Transmission and control of infections in out-of-home child care.

The epidemiology of infections associated with out-of-home child care is well-known, but our understanding of cost-effective prevention strategies is limited. Existing studies indicate that multidimensional interventional programs can reduce infection rates, but these conclusions are limited by a variety of methodologic concerns. Important areas for future research are to determine the critical elements of effective intervention programs, whether improvements in infection rates can be sustained over long periods and the costs of implementing and sustaining these programs.