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An Outbreak of Gastroenteritis in a Child Care Center in Makkah, 1419 H.

Introduction

It was reported from the Maternity and Children Hospital in Makkah that nine Saudi children had been admitted with gastroenteritis, and one child died on 4/12/1419. The objective of this study was to assess the extent of the outbreak, identify its source, and recommend changes that would prevent the recurrence of similar outbreaks.

Methodology

All the children residing in the same flat as the affected children in the Child Care Center were examined. A Questionnaire interview was completed with all care givers (baby sitters and servants) regarding history of gastroenteritis and contact with children. Stool, nasal, and pharyngeal swabs were taken from care-givers and submitted to bacteriological examination. The surrounding environment was examined. Data were collected on preparation of the children's food, drink and child hygiene. The medical records and laboratory tests of affected children admitted to the hospital were reviewed.

Results

All affected children (9) came from one Child Care Center (for homeless children). Six were male (66.6%) and 3 females, the median incubation period was 27 hours, and there was no association between food items and symptoms. One servant in the affected apartment gave a history of gastroenteritis during the week before the outbreak; the attack rate for one baby sitter was 100%. Stool cultures were negative for bacterial growth in all affected children. The organisms isolated in nasal swabs were non pathogenic

Conclusion

The clinical picture and incubation period of the cases, along with the results of laboratory examination suggested Rotavirus gastroenteritis. It is most likely that the source of infection to the index case was the diseased servant and the outbreak spread by the baby sitter to other affected children. It was recommended to increase the number of care-givers in the center, and to specify their job descriptions, more care for children's hygiene, in addition to excluding any sick care giver for the period of communicability.