Cranial irradiation in the management of extreme leukemic leukocytosis complicating childhood acute lymphocytic leukemia

Abstract

probably occurring within 72 hours of exposure? In any event a cluster of cases occurring over three weeks is unlikely to be caused by a point source of contamination; a continuing common source or person-to-person transmission is more likely. Al though poultry are frequently contaminated by Campylobacter, '~ consumption of poultry was not a factor in either outbreak. In both outbreaks, illness spread beyond the immediate household. However, neither food nor water from these homes was transported to the other households. In both clusters the only contacts for the people who were ill late in the outbreaks were the symptomatic, fecally incontinent young children. Other enteric infections, including shigellosis, 7 giardiasis? and amoebiasis, are known to be transmitted by the fecal-oral route. Symptomatic infected infants and children are important vehicles for transmitting these pathogens within households and in communities. Our experience suggests that the same may be true for Campylobacter. C. f e tu s ssp. je juni is a common enteric pathogen for young children '~ and feces of infants may be an important vehicle for transmitting infection to family members and playmates. Vertical transmission of infection from a mother to her neonate has recently been reported.' The infective dose of C. fe tus ssp. j e jun i is unknown; as with other enteric pathogens, this may be a determinant of the frequency with which specific modes of transmission are implicated. We thank Dr. Allan R. Lareau for bringing these cases to our attention and to Dr. Kenneth VanderVelde for clinical information.