Health & Wellness
Health and Medical Information
Medical Emergency
If there is a medical emergency, the center will first call 911. We will then attempt to get in touch with the child’s parents. If the child’s parent is unavailable, we will use the information provided on the Parent Agreement Form to reach the child’s doctor and then follow his instructions.
Medications
Medications will be administered between the hours of 10 am and 4 pm only. Medications that are prescribed for “once daily” or “twice daily” will not be administered at the center. These medications need to be given at home. Medications that are prescribed for “three times a day” will be given once between the hours of 10 am and 4 pm.
Please be reminded that ALL medications need to have a prescription either on file or on the medication itself before it can be given at the center. All medicine shall be stored in the Wellness Coordinator’s Office. No medicine shall remain in a child’s bag/cubby during the day. Medications need to be taken home daily. We have a small amount of storage space for “as needed” medications, but prescription medications need to go home each day. Blanket authorization forms are prohibited. The center will only administer medication which has been prescribed by a doctor and only with written permission which has been dated and signed by the parent.
Breathing Treatments
Breathing treatments will be administered between the hours of 10 am and 4 pm only. A maximum of two treatments will be given during the day. Breathing treatments that are prescribed for “once daily or twice daily” will not be administered at the center. This treatment needs to be given at home. Please be reminded that a copy of the breathing treatment prescription as well as the dosage requirements and time increments is needed for the child’s file. Nebulizers or breathing machines must be taken home daily. These are not to be left in the center overnight.
Other Health and Medical Information
The parent must provide the health record signed by the child’s physician or the health department and a current certificate of immunizations at the time of admission. The certificate of immunization must be updated in the office each time your child receives a vaccination. Parents must keep current the name of the child’s doctor and the name of other adults to contact in the event that a parent cannot be reached. Parents shall report any illnesses or exposures to communicable diseases outside the center to the staff, in order to alert other parents. The staff in turn shall inform the parents when the child has been exposed to communicable disease at the center.
We do not allow the use of teething jewelry (necklaces, bracelets, or anklets) of any kind. We are following the recommendation from the FDA which says that the risk of using jewelry for relieving teething pain include choking, strangulation, injury to the mouth and infection.
There must be cooperation between the center and the home to fight the spread of communicable disease. Because doctors differ in both the treatment and the return to class times associated with illness, CDC policies take precedent over doctor’s orders. In an attempt to limit the spread of infection, the following guidelines have been established:
CDC Health and Wellness Guidelines
The following information outlines the guidelines for The Heritage CDC, using illnesses that we commonly see in our Center. It is in no way intended to be a complete listing of illnesses, to be a diagnostic tool, or to substitute for your local pediatrician. If your child becomes ill, please consult their physician and let us know what they have so that we may inform other parents. Some of the following information has been compiled from Infection Control in the Child Care Center and Preschool by Leigh G. Donowitz, MD and kidshealth.org. Thank you.
COVID-19 (CORONAVIRUS)
We must know if your child, someone in your immediate family, or someone living in your home has been diagnosed with COVID-19 (coronavirus). All current policies regarding upper respiratory infections and fever apply. Other policies will be determined at the time of diagnosis with respect to current state and local health department requirements including, but not limited to, classroom quarantine; short-term closings for testing, cleaning, and tracing; or temporary long-term closing if mandated due to community spread. We are required to report COVID-19 cases to the Alabama Department of Public Health and follow their mandates.
BRONCHITIS
BACKGROUND Bronchitis is an inflammation of the lining of the bronchial tubes, the airways that connect the trachea (windpipe) to the lungs.
SYMPTOMS May include cough (that may bring up thick white, yellow, or greenish mucus), headache, generally feeling ill, chills, fever (usually mild), shortness of breath, soreness or a feeling of tightness in the chest, and wheezing (a whistling or hissing sound with breathing).
INCUBATION PERIOD There is no distinct incubation period as it varies depending on the virus that caused it.
CONTAGIOUS PERIOD There is no distinct contagious period as it varies depending on the virus that caused it.
EXCLUSION Until fever-free for at least 24 hours without medication and can participate in usual activities.
CANDIDA
(THRUSH/DIAPER DERMATITIS/YEAST)
BACKGROUND Oral candidiasis (thrush), the most common infection caused by Candida species, is an acute inflammation of the tongue and oral mucous membranes that is manifested as white or grayish-white focal or diffuse plaques on the mucous membranes.
