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Germ Warfare Bugs Day Care

Workers at increased risk for disease, researcher says

FRIDAY, July 27, 2001 (HealthDayNews) -- Want a job on the front lines of the germ war? Try working in a child care center, one researcher says.

Seems those who take care of your little ones, despite plenty of washing and cleaning, are at greater risk of getting infections and sharing those with their own families.

"We've known for a long time that little kids are the prime introducers of infectious diseases," says Ralph L. Cordell, an epidemiologist with the Centers for Disease Control and Prevention (CDC). And when workers deal with young kids, especially those who aren't potty trained, the risk is high for picking up a bug.

In an article that appears in the summer issue of the Journal of the American Medical Women's Association, Cordell examined the few studies that have been done on the incidence of infection among child-care workers.

Providers are often blamed for not using proper hygiene, such as wearing gloves during diaper changes or washing their hands, but that's not necessarily true, says Cordell.

"I really think you can take providers, dress them in wet suits, hose them down every 15 minutes, and you'd still have minimal impact," he says.

Children often arrive at day care centers well-stocked with bacteria, says Cordell: "People want to get their kids off to child care, so they wash their hands off real quick, not thinking about where the kids' hands have been all night. It's easy to see how this would happen."

When it comes to what disease is most commonly spread, upper respiratory infections top the list, Cordell says. Other common shared ailments are the diarrhea-causing shigellosis and giardiasis, particularly among those who care for kids who haven't been toilet-trained.

An Arizona study of 28 child care centers evaluated Hepatitis A, a disease that is asymptomatic in children under 6. Of 1,000 child-care workers, 121 were found to carry the virus. That was three times higher than other members of the household, and about five times greater than the children.

A Virginia study looked at the transmission of cytomegalovirus (CMV), a type of herpes virus that rarely causes problems for healthy adults. "Evidence that child-care providers have a significant occupational risk of CMV infection is fairly compelling," says Cordell.

Among the 34 Virginia centers studied, the rate of CMV antibodies was similar for child-care providers and hospital workers. The sero-conversion rate, or the changing of a negative finding to a positive one, was 11 percent a year in providers, compared to 2 percent for health-care workers.

Other bugs that child-care providers might take home include chicken pox, ear infections, scabies and other skin infections.

With approximately 1 million kids enrolled in day care, and the numbers expected to increase in the coming years, Cordell says more care needs to be taken on all fronts. Handwashing is paramount, and bacterial soaps are OK, he says. And make sure your kid's immunizations are current.

Just don't blame the messenger, he adds.

"The underlying thing is to have compassion for the child-care provider. I think these people have a really tough job, and that there's a little bit more than just looking after your kids," he says.

Kate Arsenault, spokeswoman for the Massachusetts Office of Child Care Services, agrees.

"Child-care providers most definitely don't get credit. They follow all the regulations, and are doing all the steps to prevent the spread of germs," she says.

However, you have to take into consideration all the different avenues for how germs get into your home, she adds.

"They can come from brothers and sisters who spend the day at school, or parents who spend the day at work," just as easily as from the child-care center, she says.

What To Do

All parents should do their homework before picking a child-care center, says Arsenault. Make sure the site is licensed, because that means it meets state standards on hygiene.

Ask what the handwashing policies are, for both workers and children. Find out how many changing tables and toilets there are, and how they clean them and with what. In Massachusetts, Arsenault says, use of a bleach solution is mandatory.

The American Academy of Family Physicians can help you choose a good day-care center.

Learn the things you can do to keep your kids healthy.

SOURCES: Interviews with Ralph L. Cordell, Ph.D., epidemiologist, Centers for Disease Control and Prevention, Atlanta; Kate Arsenault, spokeswoman, Massachusetts Office of Child Care Services, Boston; Summer 2001 Journal of the American Medical Women's Association
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