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CHILD CARE HEALTH CONSULTATIONWWW.KENTUCKYCCHC.ORG
Common Childhood Illnesses
Northern Kentucky Health Department
Susan Guthier RN, BSN
Thanks to:Sandra K. Barbour RN
School Health CoordinatorAmy Brown
Child Care Health Consultant
Class Objectives
Causes of Disease Pathogens Describe some commonly seen
Childhood Illnesses Prevention Hand Washing for Children
Keeping children healthy is a goal of caregivers/teachers, families and health professionals. However….
….there are many factors that can make staying healthy a challenge.
When children first enter group settings, their immune systems are still developing and they have not yet been exposed to many common germs that cause infections.
Infants and toddlers have high hand-to mouth activity. They play and eat close together, so they easily pass germs to each other.
It is important for families, caregivers/teachers, and health professionals to work together to promote healthy behaviors and prevent infections and disease.
Germ
Germ is the common term for a large variety of microbial agents that can grow in or on people. Some are harmless or even helpful.
Infection
Infection is the term usually used to describe a situation in which a germ causes disease. Germs include bacteria, viruses, parasites, and fungi.
Although not technically correct, sometimes infection is used to describe invasion of the body by higher organisms called parasites (e.g., worms, insects).
Causes of Disease Pathogens
Virus
Bacteria
Parasite
Fungus
Virus
The causative agent of an infectious disease
Has many characteristics of living cells
Capable of growth and multiplication in living cells
Bacteria
A living organism that is capable of causing disease
Normal flora
Parasite
An organism living in or on another
Derives its nutrition partly or wholly from the host
Fungus
An organism belonging to the kingdom of Fungi; a yeast, mold, or mushroom.
Modes of Transmission
Direct
Airborne - Respiratory
Fecal - Oral (Enteric)
Direct Contact
Any direct contact with infected person’s skin or body fluid
Chickenpox, cold sores, conjunctivitis, lice, impetigo, ringworm, scabies
Airborne
To spread infectious organisms to a suitable portal of entry, usually respiratory tract
Microbial aerosols or suspensions of particles in the air consisting of microorganisms
RespiratoryTransmission
Passes from the lungs, throat, or nose of one person to another person through the air
Diseases spread by Respiratory Transmission Chickenpox Common cold Diphtheria Fifth Disease Bacterial Meningitis Hand-Foot-Mouth
Impetigo Influenza Measles Mumps Pertussis Pneumonia Rubella
Fecal-Oral
Person to person
Animal to person
Waterborne
Foodborne
Fecal-Oral Transmission
Touching feces or objects contaminated with feces then touching your mouth
Or if food or water is contaminated with human or animal feces & is consumed
Improperly prepared foods
Fecal-Oral
Campylobacter E.coli Enterovirus Giardia Hand-Foot-Mouth Hepatitis A
Pinworms Polio Salmonella Shigella Infectious Diarrhea
Animals in child care
Animals can contribute to the transition of disease
Reptiles can carry Salmonella. Small reptiles that might be handled by children can easily transmit Salmonella to them
Iguanas, turtles, snakes, and lizards are not appropriate animals for child care centers
Blood Transmission
Spread when blood or body fluids from a person with an infection gets into the bloodstream of an uninfected person
Blood Transmission
Hepatitis B
Hepatitis C
Cytomegalovirus
HIV Infection
Common Foodborne DiseasesSpread by poor hygiene Hepatitis A Norwalk virus Shigella E-Coli Salmonella Staphylococcus aurous
COMMONLY SEEN ILLNESS IN EARLY CARE ENVIRONMENTS
Common Childhood Illnesses
Campylobacter
Bacteria found in many different birds or mammals
Leading cause of diarrhea among backpackers in some parts of the US
Contaminated water Can become infected by eating poorly cooked meats (poultry)
Chickenpox
Chickenpox is a vaccine preventable illness An acute, generalized viral disease Usually seen in children 2-8 years old Seasonal incidence - winter and spring Low grade fever, rash which progresses
from macules to papules to vesicals and then lesions scab
Spread from trunk to extremities and face
Chickenpox cont.
