Hadler S C, McFarland L
Rev Infect Dis. 1986 Jul-Aug;8(4):548-57. doi: 10.1093/clinids/8.4.548.
Hepatitis A is a significant health problem in day care centers, causing outbreaks that average 12 cases in size and three months in duration. These outbreaks have three characteristic features: children have mild or asymptomatic infections; adults (primarily parents) are the major group with clinical hepatitis; and persons having contact with one- or two-year-old children run the highest risk of infection. Outbreaks are commonest in centers that are large, have long operating hours, and enroll children younger than the age of two years (i.e., those in diapers). The presence of such children is necessary for the rapid spread of the disease. Nationally, outbreaks occur primarily in areas with many infant/toddler centers, which often form the focus for epidemics. Prevention relies on hygiene, especially hand washing. Disease control depends on early detection of outbreaks and aggressive use of immunoglobulin. The spread of hepatitis B has not been documented in day care centers; however, when a child carrying hepatitis B virus enrolls in a center, a low risk of transmission may exist and precautions are recommended, with a focus on personal hygiene.
甲型肝炎在日托中心是一个严重的健康问题，会引发平均规模为12例、持续时间为三个月的疫情。这些疫情有三个特征：儿童感染多为轻症或无症状；成年人（主要是家长）是临床型肝炎的主要群体；与一至两岁儿童接触的人感染风险最高。疫情在规模大、营业时间长且招收两岁以下儿童（即还在穿尿布的儿童）的日托中心最为常见。这类儿童的存在是疾病快速传播的必要条件。在全国范围内，疫情主要发生在有许多婴幼儿日托中心的地区，这些地区往往是疫情的集中地。预防措施依靠卫生习惯，尤其是洗手。疾病控制则依赖于疫情的早期发现以及积极使用免疫球蛋白。乙型肝炎在日托中心的传播尚无记录；然而，当携带乙肝病毒的儿童进入日托中心时，可能存在低传播风险，建议采取预防措施，重点是个人卫生。
