by Max Brantley
When they refused, four commissioners tell KATV that they heard Representative Sullivan while leaving vow to address the need for the commission during the next legislative session.Sullivan's bullying apparently can be productive. I'm still waiting a response from the Health Department on when it learned about the
Act 576...the only bill sponsored by Sullivan that became law during the 91st General Assembly...stripped the commission of its authority to regulate child care centers.
Sullivan told a house committee in February that the child care industry is vastly overregulated and that somebody has to take a stand.Sullivan has refused to answer any of my questions this week. It occurs to me, too, that other legislators who went along with his de-regulation bill should answer some questions as well.
The first case of shigella in this facility became ill on 4/27, but we began to consider it an outbreak in mid-May when we had several more kids test positive for shigella. The team that is responding to this outbreak includes our local communicable disease nurses and nurse specialists, our local environmental health service staff and food specialists, and our central office communicable disease nursing, epidemiology, and medical staff. Weekly, starting in mid-May, the outbreak was included in discussions at routine multidisciplinary meetings on Monday mornings of epidemiologists, laboratorians, physicians, communication staff, and leadership.
Routine outbreak control procedures were followed. Ill individuals were excluded until appropriately treated or proven to be noninfectious with stool culture tests. Active surveillance was begun to identify persons who were symptomatic who were attempting to return to the facility. Those individuals were excluded, reported to ADH, and sent to their doctors for evaluation and stool culture testing. An environmental health specialist inspected the facility on 5/16 and an EHS and a nurse made a second visit to the facility on 6/9. While no critical failures or major problems were observed during the inspections, standard infection control measures such as regular hand hygiene and surface sanitization were reinforced. Facility management and staff have been by all accounts very supportive and compliant with all ADH recommendations and interventions.
Normally these recommendation and interventions work pretty rapidly within a couple of weeks to contain and stop the outbreak, but in this case we continued to see ongoing spread of shigella. Dr. Haselow, our State Epidemiologist and the Medical Director for Outbreak Response, spoke with the owner on Friday, June 9 and reiterated his concerns, and Mr. Sullivan asked what else could be done. Dr. Haselow suggested closing for 5 days and he agreed that it may be the best way to put this outbreak behind them. A plan was made to close on Wednesday the 14th through Sunday the 18th. The typical time from exposure to illness (incubation period) of shigella is 1-3 days. This duration of closure should allow any newly identified cases to be identified at home and appropriately treated so they don’t return to the facility while infectious. During the closure period, intensive sanitization of the facility will be performed with direction from the ADH.
As of the morning of 6/15 there have been 8 lab confirmed cases and 42 additional ill persons at the daycare. Included in the 42 are 14 children who are currently excluded and awaiting testing.
In the last 6 years, since Dr. Haselow has been the Medical Director for Outbreak Response, he can only recall 3 previous episodes when we recommended closure and none of those outbreaks were related to shigella. This would be the first in quite some time. Closure is not recommended lightly, as we know it is a burden to parents and they may conclude their only option is to take their children to other facilities, which can spread the infection. This facility was not treated differently than any other facility. Dr. Haselow is not exactly sure when we learned who the owner was but he believes it was in the first week of June. First email record of it that he can find is on 6/9, but he believes he knew of it before then.