A web-based system that allows preschools and child care centers to report illnesses to local public health departments could improve the detection of disease outbreaks and allow resources to be mobilized more quickly.

Children under age 5 generally become sick earlier and more frequently than school-aged children and adults because their immune systems are underdeveloped. Young children often are responsible for spreading viruses to the rest of the community.

However, University of Michigan emergency physician Andrew N. Hashikawa, M.D., and colleagues have created a computerized system and tested it at four early learning centers in Michigan that head off disease outbreaks. Staff were trained to use the system daily to report any ill child. No confidential or identifying information was collected.

Data was entered into the system on illness type and symptoms in seven categories commonly seen in preschoolers: fever, influenza-like illness, pink eye, stomach illnesses (gastroenteritis), cold or respiratory symptoms, ear infections and rash. Staff also entered the age range of the ill child (infant, 0-12 months), (toddler, 13-35 months) or (preschooler, 36-59 months), daily attendance at their center, and action taken (for example, child brought to a physician). Researchers sent data electronically to the public health department weekly or more frequently if spikes in illness cases were seen.

Results presented at the American Academy of Pediatrics National Conference and Exhibition in San Diego showed that centers reported 188 individual episodes of illness from Dec. 10, 2013, through March 28, 2014. Nearly 15 percent were infants, 32 percent were toddlers and 54 percent were preschoolers. The most common illnesses reported were gastroenteritis (37 percent), fever (31 percent), cold (17 percent) and influenza (3 percent).

Data also revealed an unusually large increase in gastroenteritis cases during a two-day period, which was comparable to a countywide spike among schools reported three weeks later.

“Preliminary data suggest that using the online bio-surveillance in child care centers and preschools gives us an earlier detection and warning system because the younger children appeared to become sick first compared to middle school and high school aged children within the community,” says Hashikawa.

The presentation abstract is available here.

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