Managing infections Refer to this document for information on managing infections in children. Requirements for reporting vary across Canada. Find out which infections are reportable in your province/ territory by contacting your local public health unit. Reporting and Illness Transmission Signs/symptoms Infectious period Exclusion notifi cation Viral respiratory infections Viruses include: Viruses in the Common cold: Depends on Common cold: No. respiratory syncytial nose and throat Runny nose, cough, the virus but usually No, unless the child is virus, parainfl uenza spread by: direct sneezing, sore throat, 3 to 8 days (longer too ill to participate in virus, infl uenza, contact with headache, possibly for children with a all program activities. adenovirus, respiratory secretions fever. weakened immune rhinovirus, or contaminated system). Bronchiolitis, No, unless coronavirus, hands, indirect Bronchiolitis: croup, infl uenza, you suspect metapneumovirus. contact with toys, Cough, laboured Most infectious pneumonia: an outbreak. tissues, or other breathing, wheezing, while symptoms are Yes, until the child See page 175 for objects contaminated fever. present. is well enough to additional information. with respiratory participate in all secretions, or Croup: Hoarseness, program activities. droplets from barking cough, rapid, coughs and sneezes. laboured or noisy breathing, fever. Infl uenza: Fever, chills, cough, headache and muscle pains. Pneumonia: Fever, cough, rapid or laboured breathing, poor skin colour. Bacterial Bacteria usually Fever, cough, rapid or Usually not Yes, until the child No, unless pneumonia present in the nose laboured breathing, considered is well enough to pneumococcus and throat and can poor skin colour. contagious. participate in all or Haemophilus See pages 206, cause disease if they program activities. infl uenzae type B is 209 for additional get into the lungs. isolated during blood information. testing. Gastrointestinal infections Can be viral or Germs in stool spread by: direct contact (hand to mouth), or indirect contact with toys, other objects or surfaces bacterial. See page contaminated with stool. 186 for additional information. Campylobacter Bacteria usually Fever, diarrhea (often Bacteria excreted in Yes, if a child’s diarrhea Yes, by the testing ingested in with blood and/or stool for 2 to can’t be contained in laboratory. contaminated food or mucus in stool), 3 weeks. a diaper, or a toilet- (e.g., improperly cramps. trained child can’t Contact your local cooked poultry, Most contagious control his bowel public health unit if a unpasteurized milk) during the acute movements. child at your facility or water. illness. is diagnosed with Campylobacter Person-to-person gastroenteritis. spread by direct or indirect contact with stool can occur, especially among young children. 1 of 10 Content from Well Beings: A Guide to Health in Child Care. For more information, visit www.cps.ca. Managing infections Reporting and Illness Transmission Signs/symptoms Infectious period Exclusion notifi cation Clostridium diffi cile Bacteria are normally Diarrhea (sometimes Infectious as long as Yes, if a child’s diarrhea No. (C. diffi cile) found in soil and in with blood and/ diarrhea lasts. can’t be contained in the intestinal tract. or mucus in stool), a diaper, or a toilet- Antibiotic treatment cramps, fever. trained child can’t permits overgrowth control his bowel of C. diffi cile in the Most children under 1 movements. gut and may trigger year of age have no disease. symptoms, and most older children have a Person-to-person very mild illness. spread by direct or indirect contact with stool can occur. Escherichia Bacteria usually Starts as non-bloody Bacteria excreted Yes, until diarrhea Yes, by the testing coli O157 ingested in diarrhea, usually in stool for about a subsides and 2 stool laboratory. (E. coli) contaminated food progressing to visibly week. cultures (taken when (e.g., poultry, beef, bloody stools, with the child is no longer Contact your local milk, unpasteurized severe abdominal Infectious as long as receiving antibiotics) public health unit apple juice, raw pain. diarrhea lasts. test negative. if a child in your vegetables), or facility is diagnosed water contaminated with E. coli 0157 with animal or human gastroenteritis. feces. Also spread from person to person by direct or indirect contact with stool. Giardia Parasites in the stool Watery diarrhea, Infectious as long Yes, until diarrhea Yes, by the testing are spread from recurrent abdominal as cysts are in the subsides. laboratory. See page 187 for person to person by pain. stool, which can be additional information. direct or indirect for months. Contact your local contact with stool Some children public health unit or are ingested in experience chronic if a child at your contaminated food diarrhea with foul- facility is diagnosed or water. smelling stools, a with Giardia distended stomach gastroenteritis. and weight loss. In the case of an outbreak, authorities Many