Recovery of the Virus of Poliomyelitis from the Stools of Healthy Contacts in an Institutional Outbreak

Abstract

In a section of a small institution, comprising 20 infants and preschool children from 2 mos. to 5 yrs. of age, 1 fatal and 4 non-paralytic cases of poliomyelitis occurred. The clinical observation of all the children in the Home was excellent and included the routine recording of temp. twice daily. Poliomyelitis virus was recovered from the stools of 3 out of 12 healthy children, contacts of these cases, and from an additional 2 out of 3 children who had had fever of 24 to 48 hrs.'' duration. Thus, including the 5 clinical infections, which, however, were not examined for virus, 10 of the 20 children harbored poliomyelitis virus at some time in the 30-day period of Aug. 1 to 30. Virus was also recovered from the stool from one healthy adult out of specimens secured from 8 adult attendants of the children. This individual, the day nurse in charge of the infant and preschool group, was undoubtedly more continuously and intimately associated with them than was any other adult. In 2 children virus was again recovered from stools taken 19 days after the first positive stools were obtained from them. Thus, counting from the date of onset of the 1st case (Aug. 1) to the date of collection of the last positive stool (Aug. 30), the minimum limit in time in which the virus might have been present in some member of the group was 30 days. No case of poliomyelitis occurred in the children under 1 yr. of age, but stools from 3 of 5 children in this group yielded virus. 3 of the 5 cases of poliomyelitis, including the one terminating fatally, were in children with recent tonsillectomies and adenoidectomies. There were, however, 3 other children with recent tonsillectomies and adenoidectomies who failed to acquire the disease in this heavily infected focus. The facts developed in this institutional outbreak are consistent with a theory of transfer of infection by direct personal contact, and afford corroborative evidence that the virus of poliomyelitis is usually spread throughout the general population by healthy carriers.