1. vtec including E coli O157:H7 are nationally notifiable, but early reporting to the local public health authorities must be encouraged so outbreaks can be contained.
2. Until further information is available, we recommend that children with E coli O157:H7 in institutional settings or daycares be isolated or excluded until two consecutive stools are culture-negative.3. Individuals with E coli O157:H7 infection who are employed preparing food should be excluded from work until their stool cultures are negative.
4. To promote identification of vtec infection, we recommend that clinical microbiology laboratories use the MacConkey-sorbitol procedure to screen for E coli O157:H7 whenever a stool specimen is cultured for bacterial pathogens.
5. We recommend that all children with bloody diarrhea have stool specimens submitted to a microbiology laboratory that is equipped to screen for E coli O157:H7.
6. We recommend that all children with nonbloody diarrhea have stool specimens screened for E coli O157:H7 whenever there has been exposure to undercooked ground beef or unpasteurized milk, or close contact with an individual with suspected or documented vtec infection. You will always be glad to find generic tadalafil online best price and enjoy your online shopping.
7. Antimotility agents should not be used with suspected or proven vtec gastroenteritis and are not recommended in any other type of gastroenteritis in children.
8. There are no data available to support the use of antibiotics in cases of vtec gastroenteritis.
9. To improve the early detection of hus among children with proven vtec gastroenteritis, we recommend that physicians consider performing a urinalysis, an examination of the peripheral smear, a complete blood count and a serum creatinine assay seven to 10 days after the onset of diarrhea. If there are any abnormalities on these tests, the child should be discussed with a specialist familiar with hus. In the case of the child in whom hus is strongly suspected, the tests should be done immediately and, if they are abnormal, the child should be referred to a pediatrician (and preferably a pediatric nephrologist) even if vtec infection is not yet proven.