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March 2, 1994

A Cluster of Invasive Pneumococcal Disease in Young Children in Child Care

JAMA. 1994;271(9):695-697. doi:10.1001/jama.1994.03510330073037

Objective.  —To investigate a cluster of invasive pneumococcal disease in children 8 to 26 months of age, using standard microbiological procedures and ribosomal DNA gene-restriction patterns to characterize the outbreak strain.

Design.  —Outbreak investigation.

Setting.  —A family child-care home with six children in Baltimore, Md.

Results.  —During an 8-day period, three of the six children in the family child-care home had febrile illnesses with pneumococcal bacteremia, and a fourth had purulent pneumococcal conjunctivitis. Type 12F Streptococcus pneumoniae was isolated from the four ill children and from the nasopharynges of the two healthy children. Ribotyping revealed all outbreak isolates had an identical ribotype pattern. Administration of rifampin to the children did not eradicate carriage of the organism.

Conclusions.  —Our data demonstrate that child care provides an opportunity for outbreak of invasive pneumococcal disease in young children. This observation suggests a need for increased alertness for clusters of pneumococcal disease in young children in child-care facilities and underscores the necessity for a pneumococcal vaccine that is effective in infants and young children.(JAMA. 1994;271:695-697)