The diaper area is the most common site for candidal invasion of the skin. The affected skin is fiery red and, depending on the duration of infection, contains lesions that range from slightly raised red papules to discrete eroded lesions with a red raised border. This is more common among children in diapers who have recently been on oral antibiotics.
INCUBATION The incubation period for Candida infections is not known.
CONTAGIOUS PERIOD The mode of spread is dependent on the age of the patient. Infants and older children acquire the organism from their mother’s skin or hands, from unsterilized nipples or bottles, and often after taking oral antibiotics. Children may acquire the organism from other infected individuals. Oral or superficial Candida infections may be treated with Nystatin suspension administered three to four times daily.
EXCLUSION Once the child has begun treatment there is no reason for exclusion from day care.
NOTE If your child is prone to yeast infections during or after treatment with antibiotics, try feeding them yogurt once or twice daily while on antibiotics.
CROUP
BACKGROUND Croup is a condition that causes an inflammation of the upper airways – the voice box (larynx) and windpipe (trachea). It often leads to a barking cough or hoarseness.
SYMPTOMS At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airway becomes progressively inflamed and swollen, the child may become hoarse, with a harsh, barking cough. This loud cough, which is characteristic of croup, often sounds like the barking of a seal.
INCUBATION PERIOD Varies depending on the specific virus causing the croup.
CONTAGIOUS PERIOD During the acute stage.
EXCLUSION Until fever-free for at least 48 hours without medication and doctor says it is safe to return.
DIARRHEA – NO SPECIFIC PATHOGEN
BACKGROUND Diarrhea is characterized by increased stools that are usually watery. It can be caused by various agents.
SYMPTOMS Frequent, loose or watery stools, vomiting, and fever.
INCUBATION PERIOD 24 to 72 hours.
CONTAGIOUS PERIOD While pathogen is being shed; acute period.
EXCLUSION Until diarrhea is no longer present for at least 48 hours without medication.
DIARRHEA – ROTAVIRUS
BACKGROUND Rotavirus is the cause of a seasonal and sporadic gastroenteritis. It occurs in temperate climates in the cooler months; in tropical climates, it is present year round. Essentially all children are infected by age 3, but they are most likely to be infected between 4 and 24 months of age.
SYMPTOMS Fever, vomiting, followed by diarrhea.
INCUBATION PERIOD 24 to 72 hours.
CONTAGIOUS PERIOD During the acute stage of disease and while the virus is being shed; symptoms typically last 3 to 8 days.
EXCLUSION Until diarrhea is no longer present for at least 48 hours without medication.
FEVER
BACKGROUND At this age, there are many reasons a child may run fever. There are times when no cause will be found. Any temperature of 100.4 degrees or higher is considered fever.
EXCLUSION Anyone sent home with fever is not able to return to the Center for at least 48 hours. Children with fever need to stay home until they have been fever-free for no less than 48 hours without any medication.
FIFTH DISEASE
BACKGROUND Fifth disease is a viral infection which often affects red blood cells. For many years, fifth disease was viewed as an unimportant rash illness of children. Recently, studies have shown that the virus may be responsible for serious complications in certain individuals.
SYMPTOMS Low grade fever, fatigue, a red rash generally appears on the cheeks giving a “slapped” face appearance. The rash may then extend to the body with tendencies to fade and reappear. Sometimes, the rash is lacy in appearance and may be itchy. Some children may have vague signs of illness or no symptoms at all.
INCUBATION PERIOD Varies; typically 4 to 20 days for rash development.
CONTAGIOUS PERIOD During the week prior to the appearance of the rash to one week after onset.
EXCLUSION Until child can participate in daily activities and is fever-free for at least 24 hours without medication.
POSSIBLE COMPLICATIONS While most women infected during pregnancy will not be affected, some studies have shown that parvovirus B19 may infect the fetus and increase the risk of miscarriage. In people with chronic red blood cell disorders, such as sickle cell disease, infection may result in severe anemia. Infection has also been associated with arthritis in adults.
HAND, FOOT, AND MOUTH DISEASE
BACKGROUND The greatest occurrence of hand, foot and mouth disease is in summer and fall. It is most common in children under the age of ten.
SYMPTOMS Sudden fever, sore throat, and small grayish oral lesions on the cheeks and gums as well as on the sides of the tongue. Lesions also may appear on the palms of the hands, soles of the feet, and on the fingers.
INCUBATION PERIOD. Typically 3 to 5 days
CONTAGIOUS PERIOD During the acute stage and several weeks after.
EXCLUSION Until the child is fever-free for at least 48 hours without medication, there are no new blisters, and no oozing blisters.
