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Infectious Disease in Childcare Settings Manual

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Infectious Disease in Childcare Settings Manual INFECTIOUS DISEASES IN CHILDCARE SETTINGS Informational Guidelines for Directors, Caregivers, and Parents Third Edition July 2013 Department of Health and Social Services Delaware Division of Public Health Office of Infectious Disease Epidemiology Thomas Collins Building 540 S. DuPont Highway Dover, Delaware 19901 302-744-1033 888-295-5156 Childcare Manual Table of Contents Page About this book 5 Chapter 1 Introduction: Keeping Children Healthy 6 Chapter 2 Health History and Immunizations for Children 7-8 Health History and Immunizations for Caregivers 9 Immunization Schedule 10 Things You Need to Know about Immunizations 11-12 Chapter 3 Infection Overview: 13-14 Infection Spread by Direct Contact with People or Objects Infection Spread by the Fecal-Oral Route Infection Spread by the Respiratory Route Infection Spread through Blood, Urine, and Saliva Chapter 4 Infection Control Measures: Sanitation and Disinfection 15 Washing and Disinfecting Bathrooms and other Surfaces 16 Washing and Disinfecting Diaper Changing Areas 16 Washing Potty Chairs and Toilets 16-17 Washing and Disinfecting Clothing, Linen and Furnishings 17 Washing and Disinfecting Toys 17-18 Cleaning up Body Fluids 18 Handwashing 19-21 Hand Washing Steps and Diagram 21 Diaper Changing Steps 22-23 Food Safety and Sanitation 24-25 Breast Milk and Infectious Disease Exposure 26 Proper Handling and Storage of Breast Milk 27 Pets in the Childcare Setting 28-29 Chapter 5 Health of Childcare Providers Health Appraisals 30 Health Limitations of Staff 30 Health Risks for Pregnant Childcare Providers 31 Chapter 6 The Sick Child: Daily Health Assessment Check 32 When to get Immediate Medical Help 32 Exclusion Criteria 33 Provider Exclusion/Re-admittance Criteria 33-34 Delaware Reportable Diseases 35 Chapter 7 Oral Health: Tooth Decay 36 Avulsion (Tooth Loss by Trauma) 2 Childcare Manual Chapter 8 Quick Reference Sheets – Fact Sheets: 37 Asthma 38 Baby Bottle Tooth Decay 39 Bacterial Meningitis 40 Biting Incidents 41 Campylobacter Infections 42 Chickenpox (Varicella) 43 Cold Sores 44 Common Cold 45 Cryptosporidiosis 46 Cytomegalovirus (CMV) 47 Diarrheal Diseases 48 Diphtheria 49 Earache (Otitis Media) 50 Escherichia coli 0157:H7 Infections 51 Fifth Disease (Human Parvovirus B19) 52 Foodborne Illnesses 53-54 Giardiasis 55 Hand-Foot-Mouth Disease (Coxsackie A) 56 Head Lice (Pediculosis Capitis) 57-58 Hepatitis A 59 Hepatitis B 60 Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) 61-62 Impetigo 63 Infectious Mononucleosis 64 Influenza 65 Injuries - Intentional/Unintentional 66-67 Lyme disease (non-infectious) 68 Measles 69 Mumps 70 Pertussis (Whooping Cough) 71 Pinkeye (Conjunctivitis) 72 Pinworms 73 Pneumonia 74 Respiratory Syncytial Virus (RSV) 75 Ringworm (Tinea) 76 Roseola (Human Herpesvirus 6) 77 Rotavirus 78 Rubella (German Measles) 79 Salmonella 80 Scabies 81 Shigellosis 82 Strep Throat (Streptococcal Pharyngitis) and Scarlet Fever 83 Sudden Infant Death Syndrome (SIDS) 84-85 Tetanus 86 Tuberculosis (TB) 87 Urinary Tract Infection (UTI) 88 West Nile Virus 89 Yeast Infections (Thrush/Diaper Rash) 90 3 Childcare Manual Chapter 9 Parent/Guardian Alert Sample Letters 91 Campylobacter 92-93 Chickenpox 94-95 Conjunctivitis 96-97 E.coli 0157:H7 98-99 Fifth Disease 100-101 Giardia 102-103 Hib Disease 104-105 Hand-Foot-Mouth Disease 106-107 Head Lice 108-111 Hepatitis A 112-113 Impetigo 114-115 Meningococcal Illness 116-117 Pinworm 118-119 Ringworm 120-121 Salmonella 122-123 Scabies 124-125 Shigella 126-127 Strep Throat 128-129 Chapter 10 Bioterrorism: 130 Creating Written Emergency Plans for Natural & Man-made Disasters Chapter 11 Role of the Health Care Consultant in Childcare and Schools 131-132 Glossary 133-136 Resources 137-141 References 142 4 Childcare Manual About This Book This manual is the 3rd edition of the Infectious Diseases in Childcare Settings. It was developed as a tool to encourage common understanding among caregivers, teachers, families, and healthcare professionals about infectious diseases and to aid with efforts for reducing illnesses, injuries and other health problems in childcare settings. This guide explains the health history of immunizations, ways to prevent and control the spread of communicable diseases, symptoms of common infections seen in childcare settings, how infections are spread, when to seek medical care, inclusion/exclusion criteria, fact sheets, and sample letters to give to parents. The information in this guide is based on the latest recommendations addressing health and safety in childcare settings from the following organizations: • American Academy of Pediatrics • American Public Health Association • US Department of Health and