Effectiveness of different policies in preventing meningococcal disease clusters following a single case in day-care and pre-school settings in Europe.
(17/62)
National policies for chemoprophylaxis after single cases of meningococcal disease in day-care or nursery settings vary across Europe. We carried out a multi-national retrospective study to compare the effectiveness of different policies. Countries were divided into those recommending chemoprophylaxis only to close contacts (policy A, close) and those recommending chemoprophylaxis for all children in the same nursery (policy B, mass). Country-specific relative risk (RR) of a cluster was defined as the ratio of the number of clusters observed to the number of clusters expected by chance. In total, 37 clusters were identified between 1 January 1993 and 31 December 2002. After adjusting for marked heterogeneity in RR by country, the ratio of RR between countries suggested possible benefit from mass prophylaxis (RR ratio 3.8, 95% CI 0.7-22.0), although the difference was not statistically significant (P=0.22). The costs of this approach and the low risk of clustering need to be taken into account when deciding national policy. (+info)
Combined genogroup I and II norovirus infection at a nursery.
(18/62)
From November 2004 to April 2005, 5 cases of norovirus (NoV) occurred in Sakai City, Japan. These were all diffuse outbreaks due to infections with genogroup II genotype 4 (GII/4) virus strains. Similar outbreaks occurred throughout Japan; hence, GII/4 was assumed to be the prevalent NoV type. However, a NoV outbreak that occurred at a nursery in May 2005, was caused by infections with GI/4 and GII/6 viruses, respectively, from different children. The time course of newly infected patients showed that this nursery outbreak had a two-peak pattern, with the peak numbers of patients occurring on May 19 and May 22. Virological examination and epidemiological research could not determine whether the GI and GII NoV infections occurred at the same time, or whether there was a time difference in their appearance in the nursery. From this outbreak, it is clear that the timing of obtaining samples and obtaining the minimal necessary number of primary samples are essential for accurate epidemiological information to be obtained. In addition, we detected genotypes that were different from the previously prevalent genotypes, which raises the possibility of more frequent NoV infection or a change in the prevalent NoV genotype in this setting. In conclusion, it is difficult to predict outbreaks of NoV; however, through vigilant and early collection and analysis of later samples throughout an outbreak, it is possible to understand the prevalence and perhaps trace the source of NoV infections. (+info)
Teacher report and direct assessment of preferences for identifying reinforcers for young children.
(19/62)
Teachers were asked to identify and rank 10 preferred stimuli for 9 toddlers, and a hierarchy of preference for these items was determined via a direct preference assessment. The reinforcing efficacy of the most highly preferred items identified by each method was evaluated concurrently in a reinforcer assessment. The reinforcer assessment showed that all stimuli identified as highly preferred via the direct preference assessment and teacher rankings functioned as reinforcers. The highest ranked stimuli in the direct assessment were more reinforcing than the teachers' top-ranked stimuli for 5 of 9 participants, whereas the teachers' top-ranked stimulus was more reinforcing than the highest ranked stimulus of the direct assessment for only 1 child. A strong positive correlation between rankings generated through the two assessments was identified for only 1 of the 9 participants. Despite poor correspondence between rankings generated through the teacher interview and direct preference assessment, results of the reinforcer assessment suggest that both methods are effective in identifying reinforcers for toddlers. (+info)
Nasal carriage of a single clone of community-acquired methicillin-resistant Staphylococcus aureus among kindergarten attendees in northern Taiwan.
(20/62)
BACKGROUND: To evaluate the prevalence and microbiological characterization of community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in a kindergarten. METHODS: Point prevalence study. Nasal swabs were collected from healthy children younger than 7 years of age who were attending a kindergarten in Taipei, Taiwan. A parent questionnaire regarding MRSA risk factors was administered simultaneously. All CA-MRSA colonization isolates were archived for subsequent antimicrobial susceptibility and molecular typing. RESULTS: Of the 68 children who participated in the study, 17 (25%) had S. aureus isolated from nasal swabs. Nine (13.2%) of the 68 children had CA-MRSA carriage, and none of them had any identified risk factors. Antimicrobial susceptibility testing revealed all of the 9 CA-MRSA colonization isolates had uniformly high resistance (100%) to both clindamycin and erythromycin, the macrolide-lincosamide-streptogramin-constitutive phenotype and the ermB gene. Pulsed-field gel electrophoresis revealed 8 (88.9%) of 9 CA-MRSA colonization isolates were genetically related and multilocus sequence typing revealed all isolates had sequence type 59. All of the colonization isolates carried the staphylococcal cassette chromosome mec type IV, but none were positive for the Panton-Valentine leukocidin genes. CONCLUSION: The results of this study suggest that a single predominant CA-MRSA colonization strain featuring high clindamycin resistance circulated in this kindergarten. Additionally, due to the established transmissibility of colonization isolates, the high prevalence of nasal carriage of CA-MRSA among healthy attendees in kindergartens may indicate the accelerated spread of CA-MRSA in the community. (+info)
Afterschool snacks in the Child and Adult Care Food Program. Final rule.
(21/62)
This final rule incorporates into the Child and Adult Care Food Program (CACFP) regulations the provisions of the William F. Goodling Child Nutrition Reauthorization Act of 1998, which authorized afterschool care centers meeting certain criteria to be reimbursed for snacks served to at-risk children 18 years of age and younger. This rule establishes the eligibility of at-risk afterschool care centers to serve free snacks to children who participate in afterschool programs. The centers, which must be located in low-income areas, are reimbursed at the free rate for snacks. The intended effect of this rule is to support afterschool care programs through the provision of snacks that meet CACFP meal pattern requirements. The additional benefits provided by the 1998 reauthorization act and codified by this final rule were extended to institutions and children immediately after enactment. These changes were originally proposed by the Department in a rulemaking published on October 11, 2000. (+info)
Determinants of cognitive function in childhood: a cohort study in a middle income context.
(22/62)