ACTIVE AND PASSIVE SURVEILLANCE FOR COMMUNICABLE DISEASES IN CHILD-CARE FACILITIES, SEATTLE-KING COUNTY, WASHINGTON

Objectives. The purpose of this study was to develop and evaluate mode ls for public health-surveillance of illnesses among children in out-o f-home child care facilities. Methods. Between July 1992 and March 199 4, 200 Seattle-King County child care facilities participated in activ e or enhanced passive surveillance, or both. Reporting was based on ea sily recognized signs, symptoms, and sentinel events. Published criter ia were used in evaluating surveillance effectiveness, and notifiable disease reporting Of participating and nonparticipating facilities was compared. Results. Neither surveillance model was well accepted by ch ild care providers. Enhanced passive and active surveillance had compa rable sensitivity. Reporting delays-and the large amount of time neede d for data entry led to problems with timeliness, especially, in terms of written reporting during active surveillance. Conclusions. Widespr ead active public health surveillance in child cafe facilities is not feasible for most local health departments; Improvements in public hea lth surveillance in child care settings will depend on acceptability t o providers.