Risk of infection with hepatitis A, B or C, cytomegalovirus, varicella or measles among child care providers

La, Jackson; Lk, Stewart; Sl, Solomon; Boase, Janice; Er, Alexander; Jl, Heath; Gk, McQuillan; Pj, Coleman; Ja, Stewart; Cn, Shapiro

doi:10.1097/00006454-199607000-00005

Cited by 53 publications

(24 citation statements)

References 14 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%

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%

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

et al. 2001

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“…years of day care employment [8] and increased frequency of diaper changing [10]. Although these studies have suggested an occupational risk of day care employment, methodological limitations such as the use of convenience samples decrease the validity of these results.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for cytomegalovirus seropositivity in a population of day care educators in Montréal, Canada

Joseph

Béliveau²,

Muecke³

et al. 2005

Occupational Medicine

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Background Horizontal transmission of cytomegalovirus (CMV) is common in the day care setting. Day care educators appear to be at a high risk of infection; however, studies are limited. AimsTo determine the proportion of CMV-seropositive female educators in the day care setting and to identify associated risk factors. MethodsEducator-and day care-level risk factors for CMV seropositivity were obtained by questionnaires from day care educators and directors, respectively. Sera were collected from educators and analyzed by enzyme-linked immunosorbent assay. Significant independent risk factors for CMV seropositivity were determined using a multivariable logistic regression model which was fitted using the generalized estimating equation method. Conclusions Day care educators have risks for CMV infection related to their work in the day care setting, as well as personal risk factors. A review of current guidelines for the prevention of CMV infection in day care is needed to ensure that recommendations are evidence based. Results CMV seroprevalence in

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“…12 In child care center outbreaks, contact with feces and subsequent personal contact are important means by which transmission occurs, and cases have occurred in child care center workers and household members of children who attend the center. 18,19 Foodborne hepatitis A transmission can occur from food that is contaminated during preparation by an infected food handler (foods not cooked after handling, such as salads and sandwiches) or during growing or processing (eg, produce), but this mode of transmission accounts for a relatively small proportion of reported hepatitis A cases in the United States. 20 Waterborne outbreaks are rare in developed countries with adequate sanitation systems.…”

Section: Figurementioning

confidence: 99%

Hepatitis A Vaccine Recommendations

2007

Pediatrics

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Since licensure in 1995 of a hepatitis A vaccine, the Centers for Disease Control and Prevention and the American Academy of Pediatrics have been implementing an incremental hepatitis A immunization strategy for children. In 1996, children living in populations with the highest rates of disease were targeted for immunization, and in 1999 the program was expanded to immunization of children 2 years and older living in states and counties with rates of hepatitis A that historically have been higher than the national average. The 1999 program has been successful; the current rate of hepatitis A is the lowest ever reported in the United States. Regional, ethnic, and racial differences in the incidence of hepatitis A have been eliminated. The incidence of hepatitis A in adults in immunizing states has decreased significantly, suggesting a strong herd-immunity effect associated with immunization. In 2005, the US Food and Drug Administration changed the youngest approved age of administration of hepatitis A vaccine from 24 to 12 months of age, which facilitated incorporation of the vaccine into the recommended childhood immunization schedule. As the next step in the implementation of the incremental vaccine immunization strategy, the American Academy of Pediatrics now recommends routine administration of a Food and Drug Administration-licensed hepatitis A vaccine to all children 12 to 23 months of age in all states according to a Centers for Disease Control and Prevention-approved immunization schedule. Available data suggest that hepatitis A vaccine can be coadministered with other childhood vaccines without decreasing immunogenicity. Hepatitis A vaccines have proven to be extremely safe. In prelicensure clinical trials of both Havrix (GlaxoSmithKline, Rixensart, Belgium) and Vaqta (Merck & Co Inc, Whitehouse Station, NJ), adverse events were uncommon and mild when they occurred, with resolution typically in less than 1 day. Hepatitis A vaccine is contraindicated in people with a history of severe allergic reaction to a previous dose of hepatitis A vaccine or to a vaccine component. Because the hepatitis A vaccine is an inactivated product, no special precautions are needed for administration to people who are immunocompromised. No data exist about administration of the hepatitis A vaccine to pregnant women, but because it is not a live vaccine, the risk to mother and fetus should be extremely low to nonexistent. BACKGROUND AND RATIONALE FOR RECOMMENDATIONSThe purpose of this statement is to provide the rationale and recommendations for universal administration of hepatitis A vaccine to children living in the United States. The rationale for implementation of universal immunization is based on several considerations. For the 15 years before availability of hepatitis A vaccines www.pediatrics.org/cgi

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Risk of infection with hepatitis A, B or C, cytomegalovirus, varicella or measles among child care providers

Abstract: The anti-HAV prevalence among US-born providers was low, and seropositivity was not associated with employment characteristics, indicating that occupational exposure to HAV is uncommon under non-outbreak circumstances.

Cited by 53 publications

References 14 publications

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

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

Risk factors for cytomegalovirus seropositivity in a population of day care educators in Montréal, Canada

Hepatitis A Vaccine Recommendations

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