Infectious disease defined
An illness caused by germs that can be transmitted from an infected person via infected stool, body fluid or respiratory spray (i.e., coughing or sneezing), directly or indirectly to another person.
[ms_panel title=”Definition” title_color=”#000″ border_color=”#ddd” title_background_color=”#f5f5f5″ border_radius=”0″ class=”” id=””]The term “germ” refers to microorganisms such as bacterium, virus, fungus, or parasites.[/ms_panel]
[ms_dropcap color=”” boxed=”no” boxed_radius=”8″ class=”” id=””]1[/ms_dropcap] Ensure up-to-date immunizations1
Immunizations are vaccines that help children develop protection against specific infections. Routine immunization at the appropriate age is the best way to prevent vaccine-preventable diseases such as measles, whooping cough, etc.
What the regulations say about immunizations
Type I centers and Type II licensed homes (922 KAR 2:110) The following records shall be maintained at the child care facility for five (5) years [Sec 3(3)]: Except as provided in KRS 214.036, a current immunization certificate showing that the child is immunized pursuant to 902 KAR 2:060 shall be on file within thirty (30) days of enrollment.
Certified family child care homes (922 KAR 2:100) To assure a healthy environment, the provider shall maintain a current immunization certificate for each child within thirty (30) days of enrollment [Sec 10 (40a)], unless an attending physician or parent objects to the immunization of a child pursuant to KRS 214.036.
Registered Child Care Provider (922 KAR 2:180)
To assure a healthy environment, each child shall have a current immunization certificate, unless: there is an exception pursuant to KRS 214.036.
Resources
Kentucky child care regulations
[ms_panel title=”Credits ” title_color=”#000″ border_color=”#ddd” title_background_color=”#f5f5f5″ border_radius=”0″ class=”” id=””]
Current Immunization Schedule from the Center for Disease Control and Prevention[/ms_panel]
[ms_dropcap color=”” boxed=”no” boxed_radius=”8″ class=”” id=””]2[/ms_dropcap] Perform a daily health check
If you can minimize the number of sick children coming to your program, you can decrease the number of germs that are available to be spread.
As children arrive:
- Check for symptoms of illness.
- Exclude/isolate sick children.
Check for symptoms of illness1
Perform a health check when a child first arrives at your home or center and observe children throughout the day.
Look, listen, feel, and smell for the following possible signs of illness:
- Child complains of pain or not feeling well
- Fever
- Drainage from the nose, eyes, or ears
- Failure to urinate
- Severe coughing or sneezing
- Abnormal stool (white or gray bowl movement, diarrhea, etc.)
- Activity level, behavior or appearance seems different from normal
- Unusual odor
- Vomiting
- Sores, swelling, or bruises
- Breathing difficulties
- Skin rashes, discoloration of the skin, itchy skin or scalp
If the child has any of the symptoms listed previously, then determine the following:
- Does the child need immediate medical attention (e.g., if having an asthma attack or severe allergic reaction)?
- Should the child be isolated from the group and sent home based on your program’s exclusion criteria?
- Do additional measures need to be taken such as monitoring the child closely during the day, taking extra care when washing hands, etc.?
[ms_dropcap color=”” boxed=”no” boxed_radius=”8″ class=”” id=””]3[/ms_dropcap] Exclude and/or isolate sick children
Keep children with the following symptoms away from your home or center until a medical professional determines the child is not infectious (and never was) or is no longer infectious.
- Vomiting– Exclude until vomiting (two or more episodes in the previous 24 hours) stops. Make sure that the child gets plenty of fluids.
- Persistent stomach pain– Exclude if the pain continues for more than 2 hours or pain is associated with fever or other signs of symptoms.
- Mouth sores with drooling– Exclude until a medical exam indicates the child is not infectious.
- Rash with fever or behavior change– Exclude until a medical exam indicates these symptoms do not indicate an infectious disease.
- Eye drainage– If white or yellow eye discharge is present, exclude until 24 hours after treatment has begun or until after a health professional determines that the eye drainage is not due to a communicable disease.
- Fever
- Exclude a child who seems sick and has a temperature as indicated below:2
- Axillary (in the armpit) temperature of 100° F (or higher); OR
- Oral (in the mouth) temperature of 101° F (or higher).
