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Acute infectious diarrhea among children in day care: epidemiology and control
Insights
Diarrhea is common in children under three in day care centers, often spread by germs like rotavirus. Poor hygiene and non-toilet-trained children contribute to outbreaks, impacting families.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Epidemiology
Background:
- Diarrhea incidence is highest in children under three years old attending day care centers.
- Children in day care centers experience higher diarrhea rates compared to those cared for at home.
- Outbreaks are frequently caused by specific pathogens such as rotavirus, Giardia, and Shigella.
Purpose of the Study:
- To investigate the incidence and transmission dynamics of diarrhea in day care settings.
- To identify risk factors associated with increased diarrhea rates in child care environments.
- To explore the role of asymptomatic enteropathogen excretion in transmission.
Main Methods:
- Review of existing studies on diarrhea in day care centers.
- Analysis of reported outbreaks and associated pathogens.
- Identification of center-specific characteristics linked to diarrhea rates.
Main Results:
- Non-toilet-trained children are a significant factor in higher diarrhea rates.
- Contaminated hands, toys, and objects, along with inadequate infection control, facilitate pathogen spread.
- Asymptomatic enteropathogen excretion is common, but its transmission significance is unclear.
- Infections frequently spread from day care centers to family members.
Conclusions:
- Day care centers present unique challenges for controlling infectious diarrhea, particularly in younger, non-toilet-trained children.
- Effective infection control strategies, including education and regulatory measures, are crucial but require systematic evaluation.
- Further research is needed to understand and mitigate the transmission of enteropathogens in child care settings.
Abstract:
The incidence of diarrhea among children in day care centers is highest for those under three years of age. Limited studies indicate that diarrhea occurs more frequently among children enrolled at these centers than among age-matched children cared for at home or in family day care. Most reported outbreaks have been caused by rotavirus, Giardia, Shigella, or combinations of these organisms. Children in day care centers commonly excrete enteropathogens in the absence of symptoms; the significance of this phenomenon in transmission is unknown. An association between higher rates of diarrhea and selected characteristics of centers--the most important of which is the presence of non-toilet-trained children--has been shown. The contamination of hands, communal toys, and other classroom objects as well as a lack of infection control measures play a role in the transmission of enteropathogens in outbreaks of diarrhea in day care centers. Spread of infection from non-toilet-trained children in centers to their families is common. Potential ways of dealing with this situation include education; development, implementation, and enforcement of regulations; and use of infection control measures. However, the effectiveness of specific control measures has not been systematically evaluated.