The epidemiology of injuries in Atlanta day-care centers

Article Abstract:

Forty-one percent of American children under the age of five years were cared for outside of their home, either full or part- time, during 1987. Twenty percent of these young children were enrolled in day-care centers (DCCs). Public health agencies have conducted significant research into the incidence of infectious disease in DCCs, but little attention has focused on injury. Within the state of Georgia the Office of Regulatory Services supervises the operation of DCCs and requires that injury needing extensive medical attention or hospitalization be reported within 48 hours. When the records of 60 DCCs were reviewed only three injuries were noted, contrary to research data indicating a higher rate of DCC trauma. The patterns of injuries among 5,300 children who attended 71 DCCs in Atlanta from June, 1987 through May, 1988 are described. The 143 reported injuries included 63 lacerations, 23 fractures, and 5 crush injuries. The head was the site of injury in 98 cases. Peak hours for injuries were 11 AM and 4 PM and the peak day was Monday; these factors may relate to activity levels or staff supervision. Two-year old children had the highest incidence of injury, reflecting their stage of development. Almost half of all trauma occurred in the playground and 70 percent was due to falls; impact absorbing materials may aid in prevention of injury. Crush injuries, usually severe, were related to the use of self-closing opaque doors without windows. Overall DCC injury rates may be less than for children at home. However, verification of reporting; specifications of types of injuries; DCC and parental definitions of, reactions to and reporting; variability in reporting from profit and nonprofit DCCs require further study.

Laws, regulations and rules, Surveys, Day care centers, Georgia, Children's accidents, Georgia. Department of Human Resources

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Yersinia enterocolitica O:33 infections in infants and children, associated with the household preparation of chitterlings

Article Abstract:

Yersinia enterocolitica is a bacterial agent (pathogen) that is a major cause of diarrhea in much of the world. In Europe, Japan and Canada the organism is often associated with a reservoir of the bacteria in pigs, and human infection is associated with the eating of raw pork. Within the United States the source of this pathogen and mode of transmission is generally unknown. Although in some cases the ingestion of contaminated food has been the source of the infection, and in another, transmission of Y. enterocolitica was traced to a sick dog, the pathogen is not frequently found to be the cause of outbreaks of diarrhea. The present study investigates an outbreak of Yersinia enterocolitica in Atlanta. All 15 patients were black and 14 were infants. The resulting diarrheal illness associated with fever was found to be associated with the preparation of chitterlings, the large intestines of pigs. Although the children did not have direct contact with the pig intestines, the children's caretakers were usually involved in the cleaning of the pig intestines. In 10 of the 12 cases, the chitterlings were prepared for Thanksgiving, Christmas or New Year's meal. Ingestion of contaminated foods, contact with sick animals, and transfusion of blood products are the most common means of transmission of Yersinia enterocolitica, but the present study adds a new vehicle of transmission: household transmission. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Disease transmission, Food contamination, Yersinia infections, Yersinia enterocolitica

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Dog bite-related fatalities from 1979 through 1988

Article Abstract:

The authors of this study gathered information concerning the number of people killed by dog bites in the US from 1979 through 1988 and the breeds of dogs involved. Data were obtained from the National Center for Health Statistics and a computer search of news stories. In the ten-year period, 157 people died, 70 percent of whom were children under age ten. Infants were almost 370 times as likely to die compared to adults aged 30-49. Pit bulls were responsible for 42 of 101 deaths for which dog breed was known, which was three times the rate for German shepherds, the second most common breed involved. The increase in pit bull attacks was quite dramatic, from 20 percent of deaths in 1979-1980 to 62 percent in 1987-1988. The pit bulls were almost twice as likely to be strays than other breeds of dogs. While recent publicity may have overemphasized the involvement of pit bulls, the authors maintained that pit bulls appeared to inflict 42 percent of the fatal injuries. Since well under 42 percent of dogs in the US are pit bulls, they are clearly a real danger. To prevent dog bites, the authors recommend tighter control of strays and public education aimed at dog owners and potential victims. Special attention should be given to informing parents that infants left alone with a dog could be fatally injured.

Statistics, Dogs, Bites and stings, Bites (Injuries), Stings (Injuries), Pit bull terriers, Animal attacks

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