Web system spots preschool disease outbreaks early

A Web-based surveillance system could enable preschools and childcare facilities to identify disease outbreaks in their early stages and take prompt measures to nip them in the bud, researchers reported at the American Academy of Pediatrics National Conference in San Diego.

Researchers designed a Web-based biosurveillance program, SickChildCare.org, especially for preschools and childcare centers and tested it at 4 early learning centers in Michigan. They trained staff to use the program daily to report any sick child requiring immediate exclusion from the center or isolation and observation at the center, and any child reported absent by parents.   

Staff entered data on 7 categories of illness-fever, influenza-like illness, conjunctivitis, gastroenteritis, cold symptoms, ear infections, and rash; age ranges-infants aged 0 to 12 months, toddlers aged 13 to 35 months, and preschoolers aged 36 to 59 months; daily attendance at the center; and outcome of each case (such as medical attention required). They didn’t enter confidential or identifying information. Sickchildcare.org generated and sent reports electronically to the local health department at least weekly and more often if spikes in illness occurred.

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Between December 10, 2013, and March 28, 2014, the centers reported 188 individual episodes of illness: 14.4% in infants, 31.9% in toddlers, and 53.7% in preschoolers. The most-often reported illnesses were gastroenteritis (37.2%), fever (30.9%), colds (16.5%), and influenza (3.2%). An unusually large spike in gastroenteritis at the centers over one 2-day period was comparable to a spike in the county schools reported 3 weeks later by the local public health department.

Web-based surveillance can quickly and efficiently report evolving infectious disease trends compared with cumbersome paper-based systems, the researchers conclude. Using such systems in preschools and childcare centers has the potential to provide an early warning system for disease outbreaks, and improve public health response, because children aged younger than 5 years often become sick before school-aged children and spread infection in the community. 

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