Intense itching
Communicable period 1-2 days prior to skin eruptions and until all lesions are scabbed and no new lesions appear
Chickenpox Copyright: American Academy of Pediatrics
Conjunctivitis
Viral or bacterial Commonly accompany colds Common cause is an irritant in the eye Redness of the white part of the eye Watery discharge (viral) If bacterial yellow discharge with eyelids
matted together
Conjunctivitis cont.Incubation period 12 to 72 hours
No exclusion unless the child is unable to participate and staff determine they cannot care for the child without compromising their ability to care for the health and safety of the other children.
Conjunctivitis
Conjunctivitis is an
Croup
Inflammation of the respiratory mucosa and edema of the larynx and subglottic area.
Caused by parainfluenza virus
Common age 3 months to 3 years
Occurs late fall or early winter
Croup cont.
Symptoms Respiratory infection Fever ( low grade ) Harsh barking cough Wheezing Hoarseness Symptoms worsen at night
Croup cont.
Treatment: Encourage fluids Do not use antihistamines Immediate relief of acute symptoms:
take child into bathroom and make room steamy, allowing child to breathe moist air
Cryptosporidiosis (Crypto)
Intestinal infection caused by a parasite Reportable to the Health Department Frequent watery diarrhea, vomiting and a low
grade fever that can last for several day are the most common symptoms
Note: Bleach solutions are not effective for inactivation the Crypto parasite. Contact the Health Department for disinfecting recommendations if an outbreak of Crypto occurs
E. coli
Foodborne outbreaks occur
Uncooked beef (no pink)
Meat needs to reach 160 degrees
Do not drink unpasteurized milk or fruit juices
Fifth Disease
Caused by the human parvovirus B19 Intense red facial rash (slapped-
cheek ) Rash “lacelike” , mainly on thighs and
upper arms No fever or low-grade fever No treatment necessary
Fifth Disease cont.
Contagious during the week before rash appears
When rash appears child is no longer contagious and does not need to stay home
If pregnant obstetrician needs to be notified of exposure
Fifth Disease
Hand-Foot-Mouth Disease
Caused by the Coxsackie A virus Small ulcers in the mouth Blisters or red spots on the palms, soles,
between the fingers and toes Low grade fever Mainly occurs in children 6 mo.- 4 yrs. Incubation period is 3 to 6 days Exclusion until no fever and well enough to
participate Spread in stool and droplets
Hand-Foot-Mouth Disease
Lice ( Pediculosis)
Live on humans Spread by sharing hats, combs, brushes Examination of household and personal
contacts Nits are firmly attached to hair shaft Nits hatch in about a week
Lice cont.
Scalp itches and has a rash Examination of household and other
close personal contacts Concurrent treatment as indicated Clothing, bedding, etc. should be
laundered in hot water or by dry cleaning
Lice
Otitis Media
Occurs when mucus-containing bacteria collects in the middle ear space
Ear infections can be very painful In older children, most ear infections
resolve by themselves in a day or two. Children younger than 24 months, ear
infections can last linger and usually require antibiotic
Respiratory Syncytial Virus (RSV)
Most frequent cause of pneumonia in children <2 yrs.
Near 100% of children in child care get it within their 1st year
Mild cold, low fever, cough, runny nose, ear infection, >wheezing
Spread through sneezing and coughing
Common in winter and early spring
Parainfluenza, Adenovirus, Rhinovirus, Coxsackievirus
Ringworm
Caused by a fungus infection of the skin
May be transferred by dogs or cats Clear center, scaly, raised border Exclude for 24 hours after treatment
has begun
Ringworm
Salmonella
Diarrhea
Vomiting
Dehydration
Incidence highest in infants and young children
Abdominal pain
Fever
Nausea
Scabies
Mites that burrow under the skin Spread from human to human by
bedding Severe itch worse at night Burrows are 5 to 15 mm long Often curved Occur on the wrist, hand and finger webs
Scabies cont.
Apply topical ointment as prescribed Laundry all bedding and clothing Good handwashing Exclude child until 24 hours after
treatment
Scabies
Shigellosis
Shigella bacteria Diarrhea, fever, stomach cramps, nausea
or vomiting Illness usually lasts 4-7 days Children may show mild or no symptoms
but are infected Treatment: antibiotic Takes very few shigella to transmit disease
Thrush
Common infection caused by Candida species (yeast)
Acute inflammation of the tongue and oral mucous membranes
White or grayish-white focal or diffuse plaques on the mucous membranes
The axilla, groin, and gluteal fold are common areas of the skin
Thrush cont.
