Childhood upper respiratory tract infections: to what degree is incidence affected by day-care attendance?

• Published in: Pediatrics (Evanston) 1987, Vol.79 (1), p.55-60
• Main Authors: FLEMING, D. W, COCHI, S. L, HIGHTOWER, A. W, BROOME, C. V
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Biological and medical sciences; Child Day Care Centers; Child, Preschool; Ent and stomatologic bacterial diseases; Georgia; Human bacterial diseases; Humans; Infectious diseases; Maternal Behavior; Medical sciences; Otitis Media - epidemiology; Otitis Media - transmission; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - transmission; Risk; Smoking
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.79.1.55

Risk factors for acute upper respiratory tract disease in childhood were evaluated in a population-based sample of the Atlanta metropolitan area. Mothers from 449 households containing 575 children less than 5 years of age were selected by random-digit dialing and questioned about upper respiratory tract infection and ear infection occurring in their children during the preceding 2 weeks. Household demographic and socioeconomic characteristics, maternal smoking history and child day-care attendance and breast-feeding information were also obtained. For children less than 5 years of age, the reported incidence of upper respiratory tract infection was 24%, and of ear infection, 6%. Controlling for the other variables measured, day-care attendance was associated with a significantly increased risk of both illnesses. For upper respiratory tract infection, increased risk was present for all children attending day care (P = .02, odds ratio = 1.6), whereas for ear infection, risk could be demonstrated only for full-time attendees (P = .005, odds ratio = 3.8). Maternal smoking was a second independent risk factor for a child's having upper respiratory tract infection (odds ratio = 1.7, P = .01). Thirty-one percent of all upper respiratory tract infection among day-care attendees and 66% of all ear infections among full-time day-care attendees were attributable to day-care attendance. Given the proportion of children in day care, 9% to 14% of the total burden of upper respiratory tract disease in this population was day care related.