Exclusion of ill children from day-care centers. Policy and practice in New Haven, Connecticut.

Despite evidence that children who attend group day-care centers have an increased frequency of infectious illnesses, appropriate criteria for exclusion of ill children from day-care centers have not been defined. Of the 89 licensed day-care centers in the New Haven area, 53 (60%) returned an anonymous questionnaire about their practices in managing ill children. Most of the centers (median size--38) included only children aged 3 to 5 years. The percentage of centers that excluded children with specific signs or symptoms varied from 100% for fever to 30% for either cough or runny nose. Although all of the day-care centers excluded children with fever, the minimum temperature defined as fever varied substantially (median--99.1 degrees F). Most centers (62%) relied on the parents' discretion for allowing an ill child to return to the center.