Vaccine-preventable diseases and child day care.

Several diseases that now can be prevented by vaccines (diphtheria, measles, mumps, poliomyelitis, and rubella) have historically been widely transmitted in settings where children first congregate--primarily schools. Increasingly, children are brought together at younger ages in day care centers, and instances of these diseases have been recorded in day care settings. However, there have been few major outbreaks because of high immunization levels in these children. In 46 states, laws require immunization of children attending licensed day care facilities. Surveys show that children in day care have higher immunization levels than children of the same age who are not in day care. Because staff in day care can acquire and transmit communicable diseases, it is important that they also be immune.