Public Health

On the basis of present knowledge, the various sources and accompanying pathways by which effective contacts between susceptible infants and the staphylococcus take place in the nursery outbreaks are as follows: 1) Direct contact with infective lesions; 2) direct and indirect contact spread from the asymptomatic infant carrier to the susceptible infant within the nursery, particularly under conditions of overcrowding and poor nursery technique. Personnel carriers, fomites and air-borne droplet nuclei and dust, as sources of outbreaks, do not command a body of convincing epidemiologic evidence at this time. The epidemiologic investigation of nursery-acquired disease requires that each infant at risk be followed for a minimum of 15 days. The most probable source and route of transmission of the causative organism can be identified. Control efforts should be based on the epidemiologic diagnosis.