Hepatitis A in day care centers.

A dramatic increase in the number of preschool children in US day care facilities has presented new problems in infectious disease control, particularly with agents transmitted through the fecal-oral route. As the school health field broadens to encompass the day care setting, such issues are becoming increasingly important for school health practitioners. Hepatitis A has attributes favoring day care-related reservoirs and outbreaks. The anicteric course of infection in young children usually does not alert the school health practitioner to infectious hepatitis. This article reviews epidemiologic and clinical features of hepatitis A in day care centers. Control measures including immunoglobulin prophylaxis for contacts of infected individuals and rigid attention to hygienic standards are examined, and suggestions for designing day care systems in communities are discussed.