HEAD LICE (Pediculis capitis)
BACKGROUND Head lice are small insects about the size of a sesame seed and are usually light brown but can vary in color. They move quickly and shy away from light, making them difficult to see. Diagnosis is most often made on the basis of finding nits (eggs). Nits are tiny, grayish-white or yellowish-white oval specks attached to hair shafts. As the female louse deposits her eggs (3-4 per day), she cements them to the hairs, and unlike dandruff, nits will not wash off or brush off. Nits may be found throughout the hair, but are most often located at the nape of the neck, behind the ears, and frequently on the crown of the head.
MODE OF TRANSMISSION Head lice are incapable of hopping, jumping, or flying and are primarily acquired by coming in direct contact with an infested person. However, wearing clothing (such as a hat, coat, or scarf) recently worn by an infested person; using a contaminated comb or brush; or lying on contaminated furniture, carpeting or bedding; can also result in infestation.
SYMPTOMS Itching that occurs when lice bite and suck blood from the scalp is the primary symptom of infestation, although not everyone will experience itching. Often red bite marks or scratch marks can be seen on the scalp and neck.
INCUBATION PERIOD It may take as long as two to three weeks or longer for a person to notice the intense itching associated with this infestation.
CONTAGIOUS PERIOD Head lice can be spread as long as lice or eggs remain alive on the infested person.
EXCLUSION For no less than 48 hours after treatment and no more live lice or nits are found. Children must be checked by the Director, Assistant Director, or Wellness Coordinator before they will be admitted to their classrooms.
PREVENTION / CONTROL MEASURES
· Machine wash all washable clothing and bed linens which have been in contact with the infested person during the last 3 days.
· Articles should be washed in HOT water and dried in a HOT dryer.
· Non-washables can be vacuumed, dry cleaned, or kept in an air tight container for 2 weeks.
· Rugs, upholstered furniture and mattresses should be carefully vacuumed to pick up any living lice or nits attached to fallen hairs.
IMPETIGO
BACKGROUND Impetigo is a skin disorder commonly seen in newborns. Impetigo is the most commonly found staphylococcal disease acquired in a nursery setting. It can also be the result of infected mosquito or ant bites in older preschoolers/children.
MODE OF TRANSMISSION Usual mode of transmission is by touching sores. Spread to peripheral areas occurs by cracking open lesions.
SYMPTOMS Itchy lesions that are sticky and oozing and occur mainly in the diaper area but may spread to other places on the body.
INCUBATION PERIOD 4 to 10 days.
CONTAGIOUS PERIOD As long as lesions are producing discharge.
EXCLUSION Until treatment has been in effect for no less than 24 hours.
PREVENTION / CONTROL MEASURES
· Lesions must be covered
INFLUENZA (Flu)
BACKGROUND Influenza causes a spectrum of clinical symptoms that make up the “flu syndrome”. Influenza infections occur in epidemics during the winter months. The spread is rapid through a community.
SYMPTOMS Fever, headache, chills, body aches, cough, nausea, vomiting, sore throat
INCUBATION PERIOD 1 to 3 days.
CONTAGIOUS PERIOD The virus may be found in respiratory secretions for 24 hours prior to the onset of symptoms until 5 to 10 days after the symptoms began.
EXCLUSION After a child is diagnosed with flu, they will be sent home for the remainder of the week. Before the child can return the next week, they must be symptom free for 48 hours without medication.
MOLLUSCUM
BACKGROUND Molluscum contagiosum (mo-LUS-kum kun-tay-jee-OH-sum) is a relatively common viral infection of the skin that results in round, firm, painless bumps ranging in size from a pinhead to a pencil eraser.
SYMPTOMS Molluscum results in raised, round, flesh-colored bumps on the skin.
CONTAGIOUS PERIOD Molluscum spreads through direct person-to-person contact and through contact with contaminated objects. The bumps associated with molluscum contagiosum usually disappear within a year without treatment but doctor-assisted removal is also an option.
EXLUSION Isn’t necessary as long as bumps are covered with band-aids while at school.
MONONUCLEOSIS
BACKGROUND Infectious mononucleosis is a viral disease that affects certain blood cells. Most cases occur sporadically with outbreaks rare. While most people are exposed to the Epstein-Barr virus, the virus that causes mononucleosis, at some time in their lives, very few go on to develop the symptoms of infectious mononucleosis. The disease is rarely fatal.
SYMPTOMS Fever, sore throat, swollen lymph nodes and feeling tired. Duration is from one to several weeks. Sometimes the liver and spleen are affected.
