点。     

2005—2018年贵阳市托幼儿童传染病流行特征分析

目的 了解贵阳市托幼儿童传染病发病特征和流行趋势,为卫生行政部门制定防控措施提供科学依据。方法 采用描述性流行病学方法,对2005—2018年贵阳市托幼儿童传染病疫情资料进行统计分析。结果 2005—2018年贵阳市共报告托幼儿童传染病24种63 858例,死亡20例,年均发病率为4 043.87/10万。无甲类传染病报告,乙类、丙类和非法定传染病年均发病率分别为215.50/10万、3 005.70/10万、822.67/10万。发病数居前5位依次为手足口病、水痘、流行性腮腺炎、其他感染性腹泻病及猩红热。男生发病高于女生,男女性别比为1.47:1。报告免疫规划类传染病6 525例,占发病总数的10.28%。结论 贵阳市托幼儿童人群中流行的传染病种类多,发病率高,是重点关注人群。免疫规划疫苗可预防性传染病大幅下降。     

Infectious disease risks associated with occupational exposure: a systematic review of the literature

Employees in different types of work may be intentionally or accidentally exposed to biological agents. Improved risk assessment is needed to identify opportunities to prevent work-related infectious disease. The objective of the current study was to perform a systematic literature review of work-related infectious disease to assist in the identification of occupational infectious disease risks. A literature search of papers on work-related infectious disease published between 1999 and 2008 yielded 1239 papers of which 242 met the selection criteria and were included in the review. The results of the systematic literature review were arranged in a matrix of occupational groups and exposure pathways. Increased risk from infectious diseases appeared to be concentrated in specific professions. Healthcare workers, workers in contact with animals, laboratory workers and refuse workers seem to have the highest risk of infection by a variety of pathogens. However, pathogens reported to be associated with closely related professions were different, indicating qualitative under-reporting. Arranging the results of this systematic review on work-related infectious diseases in a matrix of occupational groups and exposure pathways allowed the reliable identification of exposure hazards for specific occupational groups beyond currently reported diseases.     

2012 - 2016年上海市松江区幼托儿童传染病发病特征分析

目的 了解2012 - 2016年上海市松江区幼托儿童传染病的发病趋势。方法 根据2012 - 2016年松江区幼托儿童传染病疫情资料,对传染病的发病顺位、主要传染病的三间分布情况进行描述性流行病学分析。结果 2012 - 2016年全区幼托儿童共报告传染病11种10 714例,年均发病率55.11‰,总体呈现下降趋势,无甲类传染病报告,无死亡病例,发病占同时期全人群发病的20.36%。5年间传染病主要以肠道传染病为主,占总发病数的76.98%;其次为呼吸道传染病,占23.00%;其他传播途径传染病占0.02%。手足口病、水痘、猩红热为发病率前3位的传染病,分别占发病总数的75.64%、9.66%、4.90%;发病病例月份分布以5、6 月(32.42%) 和11、12、1月( 27.09%) 为高峰,呈季节性双峰分布;发病地区主要集中在流动人口较多的九亭镇、新桥镇、泗泾镇。结论 2012 - 2016年松江区幼托儿童传染病总体呈下降趋势,现阶段应根据手足口病、水痘、猩红热的不同流行特征采取监测和防控措施。     

绍兴市区2006～2007年流行性感冒病例监测资料分析

目的 了解绍兴市市区流行性感冒病例监测情况,为预防与控制流行性感冒提供依据.方法 利用感染性疾病监控系统对2006～2007年发热门诊监测的流行性感冒病例进行分析.结果 共监测流行性感冒病例32891例,占门诊初诊患者的2.2%,其中男17 211例,女15 680例,≤10岁组占有较大比例(45.85%),职业分布以学生幼托儿童(29.09%)、散居儿童(27.71%)居多,就诊时间以7～9月份较多,初步诊断主要为上呼吸道感染占75.55%和肺炎支气管炎占9.59%.结论 两年内市区流行性感冒处于相对平静状态,做好儿童的预防是预防控制工作的重点,在监测中还应注意其他传染病的流行对监测的影响.     

A study of school children who had identified virus infections of the central nervous system during infancy

Forty-nine children who had a virus infection of the central nervous system (CNS) when under 1 year of age were studied. One child had died during the initial illness and three of the survivors were severely disabled. The other survivors, more than 5 years after the initial illness, were all attending normal schools. These 45 children, together with 45 matched controls, were examined. We confirm the findings of other studies that virus infections of the CNS in infancy may cause severe disabilities in some cases, and may depress intellectual abilities in others, even though they appear to have recovered fully. Many of the children who had a virus infection of the CNS in infancy had adverse birth and social histories and so were exceptionally vulnerable, but these factors did not account fully for the findings, and when their influence was included in the analysis, the index children still had a mean performance IQ (WISC) 6 points lower than the control children (P less than 0.05), whereas there was less than 1 point difference between the verbal IQs. Attention is drawn to the problem of virus infections in neonatal units.     

平顶山市湛河区2007年法定报告传染病疫情分析

目的掌握平顶山市湛河区传染病发生及变化规律，为制定有效防治措施提供科学依据。方法收集平项山市湛河区2007年疾病监测信息报告管理系统的传染病资料进行汇总分析。结果2007年全区无甲类传染病报告，共报告乙、丙类传染病17种1203例，年报告发病率476．56／10万，与上年同期相比下降18．55％。其中乙类传染病13种999例，与上年同期相比下降1．96％；丙类传染病4种204例，与上年同期相比下降55．46％。乙类传染病报告发病数位居前5位的是病毒性肝炎、肺结核、痢疾、麻疹、梅毒，占乙、丙类传染病报告病例总数的79．14％。报告死亡病例1例，报告病死率0．083％。与上年比增加的病种是布鲁菌病、狂犬病，减少的病种是流行性感冒。上升最明显的传染病是麻疹。男性发病是女性的1．63倍，20—49岁青壮年发病率最高，职业以农民、工人、散居儿童、学生为主。结论病毒性肝炎、肺结核、麻疹、梅毒及肠道传染病是防治的重点传染病；新增加的布鲁菌病、狂犬病是今后应重点关注的传染病；农民、工人、散居儿童、幼托儿童及学生是传染病防治的重点人群。减少传染病的发生与流行应采取综合性防治措施。