Human to human transmission Treated with Nystatin suspension 3-4
times daily for 5-7 days Caretakers should change diapers
frequently, clean skin with soap and water, avoid cornstarch and baby powders
Thrush cont.
No exclusion necessary Careful hygienic procedures should be
followed with good handwashing techniques
Thrush
PREVENTION
Common Childhood Illnesses
Hand washing
Hand washing is the single most effective way of preventing infectious disease!
Immunizations
No immunizations
Immunizations not given according to the recommended schedule
CDC recommended vaccines for children: http://www.cdc.gov/vaccines/schedules/easy-to-read/child.html
If a child does not receive immunizations due to the family’s beliefs, the program should require properly documented as required by state law.
Medical or Religious Exceptions from Immunizations
Medical/Religious Exemptions from Immunizations cont.If a child does not receive immunizations
due to family’s beliefs, the program should notify the parents/guardians about the risk of spread of preventable diseases.
Medical/Religious ExemptionsAlso, the program should be prepared to
exclude un-immunized children from the facility if a vaccine-preventable disease occurs in the facility to which their lack of vaccination makes them more susceptible.
Factors that increasetransmission of illness
Child
Environmental
Staff
Child Factors
Age
Immune System
Hand washing
Environmental Factors
Number in center
Mixing of age groups
Room arrangement
Maintenance
Food preparation
Staff Factors
Child to staff ratio
Sanitation Guidelines
Hand washing
Prevention
UTD Immunizations Morning health check Hand washing Proper diapering Disinfection of toys, cribs & surfaces
922 KAR 2:120
The proper methods of diapering and
hand-washing shall be posted at each diaper changing area.
Cleaning vs. Sanitizing/Disinfecting Cleaning - a mechanical process
(scrubbing), using soap and detergent and water, which removes dirt, debris and large numbers of germs.
Sanitizing –to remove soil and small amounts of certain bacteria using a sanitizing agent.
Disinfecting – destroys specific, harmful germs outside the body with chemicals (bleach, alcohol, etc.) or physical agents (heat, for example).
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PERFORM DAILY HEALTH CHECK
Use Your Senses!Listen
For reports of unusual behavior or illness in child For reports of illness in individuals with close contact to
child
Look For signs of illness Assess: General Appearance, Breathing, Skin, Head
(specifically Eyes, Ears, Nose, Mouth)
Feel For changes in temperature (fever or coolness)
Smell For unusual odors (fruity or foul)Source: Contra Costa Health Services and Contra Costa County of
Education.www.cchealth.org/topics/pandemic_flu/
child_care_provider_kit/
Temporary exclusion is recommended for a child with any of the following conditions:
Illness: that prevents the child from participating
comfortably in activities The child can participate comfortably in activities.—Exclude
until: The Child can participate comfortably in activities. Illness, resulting in a need for care that is greater than the
staff can provide without compromising the health and safety of other children —Exclude until: the child does not need a level of care that compromises the health and safety of other children.
An acute change in behavior: This could include lethargy, lack of responsiveness, irritability, persistent crying, difficulty breathing, wheezing, uncontrolled coughing, or a quickly spreading rash. Exclude until: Medical exam indicates a child may return.
*If any of the 3 criteria above are met, the child should be excluded, regardless of the type of illness.
HAND WASHING FOR CHILDREN
Common Childhood Illnesses
Palms Back and forth until there’s bubbles, Back and forth until there’s bubbles.
Backs Top of this hand ‘til there’s bubbles, Top of this hand ‘til there’s bubbles.
Between fingers
In-between, in-between,In-between ‘til they’re all clean.
Thumbs Thumb, thumb, thumb-kin clean,Thumb, thumb, thumb-kin clean.
Fingernails Twist, twist...twist-twist-twist.
Wrists Lastly wring around each wrist, Lastly wring around each wrist.
Hand Washing A song to make learning fun!
Glo-Germ
Resources
American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. 2011. Caring for our children: National health and safety performance standards; Guidelines for early care and education programs. 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association. Also available at http://nrckids.org
Kentucky Child Care Health Consultation Program: http://www.kentuckycchc.org/
Kentucky Division of Child Care: 922 KAR 2:120. Child-care center health and safety standards
Centers for Disease control and Prevention: http://www.cdc.gov/features/animalsinschools/
STAY HEALTHY!!!
6/2015