INCUBATION PERIOD 4 to 6 weeks.
CONTAGIOUS PERIOD Prolonged; one year or more.
EXCLUSION Until child can participate in daily activities and is fever-free for at least 48 hours without medication.
OTITIS MEDIA (Ear Infection)
BACKGROUND Otitis Media frequently accompanies a viral respiratory infection.
SYMPTOMS Often children become irritable, have difficulty sleeping, and may run a fever.
INCUBATION PERIOD There is no distinct incubation period for otitis media.
CONTAGIOUS PERIOD Otitis Media itself is not contagious; however, the respiratory virus that caused it may be.
EXCLUSION Children should be kept out of child care for 48 hours without documentation from a doctor or 24 hours with documentation from a doctor. If your child has a fever, they will need a note from the doctor stating that ear infection is the cause of the fever before they can return.
PINK EYE (Conjunctivitis)
BACKGROUND Conjunctivitis is inflammation of the eye that can either be allergic, viral, or bacterial.
SYMPTOMS Redness of the eye, tearing, itching, swelling, tenderness, with discharge.
INCUBATION PERIOD 12 to 72 hours for viral and 24 to 72 hours for bacterial
CONTAGIOUS PERIOD When symptoms are present until 24 hours after treatment has begun
EXLUSION For bacterial conjunctivitis until 24 hours after treatment has begun and for viral conjunctivitis until symptoms disappear but no less than 24 hours.
PNEUMONIA
BACKGROUND Pneumonia is a general term that refers to an infection of the lungs, which can be caused by a variety of organisms, including viruses, bacteria, fungi, and parasites.
SYMPTOMS May include fever, chills, cough, nasal congestion, unusually rapid breathing (in some cases, this is the only symptom), breathing with grunting or wheezing sounds, labored breathing that makes the rib muscles retract (when muscles under the ribcage or between ribs draw inward with each breath) and causes nasal flaring, vomiting, chest pain, abdominal pain, decreased activity, and loss of appetite (in older kids) or poor feeding (in infants).
INCUBATION PERIOD There is no distinct incubation period as it varies depending on the virus that caused it.
CONTAGIOUS PERIOD Varies depending on the virus causing the pneumonia.
EXCLUSION Until the child is fever-free for at least 48 hours without any medication, has no other symptoms, and can participate in usual activities.
RESPIRATORY INFECTIONS (viral)
BACKGROUND Different etiologic agents are responsible for respiratory viral infections. These infections are more commonly known as colds. Most infections occur during fall and winter.
SYMPTOMS Sneezing, chills, runny nose, fever, muscle and joint aching, sore throat, and coughing.
INCUBATION PERIOD Up to 10 days.
CONTAGIOUS PERIOD Shortly before symptoms begin to end of acute period.
EXCLUSION Until fever is no longer present for at least 48 hours without medication and child can participate in daily activities.
RESPIRATORY SYNCYTIAL VIRUS (RSV)
BACKGROUND Respiratory syncytial virus (RSV) is a viral disease affecting the respiratory tract. RSV is the most common cause of respiratory tract diseases such as bronchitis and pneumonia in early infancy, with most cases occurring within the first 2 years of life. RSV can seriously affect those that are born prematurely or those with heart, lung, or immune problems. RSV occurs seasonally in temperate zones, usually during winter and early spring, but can also occur in sharp outbreaks.
SYMPTOMS Fever, chills, headache, general aching, and anorexia.
INCUBATION PERIOD 1 to 10 days.
CONTAGIOUS PERIOD Several days before and after active disease is seen; this can be several weeks.
EXCLUSION After a child is diagnosed with RSV, they will be sent home for the remainder of the week. Before the child can return the next week, they must be symptom free for 48 hours without medication.
SPECIAL WARNINGS Children and infants with certain medical problems should not be exposed to the disease.
RINGWORM
BACKGROUND Tinea (pronounced: TIH-nee-uh) is the medical name for a group of related skin infections, including athlete's foot, jock itch, and ringworm. They're caused by several types of mold-like fungi called dermatophytes (pronounced: der-MAH-tuh-fites) that live on the dead tissues of the skin, hair, and nails.
SYMPTOMS Ringworm of the skin starts as a red, scaly patch or bump. Ringworm tends to be very itchy and uncomfortable. Over time, it may begin to look like a ring or a series of rings with raised, bumpy, scaly borders (the center is often clear).
INCUBATION PERIOD It takes 3 to 5 days for microscopic infection and 2 to 3 weeks for clinical manifestations to develop.
