1. Hepatitis Infections in the Day-Care Setting
- Author
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Carmen C. Deseda, Eugene S. Hurwitz, M. Jayne Freitg-Koontz, Craig N. Shapiro, Jun Hayashi, and David R. Nalin
- Subjects
Hepatitis B virus ,Hepatitis ,Pediatrics ,medicine.medical_specialty ,Transmission (medicine) ,business.industry ,Public health ,Hepatitis A ,Jaundice ,medicine.disease_cause ,medicine.disease ,Pediatrics, Perinatology and Child Health ,Immunology ,Epidemiology ,medicine ,medicine.symptom ,Viral hepatitis ,business - Abstract
The hepatitis session reviewed current knowledge of the epidemiology and public health importance of hepatitis A (HAV) and hepatitis B virus (HBV) in day care centers (DCCs), current recommendations and prevention measures, areas that need additional research, and the potential for new preventive measures. HEPATITIS A The clinical characteristics, modes of transmission, risk factors for day-care-related outbreaks, and characteristics of hepatitis A virus outbreaks have been well described previously.1 Within the day-care setting, HAV is transmitted via the fecal-oral route, either person to person (between children and staff); via contaminated food (often in association with individuals who prepare food and care for diapered children); or possibly via fomites on contaminated surfaces or toys. In young children, in contrast to adults, hepatitis A may be difficult to recognize, as clinical illness is frequently nonspecific and mild, consisting primarily of malaise, nausea, fever, and diarrhea. Fewer than 5% of children under 3 years of age and only about 10% of those 4 to 6 years of age develop jaundice and are thus easily recognized as having hepatitis. Consequently, recognition of hepatitis A outbreaks in the day-care setting is often dependent upon recognizing hepatitis A in adults (parents or staff) who have had contact with day-care centers (DCCs). The initial recognition of DCCs as important sources of hepatitis A virus transmission both within the centers and in the communities they serve occurred in the mid-1970s.2,3 Early studies focused on describing the characteristics of DCCs in which hepatitis A outbreaks occurred, including DCCs with large numbers (≥50) of children in diapers and centers that are open more than 15 hours per day.2
- Published
- 1994
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