Evaluation of the impact of shigellosis exclusion policies in childcare settings upon detection of a shigellosis outbreak

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dc.contributor.authorCarias, Cristina.
dc.contributor.authorUndurraga Fourcade, Eduardo Andrés
dc.contributor.authorHurd, Jacqueline.
dc.contributor.authorKahn, Emily B.
dc.contributor.authorMeltzer, Martin I.
dc.contributor.authorBowen, Anna.
dc.date.accessioned2019-10-17T14:11:58Z
dc.date.available2019-10-17T14:11:58Z
dc.date.issued2019
dc.date.updated2019-10-14T18:29:25Z
dc.description.abstractAbstract Background In the event of a shigellosis outbreak in a childcare setting, exclusion policies are typically applied to afflicted children to limit shigellosis transmission. However, there is scarce evidence of their impact. Methods We evaluated five exclusion policies: Children return to childcare after: i) two consecutive laboratory tests (either PCR or culture) do not detect Shigella, ii) a single negative laboratory test (PCR or culture) does not detect Shigella, iii) seven days after beginning antimicrobial treatment, iv) after being symptom-free for 24 h, or v) 14 days after symptom onset. We also included four treatments to assess the policy options: i) immediate, effective treatment; ii) effective treatment after laboratory diagnosis; iii) no treatment; iv) ineffective treatment. Relying on published data, we calculated the likelihood that a child reentering childcare would be infectious, and the number of childcare-days lost per policy. Results Requiring two consecutive negative PCR tests yielded a probability of onward transmission of < 1%, with up to 17 childcare-days lost for children receiving effective treatment, and 53 days lost for those receiving ineffective treatment. Conclusions Of the policies analyzed, requiring negative PCR testing before returning to childcare was the most effective to reduce the risk of shigellosis transmission, with one PCR test being the most effective for the least childcare-days lost.
dc.fuente.origenBiomed Central
dc.identifier.citationBMC Infectious Diseases. 2019 Feb 19;19(1):172
dc.identifier.doi10.1186/s12879-019-3796-7
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26679
dc.identifier.wosidWOS:000459438100004
dc.issue.numeroNo. 172
dc.language.isoen
dc.pagina.final7
dc.pagina.inicio1
dc.revistaBMC Infectious Diseaseses_ES
dc.rightsacceso abierto
dc.rights.holderThe Author(s).
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.subject.otherShigellaShigella - Diagnósticoes_ES
dc.subject.otherShigella -Terapiaes_ES
dc.titleEvaluation of the impact of shigellosis exclusion policies in childcare settings upon detection of a shigellosis outbreakes_ES
dc.typeartículo
dc.volumenVol. 19
sipa.codpersvinculados12868
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