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Internists should be aware of the increased frequency of most communicable diseases among parents and child care providers exposed to children attending child day care centers. Episodes of shigellosis and hepatitis A among adults in contact with children in day care centers should be promptly reported to public health authorities, since they may indicate the presence of a day care center outbreak for which effective control measures are available. Although effective treatment or intervention is limited or not available for many other infections acquired by adults from children in day care centers, significant illness may result in a minority of individuals at increased risk for infection with agents such as cytomegalovirus and varicella. Acute infectious diseases of children caused by organisms transmitted from day care center staff are less common and largely preventable by ensuring that staff are appropriately immunized and screened for tuberculosis.
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