| INCIDENCE | 4-7,000,000 child care-related infections/year among 7,000,000 children under age 5 in out-of-home child care 2-3 times the risk of infectious diseases (diarrhea, respiratory disease, otitis media) compared with children not in out-of-home care |
| SEQUELAE | 400,000 medical consultations and/or hospitalizations/year 25% of household contacts may be secondarily infected Increased use of antimicrobial drugs |
| COSTS | 60% of employee absenteeism attributable to unmet child care needs Parents miss 1-4 weeks work per year to care for sick or injured children |
| TRANSMISSION | Primarily person-to-person by fecal-oral and respiratory routes |
| RISK GROUPS | Children in out-of-home child care, child care workers, and their household contacts |
| SURVEILLANCE | Reports of only specific diseases to state and local health departments No formal surveillance system |
| TRENDS | By the Year 2000, 75% of mothers with children under 6 will work outside the home Number of children in alternative care settings likely to increase Incidence of some child-care associated infections (e.g., giardiasis, otitis media) is increasing Increased risk of antimicrobial-resistant bacterial infection |
| CHALLENGES | Identify cost-effective control measures Evaluate efficacy of current prevention recommendations Train employees in infection control techniques |
| OPPORTUNITIES | Reduction in infectious disease transmission will benefit families' quality of life Savings in health care and productivity costs |
| RESEARCH PRIORITIES | Evaluation of prevention and control strategies Identifying behavioral & educational interventions to facilitate adherence to good infection control practice |
| INTERVENTION PRIORITIES | Enhance capacity of public health information systems for communicating with child care providers Assess models for enhancing delivery of public health services through the child care setting |