Epidemic diarrhea of the newborn: II. Control and prevention of outbreaks in hospital nurseries

Abstract

During the past few years outbreaks of highly fatal diarrhea of unknown etiology have been occurring among the newborn babies in hospital nurseries both of New York City and elsewhere. As a result of our experience in this connection, we believe that more effective measures should be instituted in the control and prevention of morbidity and mortality from this and other infectious diseases among newborn infants. A review of the vital statistics on infant mortality shows that although success has attended campaigns to eradicate deaths resulting in the past from “summer complaint,” diarrheal disorders still persist in being an outstanding cause of mortality among infants. There exists an urgent necessity for reconsidering the entire problemof the care of the newborn baby in hospital nurseries. Efforts should be made to arrive at a more uniform, self-contained, and coherent system of organization for maternity and newborn services. Likewise, concerted attempts should be made to study the newborn period of life with greater interest and attention than has been allotted to it in the past, since our present knowledge of this phase of infancy is today too inadequate to cope with all its problems. As a means of controlling outbreaks of diarrheal disorders in lyingininstitutions, the procedures that have been adopted by us are discussed. In addition, various regulations are suggested for the prevention of such epidemics, as well as other infectious diseases, and are based on the technique of aseptic nursing and medical care, involving essentially the principles of stringent surgical asepsis and stressing individual management. The suggestions that have been advanced are by no means fully perfect, but they deserve unbiased trial. We realize that their successful application implies a complete understanding of their aims and a thorough training in their exacting details. During the past few years outbreaks of highly fatal diarrhea of unknown etiology have been occurring among the newborn babies in hospital nurseries both of New York City and elsewhere. As a result of our experience in this connection, we believe that more effective measures should be instituted in the control and prevention of morbidity and mortality from this and other infectious diseases among newborn infants. A review of the vital statistics on infant mortality shows that although success has attended campaigns to eradicate deaths resulting in the past from “summer complaint,” diarrheal disorders still persist in being an outstanding cause of mortality among infants. There exists an urgent necessity for reconsidering the entire problemof the care of the newborn baby in hospital nurseries. Efforts should be made to arrive at a more uniform, self-contained, and coherent system of organization for maternity and newborn services. Likewise, concerted attempts should be made to study the newborn period of life with greater interest and attention than has been allotted to it in the past, since our present knowledge of this phase of infancy is today too inadequate to cope with all its problems. As a means of controlling outbreaks of diarrheal disorders in lyingininstitutions, the procedures that have been adopted by us are discussed. In addition, various regulations are suggested for the prevention of such epidemics, as well as other infectious diseases, and are based on the technique of aseptic nursing and medical care, involving essentially the principles of stringent surgical asepsis and stressing individual management. The suggestions that have been advanced are by no means fully perfect, but they deserve unbiased trial. We realize that their successful application implies a complete understanding of their aims and a thorough training in their exacting details.