Mysterious slapped face rash at holiday centre.BMJ 1992; 304 doi: https://doi.org/10.1136/bmj.304.6825.477 (Published 22 February 1992) Cite this as: BMJ 1992;304:477
OBJECTIVE--To discover the cause of an outbreak of facial rash in a holiday centre. DESIGN--Questionnaire survey of those with rash; analysis of samples of linen. SETTING--Holiday centre in south west England. PATIENTS--98 holiday-makers presenting to the first aid post with a facial rash. INTERVENTION--Replacement of bed linen with new linen in selected parts of the site. RESULTS--The attack rate was 7.0-14.2/1000 for most accommodation areas in the centre, but in one accommodation area the rate was zero. The pH of rinse water from sheets varied from 7.4 to 9.0. Those parts of the accommodation provided with new linen had zero attack rates. CONCLUSION--The facial rash resulted from irritation from washing powder retained owing to insufficient rinsing during laundering. Modifications to the rinsing process led to a gradual disappearance of the rash.