A recurring outbreak of Shigella sonnei among traditionally observant Jewish children in New York City:: the risks of daycare and household transmission
A recurring outbreak of Shigella sonnei among traditionally observant Jewish children in New York City:: the risks of daycare and household transmission
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DOI：
10.1017/s0950268806006182
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发表时间：
2006-12-01
影响因子：
4.2
通讯作者：
Sobel, J.
中科院分区：
文献类型：
--
作者：
Garrett, V.;Bornschlegel, K.;Sobel, J.
宋内氏志贺氏菌的分散社区暴发在美国传统上持观望态度的犹太人中周期性地发生。2000年2月，我们调查了纽约市一个犹太社区爆发的宋内氏葡萄球菌。为了确定感染进入家庭的危险因素，我们对家庭进行了一项队列研究，以比较家庭内主要受试者和年龄匹配的好兄弟姐妹之间的疾病危险因素。用脉冲场凝胶电泳法(PFGE)对分离株进行分型。我们使用随机效应模型来评估有多个患病家庭成员的家庭的家庭外传播与家庭内传播。日托或学龄前出勤率[匹配优势比(MOR)16(.)1，P<；0(.)001]和年龄60个月(MOR 6(.)3，P<；0-001)与指标对象疾病独立相关。通过PFGE分析，暴发分离株与以前在犹太社区暴发中观察到的菌株密切相关。随机效应模型强烈地表明，一个家庭中的多种疾病是由于二次传播造成的。疾病控制工作应侧重于减少志贺氏菌在托儿场所和家庭内的传播。
Dispersed community outbreaks of Shigella sonnei have occurred cyclically among traditionally observant Jews in the United States. In February 2000, we investigated a S. sonnei outbreak in one Jewish community in New York City. To determine risk factors for introduction of infection into households, we conducted a cohort study of households to compare risk factors for illness among primary subjects within households and age-matched well siblings. Isolates were subtyped by pulsed-field gel electrophoresis (PFGE). We used a random effects model to assess extra-household vs. intra-household transmission in households with multiple ill household members. Daycare or pre-school attendance [matched odds ratio (mOR) 16(.)1, P < 0(.)001] and age < 60 months (mOR 6(.)3, P < 0-001) were independently associated with index subject illness. Outbreak isolates were closely related by PFGE analysis to the strain previously observed in Jewish community outbreaks. The random effects model strongly indicated that multiple illnesses in a single household are due to secondary transmission. Disease containment efforts should focus on reducing Shigella transmission in childcare settings and within homes.