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

Abstract

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

Early infection and asymptomatic spread of hepatitis A virus in a public child care center in Rio de Janeiro, Brazil: should attending children under two years of age be vaccinated?

“…Inadequate diaper-changing facilities may also contribute to HAV transmission. Indeed, previous findings indicate that the presence of young children wearing diapers is a factor that facilitates the spread of HAV in child care centers (Rosenblum et al 1991, Venczel et al 2001.…”

Prevalence of hepatitis A virus infection among sewage workers in Georgia

“…Although outbreaks occur in child care centers, epidemiologic studies do not consistently find an association between employment in child care centers and hepatitis A [Jackson et al, 1996;Published 2003 Wiley-Liss, Inc. { This article is a US Government work and, as such, isin the public domain in the United States of America. Venczel et al, 2001]. Data from serologic surveys have not indicated an increased prevalence of hepatitis A virus (HAV) infection among health care workers compared to appropriate control populations [Gibas et al, 1992].…”

As creches e pré-escolas e as doenças transmissíveis

“…68,69 Daycare centers are also known to be sites of dissemination of hepatitis A. the disease generally manifests in epidemic community outbreaks, during which infection is transmitted from person to person via the fecal oral route. 70 Hepatitis A outbreaks in daycare centers have been observed with increasing frequency over recent years, in parallel with the increase in the number of children attending daycare centers. 71 Children less than 2 years are the focus of outbreaks of this disease.…”