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The Effects of Hygiene Standards Pre- and Post- COVID-19 Shutdown on Fever and Diarrhea Incidence in a Daycare

Abstract

Background: One of the most broadly available forms of child care in the United States is a childcare program (CCP). Because of the nature of CCPs, children and their caregivers interact closely within confined spaces, creating op-portunities for infectious agent transmission. We hypothesized that a reduction in the room’s population density due to requirements related to the COVID-19 outbreak would lead to a reduction in incidence of disease symptom presentation.

Methods: For this observational study, data were collected beginning in January 2018 and lasting until May 2021 from a university-run CCP. Searches of email communications between caregivers and parents were conducted to look for disease exposure notices and phrases related to enteric illness. Zero-inflated Poisson models were used to look for significant influences affecting incidence rates.

Results: Our modeling found limited evidence for seasonality in fever and diarrhea incidence rates. However, there was significant evidence that an increase in attendance was associated with a decrease in fever and an increase in diarrhea incidence. The data also indicated lower fever incidence before the COVID-19 shutdown with an increase in fever incidence as time after shutdown increased.

Conclusion: This study shows evidence of a relationship between rising attendance and increasing transmission events and begins to quantify the impact of CCPs on disease transmission in infants.

Keywords: Infant, Fever, Diarrhea, COVID-19, Observational Study

How to Cite:

Cox, J. L., Salerno, M. C., Winston, J. A., Baker, K. K., Lee, J. & Garabed, R. B., (2025) “The Effects of Hygiene Standards Pre- and Post- COVID-19 Shutdown on Fever and Diarrhea Incidence in a Daycare”, Ohio Journal of Public Health 7(2), 1-6. doi: https://doi.org/10.18061/ojph.6414

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Authors

  • Jeremiah L. Cox (The Ohio State University)
  • Matthew C. Salerno (The Ohio State University)
  • Jenessa A. Winston (The Ohio State University)
  • Kelly K. Baker (University at Buffalo, State University of New York)
  • Jiyoung Lee (The Ohio State University)
  • Rebecca B. Garabed (The Ohio State University)

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