CONTAGIOUS PERIOD The condition can spread for 3 to 4 months, and then spontaneous regression may occur.
EXCLUSION Until effective treatment is started but no less than 24 hours. Area must be covered to return to school.
ROSEOLA
BACKGROUND Children ages six months to three years are most commonly affected by this disease. Roseola is a rash disease that is not highly communicable. Those that are exposed to roseola acquire immunity to the disease. Roseola appears mostly in spring or summer.
SYMPTOMS Sudden fever that can get as high as 104 F, convulsions, and a rash that appears around the 3rd to 5th day as the fever is disappearing. The rash resembles small, bumpy, rose-pink spots that start on the chest and abdomen. The rash usually lasts one to two days. Some people are asymptomatic.
INCUBATION PERIOD 5 to 15 days.
CONTAGIOUS PERIOD Unknown; the period during fever and before rash appears is suspected.
EXCLUSION Until fever is no longer present for at least 24 hours without medication.
STAPH INFECTION (of the skin)
BACKGROUND Staphylococcal infections are commonly associated with diseases of the skin.
SYMPTOMS Red, swollen, painful sores on the skin with discharge.
INCUBATION PERIOD 1 to 10 days
CONTAGIOUS PERIOD As long as there is drainage from the sore.
EXCLUSION For at least 24 hours after the initiation of appropriate antibiotics and until drainage of infected material has stopped or diminished to the point that barrier protection is effective. The infected area must be covered at all times.
STREP THROAT / SCARLET FEVER
BACKGROUND Both strep throat and scarlet fever are common illnesses among children. The majority of the time these illnesses are not serious; however, complications may develop if proper treatment is not administered.
SYMPTOMS Sudden fever, sore throat, headache, swollen glands, and abdominal cramps. Occasionally vomiting and nausea occur. Scarlet fever occurs with a rash appearing on the neck, chest, in the folds of the armpit, elbow, groin and inner thigh.
INCUBATION PERIOD 1 to 3 days.
CONTAGIOUS PERIOD Until 24 hours of treatment has been administered.
EXCLUSION Until fever is no longer present for at least 24 hours without medication and treatment has been in effect for at least 24 hours.
VOMITING
SYMPTOMS Vomiting 2 times or more or vomiting with other symptoms such as fever or diarrhea.
EXCLUSION Until there has been no vomiting, fever, or diarrhea for at least 48 hours without any medication.
vHealth and Medical Information
Medical Emergency
If there is a medical emergency, the center will first call 911. We will then attempt to get in touch with the child’s parents. If the child’s parent is unavailable, we will use the information provided on the Parent Agreement Form to reach the child’s doctor and then follow his instructions.
Medications
Medications will be administered between the hours of 10 am and 4 pm only. Medications that are prescribed for “once daily” or “twice daily” will not be administered at the center. These medications need to be given at home. Medications that are prescribed for “three times a day” will be given once between the hours of 10 am and 4 pm.
Please be reminded that ALL medications need to have a prescription either on file or on the medication itself before it can be given at the center. All medicine shall be stored in the Wellness Coordinator’s Office. No medicine shall remain in a child’s bag/cubby during the day. Medications need to be taken home daily. We have a small amount of storage space for “as needed” medications, but prescription medications need to go home each day. Blanket authorization forms are prohibited. The center will only administer medication which has been prescribed by a doctor and only with written permission which has been dated and signed by the parent.
Breathing Treatments
Breathing treatments will be administered between the hours of 10 am and 4 pm only. A maximum of two treatments will be given during the day. If a child needs more than two treatments during the day, the first treatment will need to be given before the child comes to the center. Breathing treatments that are prescribed for “once daily” will not be administered at the center. This treatment needs to be given at home. Please be reminded that a copy of the breathing treatment prescription as well as the dosage requirements and time increments is needed for the child’s file. Nebulizers or breathing machines must be taken home daily. These are not to be left in the center overnight.
Other Health and Medical Information
The parent must provide the health record signed by the child’s physician or the health department and a current certificate of immunizations at the time of admission. The certificate of immunization must be updated in the office each time your child receives a vaccination. Parents must keep current the name of the child’s doctor and the name of other adults to contact in the event that a parent cannot be reached. Parents shall report any illnesses or exposures to communicable diseases outside the center to the staff, in order to alert other parents. The staff in turn shall inform the parents when the child has been exposed to communicable disease at the center.
