Hadler S C, Erben J J, Francis D P, Webster H M, Maynard J E
J Infect Dis. 1982 Feb;145(2):255-61. doi: 10.1093/infdis/145.2.255.
Outbreaks of hepatitis in day-care centers in Maricopa County, Arizona, were studied over a two-year period to learn which center characteristics affected the spread of hepatitis A. Of the 279 licensed center, 85 (30%) had outbreaks of hepatitis affecting three or more families. Outbreaks occurred in 63% of centers enrolling infants younger than one year of age, 32% of centers enrolling children one year of age or older, and 2.5% of centers enrolling children two years of age or older (P less than 0.0001). Outbreaks were also significantly more frequent in large centers enrolling greater than or equal to 51 children, centers open greater than 15 hours per day, and centers operated for profit. The introduction of hepatitis into a center was related strongly to the number of hours open and to the size and age enrollment, but the spread of hepatitis was related solely to the presence of children younger than two years of age. These data strongly link the spread of hepatitis A in day-care centers to the presence of very young children and provide a framework for designing disease-control strategies.
在两年时间里，对亚利桑那州马里科帕县日托中心的肝炎疫情进行了研究，以了解哪些中心特征会影响甲型肝炎的传播。在279家获得许可的中心中，有85家（30%）发生了肝炎疫情，涉及三个或更多家庭。在招收一岁以下婴儿的中心中，63%发生了疫情；在招收一岁及以上儿童的中心中，32%发生了疫情；在招收两岁及以上儿童的中心中，2.5%发生了疫情（P<0.0001）。在招收51名及以上儿童的大型中心、每天开放超过15小时的中心以及营利性中心，疫情也明显更为频繁。肝炎传入一个中心与开放时间、规模和招收儿童年龄密切相关，但肝炎的传播仅与两岁以下儿童的存在有关。这些数据有力地将日托中心甲型肝炎的传播与非常年幼的儿童联系起来，并为设计疾病控制策略提供了框架。
