Reves R R, Pickering L K
Department of Internal Medicine, University of Texas Medical School, Houston 77030.
Annu Rev Med. 1990;41:383-91. doi: 10.1146/annurev.me.41.020190.002123.
Internists should be aware of the increased frequency of most communicable diseases among parents and child care providers exposed to children attending child day care centers. Episodes of shigellosis and hepatitis A among adults in contact with children in day care centers should be promptly reported to public health authorities, since they may indicate the presence of a day care center outbreak for which effective control measures are available. Although effective treatment or intervention is limited or not available for many other infections acquired by adults from children in day care centers, significant illness may result in a minority of individuals at increased risk for infection with agents such as cytomegalovirus and varicella. Acute infectious diseases of children caused by organisms transmitted from day care center staff are less common and largely preventable by ensuring that staff are appropriately immunized and screened for tuberculosis.
内科医生应意识到,在接触日托中心儿童的家长和儿童护理人员中,大多数传染病的发病率有所增加。日托中心与儿童接触的成人中发生的志贺氏菌病和甲型肝炎病例应及时报告给公共卫生当局,因为这可能表明存在日托中心疫情,对此有有效的控制措施。虽然对于成人从日托中心儿童那里感染的许多其他感染,有效的治疗或干预措施有限或无法获得,但少数感染风险增加的个体可能会因感染巨细胞病毒和水痘等病原体而患上严重疾病。日托中心工作人员传播的病原体引起的儿童急性传染病较少见,通过确保工作人员接受适当的免疫接种和结核病筛查,在很大程度上是可以预防的。