Risk Factors for Hepatitis A in Day-Care Centers

Hadler, Stephen C.; Erben, J; Francis, Donald P.; Webster, Hannah; Maynard, James E.

doi:10.1093/infdis/145.2.255

Cited by 76 publications

(20 citation statements)

References 7 publications

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“…2,7 Serologic surveys of child care workers have not found an increased prevalence of anti-HAV compared with an appropriate comparison group. 8,9 Our investigation supports previous findings 10,11 indicating that the presence of young children in diapers is a factor that may facilitate the spread of HAV in child care centers. Behavioral and environmental factors associated with diaper-wearing children may facilitate the transmission of infectious diseases.…”

Section: Discussionsupporting

confidence: 90%

“…Large facilities, in which toilettrained and non-toilet-trained children share rooms or caregivers have been shown in previous studies to be associated with more frequent transmission of infectious agents. 11 This investigation had several limitations. Collection of information by telephone, which excluded individuals who did not have a working telephone, may have reduced the representativeness of the study sample.…”

Section: Discussionmentioning

confidence: 93%

“…Behavioral and environmental factors associated with diaper-wearing children may facilitate the transmission of infectious diseases. 11 Children in this age group often mouth objects, and stool may be spread easily from diapers to the immediate environment. Other characteristics associated with hepatitis A in our investigation, including a child care capacity of Ͼ50 slots and offering full day service, are consistent with findings in previous studies.…”

Section: Discussionmentioning

confidence: 99%

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The Role of Child Care in a Community-Wide Outbreak of Hepatitis A

et al. 2001

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ABSTRACT. Objective. To evaluate the role of child care centers in a community-wide hepatitis A epidemic.Methods. We analyzed surveillance data during an epidemic in Maricopa County, Arizona, from January to October 1997 and conducted a case-control study using a sample of cases reported from June to November. Cases were physician-diagnosed and laboratory confirmed; control subjects were frequency matched by age and neighborhood. Information regarding hepatitis A risk factors, including child care-related exposures, was collected. Characteristics of all licensed child care centers in the county were obtained through review of computerized lists from the Arizona Office of Child Day Care Licensing. Surveillance data were linked to the child care list to determine which centers had reported hepatitis A cases. We conducted univariate and multivariate conditional logistic analyses and calculated population attributable risks (PAR).Results. In total, 1242 cases (50/100 000 population) were reported. The highest rates occurred among people aged 0 to 4 (76/100 000), 5 to 14 (95/100 000), and 15 to 29 (79/100 000) years. The most frequently reported risk factor was contact with a hepatitis A patient (45%). However, nearly 80% of these contacts were with individuals who attended or worked in a child care center. Overall, child care center-related contact could have been the source of infection for 34% of case-patients. In the casecontrol study, case-patients (n ‫؍‬ 116) and control subjects (n ‫؍‬ 116) did not differ with respect to demographic characteristics. A total of 51% of case-patients compared with 18% of control subjects reported attending or working in a child care setting (direct contact; adjusted odds ratio

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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The Role of Child Care in a Community-Wide Outbreak of Hepatitis A

et al. 2001

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“…Children are generally asymptomatic and easily transmit the disease to adults, at the daycare centre and at home; during hepatitis A outbreaks at daycare centers 75% of cases can be attributed to contact with child less than 2 years old with an asymptomatic infection acquired at the daycare centre. 72 Hepatitis A outbreaks in daycare centers are identified based on confirmed adult cases with a history of contact with the daycare centre, such as workers or parents. 9 Hepatitis A outbreaks are more frequent in large daycare centers that accept children in diapers.…”

Section: Other Infectious Diseasesmentioning

confidence: 99%

As creches e pré-escolas e as doenças transmissíveis

Nesti¹,

Goldbaum²

2007

J. Pediatr. (Rio J.)

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Objective: To describe the increased risk of acquiring infectious diseases associated with out-of-home childcare and the effectiveness of measures for the control and prevention of diseases transmission at daycare and preschool education centers. Sources:A review of literature in the MEDLINE, LILACS and Cochrane Library databases, found using the descriptors daycare, infection, infection control and infectious diseases and focusing on studies that have compared the risk of infectious diseases for children cared for in and out of the home, related risk to the type of out-of-home careand assessed the effectiveness of preventative measures. Summary of the findings:Children cared for at daycare or in preschool education exhibit a two to three times greater risk of acquiring infections, which impacts both on individual health and on the dissemination of diseases through the community. Among other factors, the risk is associated with the characteristics of daycare centers, and simple preventative measures are effective for reducing transmission of diseases. Recommended measures include: appropriate hand washing after exposure; employment of standard precautions; standardized routines for changing and disposal of used diapers, location and cleanliness of changing area, cleaning and disinfection of contaminated areas; use of disposable tissues for blowing noses; separate workers and area for handling foods; notification of infectious diseases; training of workers and guidance for parents. Conclusions:In the face of growing utilization of daycare and preschool education and their association with increased risk of acquired infections, control measures are indispensable to the prevention and control of infectious diseases.J Pediatr (Rio J). 2007;83(4):299-312: Daycare, infection, infection control, infectious diseases.

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“…This may play an indirect role in viral transmission to other susceptibles. Neonatal nurseries, as well as child care centers caring for <2-3 year olds, are well recognized as high-risk areas for transmission of hepatitis A because these age groups are predominantly asymptomic with acute HAV infection (11,14,(21)(22)(23).…”

Section: Serologymentioning

confidence: 99%