Bring an ill child to hospital and he could get worse.

That's the message of a recent New England Journal of Medicine report, which traced a recent outbreak of a bacterial infection (enterococcus faecalis) to a nurse, who carried the germ in her gastrointestinal tract and on her hands.The epidemic, which occurred in a Boston hospital, prompted a Journal editorial about how institutionally acquired infections in children often occur.

As the journal points out, the usual infection control procedures used as standard for adults cannot be be followed for children. For one thing, pediatric wards are usually crowded, it says, with inadequate hand washing facilities; for another, toddlers often share toys and play areas, thus offering the opportunity of quickly infecting each other. The Journal cites a recent study showing that l7 per cent of preschool children hospitalized for more than a week had acquired a respiratory viral infection.

There is also the problem, in creches as well as hospitals, of health care workers infecting children after cuddling, kissing or changing them, particularly after doing likewise to children with the bugs. In one study, children in a hospital ward were infected with whooping cough by doctors infected with the germ.

The report calls for stricter infection control in hospitals such as limiting visitors and employing stricter screening of employees. Another solution may be to limit your child's stay in hospital to the utter minimum and to look into prospects of having your convalescing child cared for at home, whenever possible.