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Transmission of Acute Gastroenteritis and Respiratory Illness From Children to Parents

Sacri, Anne Sylvia MD, MSc*; De Serres, Gaston MD, PhD*†; Quach, Caroline MD, FRCPC; Boulianne, Nicole RN, MSc; Valiquette, Louis MD, FRCPC§; Skowronski, Danuta M. MD, FRCPC

The Pediatric Infectious Disease Journal: June 2014 - Volume 33 - Issue 6 - p 583–588
doi: 10.1097/INF.0000000000000220
Original Studies

Background: Acute respiratory illness (ARI) and acute gastroenteritis (AGE) are the most common infections in children; the risk of such illness increases with daycare attendance. We estimated the risk of transmission of ARI and AGE from daycare attendees to their parents and describe measures used by families to prevent that transmission.

Methods: We performed a retrospective cohort study of parents and children 12–60 months of age attending childcare centers attended by ≥60 children in the greater Québec City area, Canada. Participants were contacted at home by phone to answer a standardized questionnaire on infections that occurred in children and parents during the winter period.

Results: Overall, 374 households and 608 participants were included. AGE and ARI occurred at an incidence of 8.7 and 19 episodes per 100 child-months, respectively. Transmission to parents occurred about once in every 3 episodes for both types of infections. AGE in parents caused more frequent work absenteeism than ARI (62% vs. 34%, P < 0.005) with slightly longer duration (23% vs. 15% missing ≥2 days). Hand hygiene with soap was the primary household preventive measure. The 2009 pandemic may have positively influenced home hand hygiene practices overall but alcohol-based disinfection was infrequently applied.

Conclusions: Parental risk and impact of AGE and ARI acquisition from their children are substantial. ARI occur more frequently overall among children, but parental work loss appears greater with AGE transmission. Our findings suggest that preventive practices to reduce the risk of secondary ARI and AGE transmission to parents warrants greater emphasis, evaluation and education.

Supplemental Digital Content is available in the text.

From the *Université Laval, Québec; Institut national de santé publique du Québec; The Montreal Children’s Hospital–McGill University Health Center, McGill University, Montreal; §Université de Sherbrooke, Sherbrooke, QC, Canada; and British Columbia Center for Disease Control, British Columbia, Canada.

Accepted for publication November 18, 2013.

This study has been funded by the Institut national de santé publique du Québec and the British Columbia Ministry of Health. The author has no other funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (

Address for correspondence: Gaston De Serres, MD, PhD, 2400 d’estimauville, Quebec, QC, G1E 7G9, Canada. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.