Primary Care Research

Alcohol-based hand gel use may reduce respiratory illness transmission in homes with young children enrolled in day care

Over 7 million children younger than age 5 were enrolled in child care in the United States in 1999. These children introduced over half of viral upper respiratory and gastrointestinal (GI) infections into their homes.

Use of alcohol-based hand gels may reduce the rate of transmission of respiratory infections from these young children to other family members, suggests a study that was supported in part by the Agency for Healthcare Research and Quality (T32 HS00063). Illness transmission typically occurs when family members kiss sick children, touch objects they have touched, and/or change their diapers, notes Grace M. Lee, M.D., M.P.H., of Harvard Pilgrim Health Care and Harvard Medical School.

Dr. Lee and her colleagues analyzed transmission rates for respiratory and GI illnesses among 208 ethnically diverse families with children enrolled in child care who were treated at five suburban practices in the Boston area. The researchers mailed the families a survey and symptom diary to record the timing and duration of respiratory and GI illnesses that occurred among family members within 2 to 7 days after a primary illness was introduced into the home. A total of 1,545 respiratory and 360 GI illnesses occurred in the 208 families from November 2000 to May 2001.

Of these, 71 percent of respiratory and 83 percent of GI illnesses were considered primary illnesses introduced into the home, and children younger than 5 were responsible for introducing 54 percent of the illnesses. The secondary transmission rates for respiratory and GI illnesses were 0.63 and 0.35 illnesses per susceptible person-month, respectively.

Twenty-two percent of respondents reported use of alcohol-based hand gels, and 33 percent reported always washing their hands after blowing or wiping a nose. After adjusting for several factors, including education and insurance status, use of alcohol-based hand gels had a protective effect against respiratory illness transmission in the home.

See "Illness transmission in the home: A possible role for alcohol-based gels," by Dr. Lee, Joshua A. Salomon, Ph.D., Jennifer F. Friedman, M.D., M.P.H., and others in the April 2005 Pediatrics 115(4), pp. 852-860.

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