We do not allow the use of teething jewelry (necklaces, bracelets, or anklets) of any kind. We are following the recommendation from the FDA which says that the risk of using jewelry for relieving teething pain include choking, strangulation, injury to the mouth and infection.
There must be cooperation between the center and the home to fight the spread of communicable disease. Because doctors differ in both the treatment and the return to class times associated with illness, CDC policies take precedent over doctor’s orders. In an attempt to limit the spread of infection, the following guidelines have been established:
CDC Health and Wellness Guidelines
The following information outlines the guidelines for The Heritage CDC, using illnesses that we commonly see in our Center. It is in no way intended to be a complete listing of illnesses, to be a diagnostic tool, or to substitute for your local pediatrician. If your child becomes ill, please consult their physician and let us know what they have so that we may inform other parents. Some of the following information has been compiled from Infection Control in the Child Care Center and Preschool by Leigh G. Donowitz, MD and kidshealth.org. Thank you.
COVID-19 (CORONAVIRUS)
We must know if your child, someone in your immediate family, or someone living in your home has been diagnosed with COVID-19 (coronavirus). All current policies regarding upper respiratory infections and fever apply. Other policies will be determined at the time of diagnosis with respect to current state and local health department requirements including, but not limited to, classroom quarantine; short-term closings for testing, cleaning, and tracing; or temporary long-term closing if mandated due to community spread. We are required to report COVID-19 cases to the Alabama Department of Public Health and follow their mandates.
BRONCHITIS
BACKGROUND Bronchitis is an inflammation of the lining of the bronchial tubes, the airways that connect the trachea (windpipe) to the lungs.
SYMPTOMS May include cough (that may bring up thick white, yellow, or greenish mucus), headache, generally feeling ill, chills, fever (usually mild), shortness of breath, soreness or a feeling of tightness in the chest, and wheezing (a whistling or hissing sound with breathing).
INCUBATION PERIOD There is no distinct incubation period as it varies depending on the virus that caused it.
CONTAGIOUS PERIOD There is no distinct contagious period as it varies depending on the virus that caused it.
EXCLUSION Until fever-free for at least 24 hours without medication and can participate in usual activities.
CANDIDA
(THRUSH/DIAPER DERMATITIS/YEAST)
BACKGROUND Oral candidiasis (thrush), the most common infection caused by Candida species, is an acute inflammation of the tongue and oral mucous membranes that is manifested as white or grayish-white focal or diffuse plaques on the mucous membranes.
The diaper area is the most common site for candidal invasion of the skin. The affected skin is fiery red and, depending on the duration of infection, contains lesions that range from slightly raised red papules to discrete eroded lesions with a red raised border. This is more common among children in diapers who have recently been on oral antibiotics.
INCUBATION The incubation period for Candida infections is not known.
CONTAGIOUS PERIOD The mode of spread is dependent on the age of the patient. Infants and older children acquire the organism from their mother’s skin or hands, from unsterilized nipples or bottles, and often after taking oral antibiotics. Children may acquire the organism from other infected individuals. Oral or superficial Candida infections may be treated with Nystatin suspension administered three to four times daily.
EXCLUSION Once the child has begun treatment there is no reason for exclusion from day care.
NOTE If your child is prone to yeast infections during or after treatment with antibiotics, try feeding them yogurt once or twice daily while on antibiotics.
CROUP
BACKGROUND Croup is a condition that causes an inflammation of the upper airways – the voice box (larynx) and windpipe (trachea). It often leads to a barking cough or hoarseness.
SYMPTOMS At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airway becomes progressively inflamed and swollen, the child may become hoarse, with a harsh, barking cough. This loud cough, which is characteristic of croup, often sounds like the barking of a seal.
INCUBATION PERIOD Varies depending on the specific virus causing the croup.
CONTAGIOUS PERIOD During the acute stage.
EXCLUSION Until fever-free for at least 48 hours without medication and doctor says it is safe to return.
DIARRHEA – NO SPECIFIC PATHOGEN
BACKGROUND Diarrhea is characterized by increased stools that are usually watery. It can be caused by various agents.
SYMPTOMS Frequent, loose or watery stools, vomiting, and fever.
INCUBATION PERIOD 24 to 72 hours.
CONTAGIOUS PERIOD While pathogen is being shed; acute period.
EXCLUSION Until diarrhea is no longer present for at least 48 hours without medication.
DIARRHEA – ROTAVIRUS
BACKGROUND Rotavirus is the cause of a seasonal and sporadic gastroenteritis. It occurs in temperate climates in the cooler months; in tropical climates, it is present year round. Essentially all children are infected by age 3, but they are most likely to be infected between 4 and 24 months of age.
