Infectious Disease in Child Day Care: An Overview

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 987-990
Author(s):  
Michael T. Osterholm
Keyword(s):  
Public Health ◽  
Child Care ◽  
Infectious Diseases ◽  
Day Care ◽  
Health And Safety ◽  
Health Science ◽  
American Public Health Association ◽  
Child Day Care ◽  
Health Association ◽  
Care Health

In the early 1980s, the Minnesota Department of Health began to address the growing concern of the risk of infectious diseases in child day care by initiating a planning process that resulted in the first national symposium on infectious diseases in child day care. That symposium, which was held in June 1984 in Minneapolis, highlighted the fact that different vocabularies and points of reference would need to be bridged if day-care providers and regulators, clinicians, and public health practitioners are to work side-by-side in defining the risk of infectious diseases in day care and in developing appropriate prevention strategies.1 As a result of this meeting, the Minnesota Public Health Association submitted a resolution to the American Public Health Association (APHA) in the fall of 1984, stating that child-care standards, especially in the area of prevention of infectious diseases, were needed. This resolution, together with a simultaneous recommendation from the APHA's Maternal and Child Health Section for the development of health and safety standards for out-of-home child-care facilities, began a process which eventually led to the monumental effort now known as the American Public Health Association/American Academy of Pediatrics, National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.2 In June, 1992, the Centers for Disease Control and Prevention sponsored the "International Conference on Child Day Care Health: Science, Prevention and Practice," a historic meeting bringing together concerned individuals from many disciplines to further define and set the future agenda for the science, prevention and practice of child day-care health.

The Science Behind the American Public Health Association/American Academy of Pediatrics National Health and Safety Guidelines for Child-Care Programs

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1101-1104
Author(s):  
Susan S. Aronson
Keyword(s):  
Public Health ◽  
Child Care ◽  
American Academy ◽  
National Health ◽  
Health And Safety ◽  
Cost Of Care ◽  
Care Providers ◽  
American Public Health Association ◽  
American Academy Of Pediatrics ◽  
Health Association

THE DEVELOPMENT OF THE APHA/AAP STANDARDS In 1992, the American Public Health Association (APHA) and the American Academy of Pediatrics (AAP) published the long-awaited Caring for Our Children—National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.1 This publication was the product of a 4-year effort involving many experts in child health and safety and day-care providers. The standards document provides a national consensus on approaches to reducing diseases and injury and promoting prevention among children and providers in group-care settings. Consumer protection initiatives are needed because market-place forces are inadequate to ensure a health environment for children in child care. Over the past two decades, a growing number of investigators have documented the increased occurrence of infectious diseases2-4 and injuries,5-7 and missed opportunities for health protection and promotion in child care.8 Despite the tendency to focus on reports of negative health outcomes, children and families thrive in early childhood programs that provide safe, nurturing care and developmentally appropriate education. Day-to-day excellence in child care depends on committed, well-educated care givers who work in a child-friendly and staff-friendly environment. In the US, good child care is limited. Few parents can afford the full cost of care. Most lack the knowledge, skills, or objectivity to critically evaluate the care they choose for their children. Convenience, availability, and affordability motivate parents when they choose child care. Parents are pressured to meet occupational expectations, and tend to overlook significant risks in their children's child-care arrangements. Even parents who are pediatricians (who are expected to be well-versed in child development, health, and safety) ignore hazards and poor quality when rating convenient and available child-care arrangements (Aronson S, unpublished data).

Injuries in Child Day Care: An Overview

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1031-1033
Author(s):  
Frederick P. Rivara ◽  
Jeffrey J. Sacks
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Child Care ◽  
Brain Injury ◽  
Infectious Diseases ◽  
Medical Care ◽  
Day Care ◽  
Permanent Disability ◽  
Child Day Care ◽  
Childhood Death

Injuries in child day care are a microcosm of the overall problem of childhood injury. In 1985 the National Academy of Sciences characterized injury as the most important public health problem in America.1 Although infectious diseases account for substantial morbidity among children—including the needs for medical care and hospitalization—injury is the most common cause of serious disability and death to children. Over the last 25 years there have been remarkable reductions in morbidity and mortality from other causes of childhood death, particularly those from infections and more recently from childhood cancer.2 Unfortunately, the reduction in childhood death from injuries has been minimal.2 Thus, addressing injuries to children in child-care and other settings is a public health priority. INCIDENCE OF INJURIES Approximately 25% of children annually incur injuries requiring medical care, either in the emergency department or the physician's office.3 The most common injury event is a fall. Falls are a particular problem because they can result in head trauma and permanent disability. Falls are the main cause of traumatic brain injury in children and account for 55% of traumatic brain injury requiring admission to the hospital.4 Contrary to popular belief, outcomes from head injuries in children are worse than outcomes in adults.5 Comparison of injuries to children in out-of-home child care (OOHCC) and in home care (HC) requires the calculation of comparable incidence rates. All children in OOHCC also spend time in HC, so comparisons based on population denominators are not accurate. In addition, unlike most infectious diseases—for which illnesses occur following an incubation period—injuries occur immediately after the exposure.

