Spread of Common Day Care Illnesses Caused by Misconceptions About Illness Transmission

FOR IMMEDIATE RELEASE:

Monday, April 4, 2005

For Further Information:
Leah Gourley & John Lacey
617-432-0442 or public_affairs@hms.harvard.edu

Simple Public Health Tool Can Reduce Transmission

Viral upper respiratory and gastrointestinal infections are the two most common illnesses that occur in children enrolled in day care, and secondary attack rates within families can be as high as 27 percent for respiratory illnesses and 70 percent for gastroenteritis.

New research published in the April issue of Pediatrics shows that in homes with children enrolled in day care, several misconceptions regarding illness transmission may be contributing to the spread of these diseases.

The study found that only two thirds of parents believed that contact transmission was important for the spread of colds, and fewer than half believed it was important in the spread of stomach flus. Perhaps more surprising, fewer than half stated that changing a diaper and eating food prepared by a person with gastroenteritis were important in spreading stomach flus.

''Misconceptions about the mechanisms of illness transmission were common,'' said the study's lead author Grace Lee, Harvard Medical School instructor in ambulatory care and prevention in the HMS Department of Ambulatory Care and Prevention. ''We need to educate families about the importance of hand hygiene in reducing the spread of illnesses.'' Lee is also an HMS instructor in pediatrics at Children's Hospital Boston.

The study measured respiratory and gastrointestinal illness transmission rates in 208 families from the metropolitan Boston area with at least one child in day care. It also surveyed these families about beliefs and practices regarding illness transmission.

''Our study also suggests that use of alcohol-based hand gels may play an important role in decreasing respiratory illness transmission in the home, '' Lee said. The study indicated a 40 percent reduction in secondary illness transmission in families who frequently used alcohol-based hand gels.

''Alcohol hand sanitizers kill most viruses that cause respiratory and gastrointestinal illnesses in the home, and they are extremely convenient and portable. They also are remarkably gentle on the hands. If families understood how useful these products are, I think they would use them more often,'' said Donald Goldmann, HMS professor of pediatrics at Children's Hospital Boston and senior author of the study.

This is one of the few longitudinal studies of illness transmission in the home since the widespread use of childcare has altered the epidemiology of infectious disease in the U.S. The investigators focused on secondary transmission to family members since these infections are potentially preventable through household hygiene. The study findings bolster the results of recent studies that found use of alcohol gel hand sanitizers reduced absenteeism when used in the classroom and reduced respiratory tract infections in extended care facilities. The researchers believe that targeted educational interventions about the importance of hand hygiene and use of alcohol-based gels should be considered in the future to reduce the spread of illnesses in the home.

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CHILDREN'S HOSPITAL BOSTON
Children's Hospital Boston is the nation's leading pediatric medical center, the largest provider of health care to Massachusetts' children, and the primary pediatric teaching hospital of Harvard Medical School. Children's provides pediatric and adolescent health services for patients from birth through age 21. In addition to 325 inpatient beds and comprehensive outpatient programs, it houses the world's largest research enterprise based at a pediatric medical center. More than 500 scientists, including eight members of the National Academy of Sciences, nine members of the Institute of Medicine and 10 members of the Howard Hughes Medical Institute comprise Children's research community. For more information about the hospital visit: www.childrenshospital.org.