title: [Experience on the management of a hepatitis A outbreak in a children daycare center].
abstract: BACKGROUND
  Since hepatitis A virus is transmitted via the fecal-oral route, outbreaks in nurseries are favored by constant diaper changes and failures in hygienic measures. The purpose of this investigation was to describe an outbreak of hepatitis A between November 2012 and February 2013 at a nursery in Mexicali, Baja California, as well as the measures adopted for its control.
  
  
  METHODS
  A descriptive study was conducted on the outbreak and the control measures, calculating the rates of attack and establishing proportions using the Wilson's scale. Pupils, workers or family members with symptoms consistent with hepatitis A were considered to be suspected cases. First-occurrence hepatitis A records were reviewed on the Weekly Disease Surveillance Report at the involved medical units and on the nursery's infirmary records.
  
  
  RESULTS
  The global attack rate was 13.1 %, and in those captive in the nursery, 9.5 %. Jaundice, biliuria and abdominal pain were the most important clinical data. There were no deaths or hospitalizations. The outbreak lasted 86 days. Control measures were based on epidemiological surveillance reinforcement and preventive hygienic measures.
  
  
  CONCLUSIONS
  The outbreak showed a spreading trend, it affected mainly children and showed the importance of health education and epidemiological surveillance maintenance, extensive to the familial setting.
authors.affiliation: Coordinación de Vigilancia Epidemiológica, Instituto Mexicano del Seguro Social, Distrito Federal, México. dcpreventiva@gmail.com.
authors.forename: David Alejandro
authors.initials: DA
authors.lastname: Cabrera-Gaytán
authors.forename: Martha Lorena
authors.initials: ML
authors.lastname: Nava-Martínez
authors.forename: David
authors.initials: D
authors.lastname: Ontiveros
authors.forename: María Rosario
authors.initials: MR
authors.lastname: Niebla-Fuentes
authors.forename: Concepción
authors.initials: C
authors.lastname: Grajales-Muñiz
authors.forename: Teresita
authors.initials: T
authors.lastname: Rojas-Mendoza
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D016358:Contact Tracing; D004196:Disease Outbreaks; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Child day care centers; Disease outbreaks; Hepatitis A