American Public Health Association/American Academy of Pediatrics National Health and Safety Guidelines for Child-Care Programs: An Overview

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1107-1108
Author(s):  
Albert Chang
Keyword(s):  
Public Health ◽  
Child Care ◽  
Care Setting ◽  
Health And Safety ◽  
American Public Health Association ◽  
Valuable Resource ◽  
American Academy Of Pediatrics ◽  
Child Care Setting ◽  
Health Association ◽  
Safety Guidelines

Caring for Our Children represents a model collaboration of government, voluntary health associations, and individuals in a national aspiration to create in every child-care setting a safe, healthful, and nurturing environment for our children, our most valuable resource and our future.

Hospital Isolation and Precaution Guidelines

PEDIATRICS ◽  
1974 ◽  
Vol 53 (5) ◽  
pp. 663-673
Author(s):  
Pierce Gardner ◽  
Sylvia Breton ◽  
Diana G. Carles
Keyword(s):  
Public Health ◽  
New York ◽  
Infectious Diseases ◽  
Medical Center ◽  
Government Printing ◽  
American Public Health Association ◽  
American Hospital ◽  
American Hospital Association ◽  
Isolation Techniques ◽  
Health Association

Infections acquired in hospitals have been recognized as a significant cause of morbidity and mortality since before the era of Semmelweis and Lister. Hospital isolation and precaution procedures have evolved along highly individualistic lines depending on the facilities, patient population and the degree of concern regarding nosocomial infections at a particular hospital. In recent years, a number of valuable manuals which offer details of isolation and precaution techniques as well as recommendations for the hospital control of particular infectious diseases have become available. These include: 1. Public Health Service, U. S. Department of Health, Education and Welfare: Isolation Techniques Used in Hospitals. Washington, D.C.: U.S. Government Printing Office, 1970. 2. Report of the Committee on Infectious Diseases, ed. 16. Evanston, Illinois: American Academy of Pediatrics, 1970. 3. Infection Control in the Hospital, ed. 2. Chicago: American Hospital Association, 1970. 4. Benenson, A. S. (ed.): Control of Communicable Diseases in Man, ed. 11. New York: American Public Health Association, 1970. 5. Top, F. H. (ed.): Control of Infectious Diseases in General Hospitals. New York: American Public Health Association, 1967. In an attempt to synthesize these recommendations into a more easily utilized form, the following alphabetical listing of diseases and conditions has been developed by members of the Infections Control Committee at the Children's Hospital Medical Center. It should be stressed that these are guidelines based on current understanding of the natural history and epidemiology of certain infections. In our hospital, modifications are frequently necessary due to heavy demand for the limited isolation facilities.

Control of Communicable Diseases in Man

PEDIATRICS ◽  
1965 ◽  
Vol 36 (1) ◽  
pp. 152-152
Author(s):  
SAMUEL L. KATZ
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Preventive Medicine ◽  
Communicable Disease ◽  
Emeritus Professor ◽  
American Public Health Association ◽  
Communicable Disease Control ◽  
School Of Public Health ◽  
Health Association ◽  
Harvard School

That a volume achieves its tenth edition and its fiftieth anniversary may be accepted as highly suggestive evidence of its value and popularity. A brief, or more leisurely, reading of the 1965 version of this handbook quickly convinces one of the great service rendered its readers by the editors. Dr. John E. Gordon, Emeritus Professor of Preventive Medicine and Epidemiology at the Harvard School of Public Health, and his Committee on Communicable Disease Control of the American Public Health Association present succinctly and lucidly the pertinent and current material in more than one hundred fifty infectious diseases, in a paperback pocket-size book.

Health in Child Day Care: The Physician—Child-Care-Provider Relationship

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1062-1063
Author(s):  
Howard L. Taras
Keyword(s):  
Child Care ◽  
Health Professionals ◽  
Day Care ◽  
Health And Safety ◽  
Child Care Providers ◽  
Health Issues ◽  
Care Providers ◽  
Gastrointestinal Infections ◽  
Child Day Care ◽  
Care Givers

Health promotion and disease prevention strategies for child day-care have not kept pace with the needs of children. One example is the inconsistent interaction between community physicians and child-cane providers. Although there isn't yet data documenting benefits of increased communication between health practitioners and child-care professionals, there is speculation by many that these sorts of physician-community liaisons will help to close serious gaps in current health-care practices.1-3 This paper reviews how increased physician involvement could improve the health situation in child day care and explores ways physicians can become more involved. THE HEALTH NEEDS Need for Consultants There are basic and predictable health issues that arise from grouping young children together. They are topics for research and discussion among epidemiologists, medical investigators, and other health professionals. The issues include exclusion criteria for attendance in day care, spread of respiratory and gastrointestinal infections,4 the potential for childhood viruses to affect unborn children of pregnant care givers,5 medication policies,6 and the pros and cons of "sick-care" centers.7 Other health issues such as child development and emotional, behavioral, and nutritional health of children are also under study.8 This body of literature has served to define most health consultation needs of child day-care programs. Few day-care centers on family day-care homes actually use a health consultant.9 It is hoped that publication of the American Public Health Association's and American Academy of Pediatrics' (APHA/AAP's) National Health and Safety Performance Standards10 and its distribution to health professionals and child-care providers will help to change that. Its success depends partly on whether health professionals will be available, willing, and trained to serve as health consultants.

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