SYMPTOMS Fever, vomiting, followed by diarrhea.
INCUBATION PERIOD 24 to 72 hours.
CONTAGIOUS PERIOD During the acute stage of disease and while the virus is being shed; symptoms typically last 3 to 8 days.
EXCLUSION Until diarrhea is no longer present for at least 48 hours without medication.
FEVER
BACKGROUND At this age, there are many reasons a child may run fever. There are times when no cause will be found. Any temperature of 100.4 degrees or higher is considered fever.
EXCLUSION Anyone sent home with fever is not able to return to the Center for at least 48 hours. Children with fever need to stay home until they have been fever-free for no less than 48 hours without any medication.
FIFTH DISEASE
BACKGROUND Fifth disease is a viral infection which often affects red blood cells. For many years, fifth disease was viewed as an unimportant rash illness of children. Recently, studies have shown that the virus may be responsible for serious complications in certain individuals.
SYMPTOMS Low grade fever, fatigue, a red rash generally appears on the cheeks giving a “slapped” face appearance. The rash may then extend to the body with tendencies to fade and reappear. Sometimes, the rash is lacy in appearance and may be itchy. Some children may have vague signs of illness or no symptoms at all.
INCUBATION PERIOD Varies; typically 4 to 20 days for rash development.
CONTAGIOUS PERIOD During the week prior to the appearance of the rash to one week after onset.
EXCLUSION Until child can participate in daily activities and is fever-free for at least 24 hours without medication.
POSSIBLE COMPLICATIONS While most women infected during pregnancy will not be affected, some studies have shown that parvovirus B19 may infect the fetus and increase the risk of miscarriage. In people with chronic red blood cell disorders, such as sickle cell disease, infection may result in severe anemia. Infection has also been associated with arthritis in adults.
HAND, FOOT, AND MOUTH DISEASE
BACKGROUND The greatest occurrence of hand, foot and mouth disease is in summer and fall. It is most common in children under the age of ten.
SYMPTOMS Sudden fever, sore throat, and small grayish oral lesions on the cheeks and gums as well as on the sides of the tongue. Lesions also may appear on the palms of the hands, soles of the feet, and on the fingers.
INCUBATION PERIOD. Typically 3 to 5 days
CONTAGIOUS PERIOD During the acute stage and several weeks after.
EXCLUSION Until the child is fever-free for at least 48 hours without medication, there are no new blisters, and no oozing blisters.
HEAD LICE (Pediculis capitis)
BACKGROUND Head lice are small insects about the size of a sesame seed and are usually light brown but can vary in color. They move quickly and shy away from light, making them difficult to see. Diagnosis is most often made on the basis of finding nits (eggs). Nits are tiny, grayish-white or yellowish-white oval specks attached to hair shafts. As the female louse deposits her eggs (3-4 per day), she cements them to the hairs, and unlike dandruff, nits will not wash off or brush off. Nits may be found throughout the hair, but are most often located at the nape of the neck, behind the ears, and frequently on the crown of the head.
MODE OF TRANSMISSION Head lice are incapable of hopping, jumping, or flying and are primarily acquired by coming in direct contact with an infested person. However, wearing clothing (such as a hat, coat, or scarf) recently worn by an infested person; using a contaminated comb or brush; or lying on contaminated furniture, carpeting or bedding; can also result in infestation.
SYMPTOMS Itching that occurs when lice bite and suck blood from the scalp is the primary symptom of infestation, although not everyone will experience itching. Often red bite marks or scratch marks can be seen on the scalp and neck.
INCUBATION PERIOD It may take as long as two to three weeks or longer for a person to notice the intense itching associated with this infestation.
CONTAGIOUS PERIOD Head lice can be spread as long as lice or eggs remain alive on the infested person.
EXCLUSION For no less than 48 hours after treatment and no more live lice or nits are found. Children must be checked by the Director, Assistant Director, or Wellness Coordinator before they will be admitted to their classrooms.
PREVENTION / CONTROL MEASURES
· Machine wash all washable clothing and bed linens which have been in contact with the infested person during the last 3 days.
· Articles should be washed in HOT water and dried in a HOT dryer.
· Non-washables can be vacuumed, dry cleaned, or kept in an air tight container for 2 weeks.
· Rugs, upholstered furniture and mattresses should be carefully vacuumed to pick up any living lice or nits attached to fallen hairs.
