Pediatricians Bring Tracking of Illnesses at Childcare Centers Online

Speedier identification of diseases like flu in daycares and pre-schools could help limit the scope of outbreaks


Packed with small kids who may have yet to make habits of covering their mouths when they sneeze or cough or of washing their little germy hands, a daycare can serve as ground zero for infectious diseases like influenza. Now, a team of pediatricians is trying to improve reporting of illnesses in childcare centers by replacing pen and paper reporting with a more nimble online illness tracker. By more quickly collecting and disseminating information about what’s making kids sick, the researchers hope to help childcare providers identify diseases and stem their spread.

Researchers from Kalamazoo College and the Medical College of Wisconsin, led by Dr. Andrew Hashikawa, a physician at the University of Michigan, enrolled four childcare centers in Washtenaw County, Michigan, in a four-month pilot study examining the effectiveness of an online system for reporting and tracking illnesses in about 600 preschool-aged children. When kids were kept home sick or needed to be picked up by an adult due to an illness, staffers reported the illness using an onilne form at, a site set up by Hashikawa and his colleagues with the aim of more efficiently capturing data about symptoms reported in young children and making that data easier to analyze. 

While similar reporting systems have been tested in schools to little effect, Hashikawa thinks that a group of preschool age kids makes a great petri dish for testing this kind of tracking. That’s thanks in no small part to how closely the kids themselves can resemble petri dishes.

“They’re in close contact, they have immature immune systems, they’re slobbering over each other,” Hashikawa told IEEE Spectrum prior to his presentation at the American Academy of Pediatricans conference in San Diego.

Young children in childcare, Hashikawa says, could also make more reliable indicators of disease spread than older kids because their sick days are more likely than others to be days when they’re actually sick, something that’s not always the case with middle school and high school students. And since childcare centers don’t take summer breaks, the reporting can also run year round without gaps in information gathering. 

According to Hashikawa, Washtenaw County made a good testing ground for the pilot programs because childcare workers are already required to turn over data on sick kids to public health agencies. The process for doing so, though, is pretty antiquated. 

“Flu-like [symptoms] and stomach flu cases are reported on a weekly basis on paper,” Hashikawa says. “Those are faxed to the public health department of the community, and then someone puts it into a spreadsheet.” The result is a well-intentioned reporting system that lags well behind the actual spread of illness in a community.

During the pilot program, gathered 188 instances of illnesses in children. Included in that data was a small outbreak of stomach flu that the online system identified in near real-time. Public health officials also noticed the outbreak in the faxed records—nearly three weeks after the fact.

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