COMMUNICABLE DISEASE OUTBREAKS IN LONG-DAY CARE CENTERS IN WESTERN SYDNEY - OCCURRENCE AND RISK-FACTORS

We surveyed the directors of all 92 long day care centres in western S ydney to document the occurrence of communicable disease outbreaks dur ing 1992 and to identify risk factors for the occurrence of these outb reaks. A total of 6092 children were enrolled at the centres, of whom 530 (8.7%) were less than 3 years old. Most centres (80.4%) reported a t least one outbreak of communicable disease, Diarrhoea was the most c ommonly reported outbreak type (60 outbreaks), followed by conjunctivi tis, head louse infestation and chicken pox (46, 44 and 24 outbreaks, respectively). Chicken pox outbreaks had the largest mean number of ca ses per outbreak (9.6) and the longest mean outbreak duration (4.4 wee ks). Centres with a large total enrolment (50 or more children), those that were open for 12 or more hours each day and those which had comm enced operating in 1990 or more recently were generally more likely to report outbreaks, particularly of diarrhoea. The vast majority of com municable disease outbreaks (92.1%) were handled by day-care staff wit hout seeking outside assistance. Day-care centre directors may be unaw are of the health services that could help them. We need to work more closely with long day care centres, and to focus preventative efforts on large centres, those open for long hours, and newly opened centres.