AN OUTBREAK OF HEPATITIS-A IN A FRENCH DAY-CARE-CENTER AND EFFORTS TOCOMBAT IT

An outbreak of hepatitis A in a French day-care center was identified during a survey of risk factors for such events in a sample of 210 cen ters. In the period between 29 March and 9 July 1994, 17 cases were di agnosed in the center (anti-HAV IgM serum antibody) including 11 child ren aged 2-3 (attack rate = 55.5% of class), 2 staff members, 3 parent s and 1 educator-parent (secondary attack rate = 27.6%). The source ca se was probably a classmate of Case 1's older brother, who was diagnos ed earlier in the spring. Intensive hygiene measures and the organisat ional features of the clinic limited all transmission except by direct physical contact with infected children, Vaccination of staff was beg un too late to be effective; gamma-globulin prophylaxis might have bee n administered but was not. This is the first documented outbreak of t he disease in a French center.