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Michael T. Osterholm, PhD, MPH
Minneapolis

Joel N. Kuritsky, MD
Rockville, Md

Trudy V. Murphy, MD
Dallas

William C. Mead
Rochester, NY

JAMA. 1985;253(18):2647.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Redmond and Pichichero¹ report that child day-care attendees in Monroe County, New York, who are younger than 3 years of age are at an increased risk of primary Haemophilus influenzae type b (HIB) invasive disease. While child day-care attendance may increase the risk of primary HIB disease, we believe that because of deficiencies with the Monroe County study methodology, the total number of children in day-care facilities younger than 3 years of age was significantly underestimated, and, therefore, the risk of primary disease among this group was significantly overestimated. A recent study in Colorado determined that children in day-care facilities were at an increased risk of HIB infections; however, contrary to the Monroe County study, this increased risk was only for older children.²

The underestimation of child day-care attendance for the younger children in the Monroe County study occurred for three reasons. First, the authors . . . [Full Text PDF of this Article]

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