A CLUSTER OF INVASIVE PNEUMOCOCCAL DISEASE IN YOUNG-CHILDREN IN CHILD-CARE

Objective.-To investigate a cluster of invasive pneumococcal disease i n children 8 to 26 months of age, using standard microbiological proce dures and ribosomal DNA gene-restriction patterns to characterize the outbreak strain. Design.-Outbreak investigation. Setting.-A family chi ld-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 ha d febrile illnesses with pneumococcal bacteremia, and a fourth had pur ulent pneumococcal conjunctivitis. Type 12F Streptococcus pneumoniae w as isolated from the four ill children and from the nasopharynges of t he two healthy children. Ribotyping revealed all outbreak isolates had an identical ribotype pattern. Administration of rifampin to the chil dren did not eradicate carriage of the organism. Conclusions.-Our data demonstrate that child care provides an opportunity for outbreak of i nvasive pneumococcal disease in young child ren. This observation sugg ests a need for increased alertness for clusters of pneumococcal disea se in young children in child-care facilities and underscores the nece ssity for a pneumococcal vaccine that is effective in infants and youn g children.