Infectious diseases and daycare and preschool education.

OBJECTIVE To describe the increased risk of acquiring infectious diseases associated with out-of-home childcare and the effectiveness of measures for the control and prevention of diseases transmission at daycare and preschool education centers. SOURCES A review of literature in the MEDLINE, LILACS and Cochrane Library databases, found using the descriptors daycare, infection, infection control and infectious diseases and focusing on studies that have compared the risk of infectious diseases for children cared for in and out of the home, related risk to the type of out-of-home care and assessed the effectiveness of preventative measures. SUMMARY OF THE FINDINGS Children cared for at daycare or in preschool education exhibit a two to three times greater risk of acquiring infections, which impacts both on individual health and on the dissemination of diseases through the community. Among other factors, the risk is associated with the characteristics of daycare centers, and simple preventative measures are effective for reducing transmission of diseases. Recommended measures include: appropriate hand washing after exposure; employment of standard precautions; standardized routines for changing and disposal of used diapers, location and cleanliness of changing area, cleaning and disinfection of contaminated areas; use of disposable tissues for blowing noses; separate workers and area for handling foods; notification of infectious diseases; training of workers and guidance for parents. CONCLUSIONS In the face of growing utilization of daycare and preschool education and their association with increased risk of acquired infections, control measures are indispensable to the prevention and control of infectious diseases.