Epidemiology of infections in children's day care centres.

Children attending day care centres are more open to the risk of infection and repeated infection than children who are looked after at home. Most inf ections involve the upper respiratory tract; they are usually benign, bur i t is also possible that they have repercussions on the child's health. Furt hermore, they lead to the repeated prescription of antibiotics, and thus si gnificant expense to the community. preventive measures should be taken, in the first place by respecting the basic rules of hygiene, which sometimes appear to have been overlooked. Infectious risk is influenced by the type o f day care structure, is higher during the initial attendance period, and i s maximum in the smaller day care centres. the younger the child's age at t he first infection, the greater the risk of he or she being exposed to recu rrent infectious episodes. these factors should be taken into account when determining the type of structure to be built, with family day care centres being given priority, as should the age factor: the age for admission to t he centre should be raised as a precautionary measure to prevent the spread of infection at an early age. Due to the excessive use of antibiotics, chi ldren attending day care centres are at high risk of acquiring and spreadin g penicillin-resistant pneumococcal strains. A more judicious use of antibi otics for seasonally-occurring upper respiratory tract infections, most of them of viral origin, could contribute to reducing the incidence and extent of this phenomenon. (C) 2000 Editions scientifiques et medicales Elsevier SAS.