In the confined space of a classroom, gastrointestinal illnesses can spread quickly. But what exactly is to blame for a school-based outbreak? In most cases, improper food handling is the culprit, says a public-health expert at Ryerson University in Toronto, Canada.
Typically, gastrointestinal illnesses are short-lived and their symptoms — cramps, fever, vomiting, and diarrhea — don’t require medical treatment. Some children, however, require hospitalization and can die from their conditionin if E. coli contamination is involved, says professor Marilyn Lee of Ryerson’s School of Occupational and Public Health.
Together with epidemiologist Judy Greig of the Public Health Agency of Canada, Lee searched documented reports published between 1998 and 2008 to identify a number of factors, including the cause of a gastrointestinal outbreak, how the infection was transmitted, the number of children affected, mortality rates, and control and prevention measures.
“The reports of documented cases are just the tip of the iceberg,” Lee says. “There are easily thousands of other outbreaks that aren’t reported to public-health authorities. So, to avoid future outbreaks, it’s important that people take lessons from this study.”
Among the 121 outbreaks cited, slightly more than half involved bacterial infections or viral infections. The rest were caused by one or more parasites. In almost half of the cases, transmission was identified as being food-borne, followed by person-to-person, waterborne, and via animal contact.
The researchers found that the risk of food-borne illness was reduced when food handlers practiced effective hand washing and received food-safety training and certification. In addition, student-training programs on hand washing and enhanced cleaning and disinfection of schools were effective strategies.
“Everyone has a role to play,” Lee says. “Many classrooms contain sinks, so teachers can model proper hand washing for their students. School administrators must ensure that students always have access to warm water, soap, and paper towels. Custodians must frequently check the cleanliness of bathrooms.” Lee also says it is vital that education officials notify public-health authorities at the start of an outbreak — a step that was not taken by many of the schools in the study.
Kathy Sena is a freelance journalist specializing in health and parenting issues and is the mother of a 15-year-old son. Visit her blog at parenttalktoday.com