Documente Academic
Documente Profesional
Documente Cultură
I. Hepatitis A Infection
A. Infectious diseases that adults are likely to acquire from children who attend day care
centers include the following:
1. Hepatitis A: Fecal oral transmission
2. Cytomegalovirus: Transmission by contact with saliva, urine; risk to fetus if pregnant day
care provider develops infection (primary infection in particular)
3. Parvovirus B 19-respiratory transmission, risk to fetus in pregnant day care provider who
becomes infected
4. Children are at risk of acquiring tuberculosis from infected adults who care for them
B. Classification of Child Care
1. Because enteric pathogens are much more easily spread among diapered children
2. Home care (small family child-care home)
5-6 children, no licensing
3. Day care home (large family child-care home)
7-12 children, variable licensing requirements
4. Day care centers > 13 children, licensed
C. Enteric pathogens spread in child care
1. Viruses
a. Hepatitis A
b. Rotavirus
c. Astrovirus
d. Enteric adenovirus
e. Calicivirus
f. Enteroviruses
2. Bacteria
a. Salmonella
b. Shigella-small inocula infection, highly contagious-exclude until treated
c. E. coli O157:H7
d. Campylobacter
e. Clostridium difficile
3. Parasites and Fungi
a. Cryptosporidium
b. Giardia lamblia
c. Enterobius vermicularis
(1) Day care attendees with vomiting and diarrhea should generally be excluded until
symptoms have resolved (they need ill care, which daycare centers usually
cannot provide; it is more difficult to contain secretions in this situation)
4. Hepatitis A -Epidemiology/Clinical Features
a. Common infection in children and particularly in day care centers with diapered
attendees
b. Infection in young children is usually asymptomatic or mildly symptomatic only, but
infection in adults is symptomatic 75-100% of the time