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Hepatitis A outbreaks are a growing concern in US day care centers due to increased attendance. Enhanced hygiene and prompt immunoglobulin prophylaxis are crucial for controlling infectious hepatitis transmission among young children.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Rising enrollment in US day care facilities presents challenges for infectious disease control.
- Fecal-oral transmission routes are a significant concern in congregate child care settings.
- Hepatitis A poses a particular risk due to its potential for reservoirs and outbreaks in day care centers.
Purpose of the Study:
- To review the epidemiologic and clinical features of Hepatitis A in day care settings.
- To examine control measures for Hepatitis A in child care environments.
- To provide suggestions for designing safer day care systems.
Main Methods:
- Review of epidemiologic data on Hepatitis A in day care centers.
- Analysis of clinical presentations of Hepatitis A in young children.
- Examination of current control strategies, including prophylaxis and hygiene.
Main Results:
- Hepatitis A outbreaks can occur in day care centers, often with anicteric (without jaundice) presentations in young children.
- Inapparent infections can delay recognition by health practitioners.
- Effective control relies on prompt identification of cases and contacts.
Conclusions:
- Day care centers require specific strategies for managing Hepatitis A outbreaks.
- Immunoglobulin prophylaxis for exposed individuals is a key control measure.
- Strict adherence to hygienic standards is essential to prevent fecal-oral transmission.
Abstract:
A dramatic increase in the number of preschool children in US day care facilities has presented new problems in infectious disease control, particularly with agents transmitted through the fecal-oral route. As the school health field broadens to encompass the day care setting, such issues are becoming increasingly important for school health practitioners. Hepatitis A has attributes favoring day care-related reservoirs and outbreaks. The anicteric course of infection in young children usually does not alert the school health practitioner to infectious hepatitis. This article reviews epidemiologic and clinical features of hepatitis A in day care centers. Control measures including immunoglobulin prophylaxis for contacts of infected individuals and rigid attention to hygienic standards are examined, and suggestions for designing day care systems in communities are discussed.