Transmission also occurs directly from person to person in families, child care centres and custodial institutions. Waterborne transmission has occurred. Up to three weeks in some children. The infectious dose is very low. Little is known about susceptibility and immunity.
Old age appears to be a risk factor.
Control of Case Standard Precautions should be undertaken during acute illness. The patient should not handle food or provide child or patient care until two successive negative faecal samples are taken more than 24 hours apart, and more than 48 hours after ceasing treatment. Specific treatment includes fluid and electrolyte replacement. Depending on severity and complications, the patient may need transfusion, dialysis, anticonvulsants or antihypertensives. Control of Contacts Contacts with diarrhoea should be excluded from food handling and the care of children or patients until the diarrhoea has ceased and two negative faeces cultures obtained.