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Interventions needed to reduce spread of respiratory, GI infections from children to parents
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There is a substantial risk of parents contracting acute gastroenteritis and acute respiratory illnesses from their children, according to recent study findings published in The Pediatric Infectious Disease Journal.
“[Acute respiratory illnesses] occur more frequently overall among children, but parental work loss appears greater with [acute gastroenteritis] transmission,” the researchers wrote. “Our findings suggest that preventive practices to reduce the risk of secondary [acute respiratory illness] and [acute gastrointestinal] transmission to parents warrants greater emphasis, evaluation and education.”
Gaston De Serres, MD, PhD, of the Université Laval in Quebec, Canada, and colleagues conducted a retrospective cohort study of 374 households and 608 parents and children aged 12 to 60 months to determine the risk of transmission of acute respiratory illness (ARI) and acute gastroenteritis (AGE) from day care attendees to their patients. Researchers also sought to determine methods used by families that prevent transmission.
Gaston De Serres
There were 42% episodes of at least one AGE and 65% episodes of at least one ARI among 374 children. Forty percent of the 257 parents whose children had AGE acquired it within the week after their child’s illness. Thirty-six percent of the 395 parents who children had ARI acquired it within the week after their child’s illness.
Eighty-six percent of children with AGE had to stay home from child care centers. Ninety-three percent of children with ARI also had to stay home from child care centers. Sixty-two percent of parents with AGE missed work due to the illness compared with 32% with ARI.
Eighty-two percent of households with AGE and 78% with ARI used hand-washing with soap as a method for preventing transmission. Disinfection of surfaces was used twice as much for AGE (61%) compared with ARI (28%). The same was true for sheet washing (16% for AGE vs. 6% for ARI). Twenty-two percent of families reduced contact with the ill child for both illnesses.
“In summary, parental risk and impact of AGE and ARI transmission from their children may be substantial,” the researchers wrote. “Given the limitations of this retrospective study, prospective studies inclusive of microbiological confirmation are needed to confirm secondary parental ARI and AGE incidence estimates and to evaluate the effectiveness of preventive practices in the household to limit transmission.”
Disclosure: The study was funded in part by the British Columbia Ministry of Health and the Institut national de sante publique du Quebec.
Perspective
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Shawn L. Ralston, MD
Sacri and colleagues performed a survey of parents of children attending day care centers in Quebec, Canada, intended to answer the question: “How often do our children make us sick?” The answer, it seems, is fairly frequently.
The investigators surveyed a sample of 608 parents obtained from 19 child care centers serving a population with generally higher than average socioeconomic status and education levels who had children at least 12 months of age at the time of the survey. The survey retrospectively assessed the child’s experience with acute respiratory infection (ARI) and acute gastroenteritis (AGE) in the preceding 4 to 6 months and took place during 2009 and 2010, with an interruption due to the H1N1 influenza outbreak.
Parents reported 42% of children had at least one episode of AGE and 65% at least one episode of ARI for a rate of 8.9 AGE episodes per 100 child-months and 18.7 ARI episodes per 100 child-months. These estimates were susceptible to recall bias since the survey was retrospective; however, they were similar to other published reports. The most interesting findings from the survey were that 40% of parents reported contracting AGE in the week after their child’s illness and 36% reported contracting ARI. AGE episodes resulted in 62% of parents reporting missing work due to their own illness, whereas ARI resulted in significantly fewer (32%) parents reporting missed work days. While the investigators assessed for any association between reported infection control practices and intrafamilial transmission of disease, they felt these associations were most likely due to recall and social desirability bias.
Certainly, given the number of missed parental work days reported in this cohort, future investigations focused on how to keep our children from making us sick would be a welcome addition to the literature.
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