infected children may screen and/or have no symptoms. treat all children and staff , with or without symptoms. Rotavirus Viruses in the stool High fever, vomiting, Infectious just Yes, if a child’s diarrhea No. spread easily from followed within 12 to before onset of can’t be contained in See page 186 for person to person by: 24 hours by profuse, symptoms and as a diaper or a toilet- Contact your local additional information. watery diarrhea. long as 3 weeks trained child can’t public health unit Direct or indirect later. control her bowel if you suspect an contact with stool movements. outbreak (i.e., 2 to 3 and contaminated or more children have objects/surfaces. diarrhea within 48 hours). Salmonella typhi Bacteria in the stool Diarrhea, cramps, Infectious as long as Yes, until diarrhea Yes, by the treating (gastroenteritis or are spread from fever. bacteria are in the subsides and 3 stool physician and testing typhoid fever) person to person by stool, which can be cultures (taken when laboratory. direct or indirect for many weeks. the child is no longer contact with stool, receiving antibiotics) Inform your local or are ingested in test negative. public health unit contaminated food. immediately if a child or adult at your facility is diagnosed with S. typhi infection. Stool cultures for other children and staff may be required. 2 of 10 Content from Well Beings: A Guide to Health in Child Care. For more information, visit www.cps.ca. Managing infections Reporting and Illness Transmission Signs/symptoms Infectious period Exclusion notifi cation Salmonella Bacteria are Diarrhea, cramps, Infectious as long as Yes, until the child Yes, by the testing gastroenteritis usually ingested in fever. bacteria are in the is well enough to laboratory. (non-typhi) contaminated food stool, which can be participate in all (e.g., meat, poultry, many weeks. program activities. Contact your local eggs, unpasteurized public health unit dairy products, if a child at your vegetables and fruit). facility is diagnosed with Salmonella Person-to-person gastroenteritis. spread may occur from direct or indirect contact with stool. Reptiles and amphibians are also sources of infection. Shigella Bacteria in stool Watery diarrhea, Infectious as long as Yes, until diarrhea Yes, by the testing gastroenteritis spread from person with or without blood bacteria are in the subsides and 2 stool laboratory. to person by direct and/or mucus, fever, stool, which can be cultures (taken when or indirect contact cramps. up to 4 weeks. the child is no longer Contact your local with stool. receiving antibiotics) public health unit test negative. if a child at your facility is diagnosed with Shigella gastroenteritis. Other children, staff or household contacts with symptoms may need testing. Yersinia Bacteria are ingested Fever, diarrhea (often Infectious as long as Yes, if a child’s diarrhea Yes, by the testing gastroenteritis in contaminated with blood and/or bacteria are in the can’t be contained in laboratory. food (e.g., raw or mucus in stool). stool, which can be a diaper, or a toilet- undercooked pork, for up to 2 to trained child can’t Contact your unpasteurized milk) 3 weeks. control his bowel public health unit or water. movements. if a child at your facility is diagnosed Person-to-person with Yersinia spread is rare. gastroenteritis. Other illnesses Chickenpox Viruses in the throat Fever and itchy rash. Infectious for 2 days No. Children with mild Yes, in some (varicella) and from skin lesions Crops of small red before rash starts chickenpox can attend jurisdictions, by the spread easily from spots turn into fl uid- until all blisters have child care regardless of treating physician and For more information person to person fi lled blisters that crusted over and the state of their rash, testing laboratory. and important through the air, crust over within a dried (usually about as long as they feel well requirements, and can travel large few days and become 5 days after start of enough to participate in Contact your local see pages 198–99 and distances. itchy. rash). all program activities. public health unit if 375. there is an outbreak Viruses in skin lesions at your facility. Non- spread by contact immune children and with fl uid from staff may need to see blisters. a doctor right away. Preventive treatment Virus persists in the (vaccine or immune body for life and may globulin) may be recur as shingles. needed. Viruses can spread by contact with Notify all shingles if lesions parents and staff are not covered. immediately. 3 of 10 Content from Well Beings: A Guide to Health in Child Care. For more information, visit www.cps.ca. Managing infections Reporting and Illness Transmission Signs/symptoms Infectious period Exclusion notifi cation Cold sores Viruses spread from Range from no Infectious for at No, for a child with No. (herpes simplex type person to person by symptoms to a simple least a week during simple cold sores. 1 virus) direct contact of cold sore or many the fi rst infection.