Human Services • Centers for Disease Control and Prevention Should you have concerns regarding the contents of this manual, please direct your inquiries to: Department of Health and Social Services Delaware Division of Public Health Office of Infectious Disease Epidemiology Thomas Collins Building 540 S. DuPont Highway Dover, Delaware 19901 302-744-1033 888-295-5156 5 Childcare Manual Chapter 1 Introduction: Keeping Children Healthy Delaware’s early care providers, teachers, families and health professionals are committed to keeping all children healthy. As families enter the workforce, they must rely on childcare centers to provide a safe, healthy and caring environment for their child. These children are very susceptible to contagious diseases because they have not been exposed to many infections (e.g., viruses, bacteria, parasites, fungi) and have no resistance to them, or have not received recommended immunizations. Therefore, children are acquiring infections at an earlier age. A variety of infections have been documented in children attending childcare, sometimes with spread to caregivers and to others at home. Infants and toddlers have high hand to mouth activity. They play and eat close together. Their hygiene habits and immune systems are not well developed. In addition, wherever there are children in diapers, the spread of diarrheal diseases may readily occur as the result of poor or inadequate handwashing, diaper changing and environmental sanitation measures. In general, sending home (excluding) mildly ill children is not an effective way to control the spread of most germs. Individuals who are not ill or never become ill can spread many infections. All of these factors make infections in childcare settings common and fast spreading. This manual contains disease fact sheets specifically meant for childcare settings. It explains ways to recognize and minimize the spread of infectious diseases. These fact sheets may be distributed to parents and staff; fact sheets will help staff determine when children should be sent home or readmitted to your facility. 6 Childcare Manual Chapter 2 Health History & Immunizations Policy for Children in Childcare You need to know the health history and medical emergency information for every child in your care. When a child enrolls in your childcare facility, you should find out: • Contact information for parents with names, addresses, work, home and cell phone numbers. • Two secondary contacts if parents cannot be reached (with same contact information as above). • The child's regular healthcare provider with name, address, and phone numbers. • The hospital that the child's family uses with name, address, and phone numbers. • The date of the child's last physical examination. Any child who has not had a well baby or well child examination recently (within the past 6 months) should be examined within 30 days of entering your childcare facility. • Any special health problems or medical conditions that a child may have and procedures to follow to manage with these conditions (e.g. allergies, asthma, diabetes, seizures, sickle cell disease). These conditions can cause sudden attacks that may require immediate action. • You should know: • What happens to the child during a crisis related to the condition. • How to prevent a crisis • How to help manage a crisis • Whether you need training in a particular emergency procedure. • The child's current immunization status. You should assure that all children admitted to your facility are up to date on their vaccinations. The State of Delaware requires you to have written proof of each child's vaccinations. Children attending childcare especially need all of the recommended vaccinations to protect themselves, the other children, the childcare provider, and their families. Several diseases that can cause serious problems for children and adults can be prevented by vaccination. These diseases are chickenpox, diphtheria, Haemophilus influenzae certain types of meningitis, hepatitis A and B, influenza, measles, mumps, pneumococcal disease, polio, rubella (German measles or 3-day measles), tetanus, and whooping cough (pertussis). Many of these diseases are becoming less common because most people have been vaccinated against them. However, cases still occur and children in childcare are at increased risk for many of these diseases because of the many hours they spend in close contact with other children. State law requires that all children undergo lead screening at 1 year of age. Medicaid children must also be screened again at 2 years of age. Children who are not up to date on their vaccinations should be taken out of childcare (excluded) until they have begun the series of shots needed. Each child in your care should have an Immunization certificate on file at the facility. Each child shall also
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