- Get immediate medical attention when:
- Infants (under 4 months of age) have a temperature of 100° F, OR
- A child of any age has a temperature of 105° F or higher.
- Diarrhea or unexplained blood in stools– Exclude until diarrhea (more than one loose stool) stops or until a medical exam indicates that the condition is not due to an infectious disease.
- Head lice– Child does not need to be excluded immediately. Exclude child starting at the end of the day that the head lice were first noticed until after the first treatment.
- Additional signs and symptoms of possible severe illness-
To rule out severe illness, children should see a health care provider immediately if they are experiencing:
- Extreme tiredness or sluggishness.
- Uncontrolled coughing.
- Persistent crying.
- Difficulty breathing.
- Wheezing.
- Persistent or severe pain.
If a child is unable to participate in normal activities, or needs more care than can be provided by the staff, then that child should be excluded.
Children with chronic health conditions3
Chronic health conditions are different from infectious diseases because they:
- Are not contagious.
- May continue for a long time and have a long recovery period.
- May interfere with typical growth and development.
Some examples of chronic health conditions are: allergies, asthma, cancer, cystic fibrosis, diabetes, heart problems, hemophilia, rheumatoid arthritis, obesity, sickle-cell disease, and seizure disorder.
Most children with chronic health conditions do not need to be isolated or excluded from early care and education programs since the conditions are not contagious. Additionally, the Americans with Disabilities Act prohibits discrimination against children with disabilities, including chronically ill children4.
[ms_alert icon=”fa-info-circle” background_color=”#f5f5f5″ text_color=”” border_width=”0″ border_radius=”0″ box_shadow=”no” dismissable=”no” class=”” id=””]
Important Information
2 According to the KY Cabinet for Health and Family Services, glass thermometers should NOT be used in early care and education settings. Use a digital thermometer for children under 4 years of age. Exclude a child if his/her temperature is 101degrees F. or higher. For children over 4 years, digital ear thermometers or digital oral thermometers may be used. Forehead strips are not recommended since their accuracy has not been validated. Your program’s health policies may be more or less stringent. For additional information on excluding and/or isolating sick children, please contact the Child Care Health Consultant at your regional health department.
Kentucky Child Care Health Consultants contact information.
[/ms_alert]
[ms_panel title=”Credits” title_color=”#000″ border_color=”#ddd” title_background_color=”#f5f5f5″ border_radius=”0″ class=”” id=””]
These recommendations are based on health and safety standards in Caring for our children: National health and safety performance standards, Guidelines for out-of-home child care (3rd ed.).[/ms_panel]
What the regulations say about isolating/excluding sick children
Type I centers and Type II licensed homes (922 KAR 2:120)
A child showing signs of an illness or condition that may be communicable shall not be admitted to the regular child care program. If a child becomes ill during the day:
- The child shall be placed in a supervised area isolated from the rest of the children.
- The parent or person exercising custodial control shall be contacted immediately.
- Arrangements shall be made to remove the child from the child care facility as soon as practicable [Sec 7 (2, 3)].
Certified family child care homes (922 KAR 2:100)
A quiet, separate area that can be easily supervised shall be provided for a child too sick to remain with other children [Sec 10 (42)].
Registered Child Care Providers (922 KAR 2:180)
A quiet, separate area that can be easily supervised shall be provided for a child too sick to remain with other children.
[ms_panel title=”Credits” title_color=”#000″ border_color=”#ddd” title_background_color=”#f5f5f5″ border_radius=”0″ class=”” id=””]
Signs and Symptoms, a handout about Communicable Diseases.
Managing infectious diseases in child care and schools: A quick reference guide. Aronson, T. R. Shope. 2nd ed. Elk Grove Village, IL: AAP. Used with permission of the American Academy of Pediatrics, 2009
CHILD CARE HEALTH CONSULTANT PROGRAM The Child Care Health Consultant program was developed as part of the KIDS NOW Initiative to serve licensed and certified child care programs throughout Kentucky. The program consists of a network of child care health consultants who work with providers, children, and families on issues related to health, safety, and nutrition. Consultants provide a variety of services at no cost to the provider, including telephone/on-site consultation, clock hour trainings, and learning sessions for children. To contact a Child Care Health Consultant in your area, call your regional health department. Child Care Health Consultants and their contact information.[/ms_panel]
