Health Education

Illness in the Day Care Setting

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The transmission of disease in day care setting is clearly dependent on the type of child-care arrangement. It seems only logical that the larger the group of children, the more likely it is that any particular child will contact an illness. Indeed, periodically there are reports in newspapers and magazines describing epidemics of diarrhea, lice, meningitis and respiratory disease. What has not been evaluated however is whether these same children who are at higher risk in the first few years, are less likely to develop similar diseases during the school age years. And who is to say that that would not be a reasonable tradeoff.

What can be done to prevent illness?

Each child-care program must have a policy on preventing and dealing with illness. As you observe the program, watch carefully to see if there is frequent hand washing with soap and water. Liquid soap dispensers should be available and sanitizing solutions should be available for treatment of common surfaces and toys. Check out the food preparation area. There should be a dishwasher for sterilization of reusable utensils. Dishtowels should not be utilized.

What happens if a child is sick?

Each program should have a policy of exclusion, the types of illnesses that would preclude participation in the day care program. This policy should exist for any setting of 2 or more children and should be modified only on the advice of a physician. The policy should be in writing and should be made available prior to enrollment. You will be called frequently, to pick up your child because he/she has been exposed to…. any number of illnesses. If you have any questions, please call and perhaps we can resolve the matter before you waste too many days of work.

What types of illness should children be excluded from daycare?

  • Conjunctivitis, which is the inflammation of the conjunctiva or lining of the eye. This is commonly caused by a virus and is potentially contagious for a few days. If caused by a bacterium, it may be treated and rendered non–infectious within 24 hours.
  • Skin infections such as impetigo. Such superficial infections require antibiotic therapy and the child will no longer be contagious after 24 hours.
  • Diarrhea, particularly bloody diarrhea. Usually, this requires immediate removal from day care. But how diarrhea is defined is a good question to ask up front.
  • Rashes like chickenpox are a no-no, and anyone exposed is likely to develop the disease 10-14 days down the road.
  • Pinworms. Unfortunately, this parasite has usually already infected everyone else and it is usually cheaper, and equally safe, to treat everyone.
  • Lice is another embarrassing disease, as common in upper class families as in lower class families.
  • Colds, ear infections, sinusitis and many other diseases do not require exclusion from day care and many of the aforementioned illnesses can be cared for quite well without spread if the day care provider is interested in going the extra mile. Remember, day care providers make the policy; we don’t, so no matter what we say, you may not get your child back in.