Open Access Study protocol

The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol

Remko Enserink13*, Harold Noel13, Ingrid HM Friesema1, Carolien M de Jager1, Anna MD Kooistra-Smid4, Laetitia M Kortbeek2, Erwin Duizer2, Marianne AB van der Sande13, Henriette A Smit3, Wilfrid van Pelt1* and on behalf of the Sentinel Surveillance Network of Infectious diseases in Child Day Care Centers (the KIzSS network)

Author Affiliations

1 Center for Infectious Disease Control (Epidemiology and Surveillance Unit), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

2 Center for Infectious Disease Control (Laboratory for Infectious Diseases and Perinatal Screening), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

3 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

4 Laboratory for Infectious Diseases, Department of Research and Development, Groningen, The Netherlands

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BMC Infectious Diseases 2012, 12:259  doi:10.1186/1471-2334-12-259

Published: 15 October 2012



Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network). The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics.


The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff), medical consumption, absenteeism and circulating enteric pathogens (children) are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers.


The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (bio)databases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.

Day care; Infectious disease; Public health; Surveillance; Study design