IMPETIGO
BACKGROUND Impetigo is a skin disorder commonly seen in newborns. Impetigo is the most commonly found staphylococcal disease acquired in a nursery setting. It can also be the result of infected mosquito or ant bites in older preschoolers/children.
MODE OF TRANSMISSION Usual mode of transmission is by touching sores. Spread to peripheral areas occurs by cracking open lesions.
SYMPTOMS Itchy lesions that are sticky and oozing and occur mainly in the diaper area but may spread to other places on the body.
INCUBATION PERIOD 4 to 10 days.
CONTAGIOUS PERIOD As long as lesions are producing discharge.
EXCLUSION Until treatment has been in effect for no less than 24 hours.
PREVENTION / CONTROL MEASURES
· Lesions must be covered
INFLUENZA (Flu)
BACKGROUND Influenza causes a spectrum of clinical symptoms that make up the “flu syndrome”. Influenza infections occur in epidemics during the winter months. The spread is rapid through a community.
SYMPTOMS Fever, headache, chills, body aches, cough, nausea, vomiting, sore throat
INCUBATION PERIOD 1 to 3 days.
CONTAGIOUS PERIOD The virus may be found in respiratory secretions for 24 hours prior to the onset of symptoms until 5 to 10 days after the symptoms began.
EXCLUSION After a child is diagnosed with flu, they will be sent home for the remainder of the week. Before the child can return the next week, they must be symptom free for 48 hours without medication.
MOLLUSCUM
BACKGROUND Molluscum contagiosum (mo-LUS-kum kun-tay-jee-OH-sum) is a relatively common viral infection of the skin that results in round, firm, painless bumps ranging in size from a pinhead to a pencil eraser.
SYMPTOMS Molluscum results in raised, round, flesh-colored bumps on the skin.
CONTAGIOUS PERIOD Molluscum spreads through direct person-to-person contact and through contact with contaminated objects. The bumps associated with molluscum contagiosum usually disappear within a year without treatment but doctor-assisted removal is also an option.
EXLUSION Isn’t necessary as long as bumps are covered with band-aids while at school.
MONONUCLEOSIS
BACKGROUND Infectious mononucleosis is a viral disease that affects certain blood cells. Most cases occur sporadically with outbreaks rare. While most people are exposed to the Epstein-Barr virus, the virus that causes mononucleosis, at some time in their lives, very few go on to develop the symptoms of infectious mononucleosis. The disease is rarely fatal.
SYMPTOMS Fever, sore throat, swollen lymph nodes and feeling tired. Duration is from one to several weeks. Sometimes the liver and spleen are affected.
INCUBATION PERIOD 4 to 6 weeks.
CONTAGIOUS PERIOD Prolonged; one year or more.
EXCLUSION Until child can participate in daily activities and is fever-free for at least 48 hours without medication.
OTITIS MEDIA (Ear Infection)
BACKGROUND Otitis Media frequently accompanies a viral respiratory infection.
SYMPTOMS Often children become irritable, have difficulty sleeping, and may run a fever.
INCUBATION PERIOD There is no distinct incubation period for otitis media.
CONTAGIOUS PERIOD Otitis Media itself is not contagious; however, the respiratory virus that caused it may be.
EXCLUSION Children should be kept out of child care for 48 hours without documentation from a doctor or 24 hours with documentation from a doctor. If your child has a fever, they will need a note from the doctor stating that ear infection is the cause of the fever before they can return.
PINK EYE (Conjunctivitis)
BACKGROUND Conjunctivitis is inflammation of the eye that can either be allergic, viral, or bacterial.
SYMPTOMS Redness of the eye, tearing, itching, swelling, tenderness, with discharge.
INCUBATION PERIOD 12 to 72 hours for viral and 24 to 72 hours for bacterial
CONTAGIOUS PERIOD When symptoms are present until 24 hours after treatment has begun
EXLUSION For bacterial conjunctivitis until 24 hours after treatment has begun and for viral conjunctivitis until symptoms disappear but no less than 24 hours.
PNEUMONIA
BACKGROUND Pneumonia is a general term that refers to an infection of the lungs, which can be caused by a variety of organisms, including viruses, bacteria, fungi, and parasites.
SYMPTOMS May include fever, chills, cough, nasal congestion, unusually rapid breathing (in some cases, this is the only symptom), breathing with grunting or wheezing sounds, labored breathing that makes the rib muscles retract (when muscles under the ribcage or between ribs draw inward with each breath) and causes nasal flaring, vomiting, chest pain, abdominal pain, decreased activity, and loss of appetite (in older kids) or poor feeding (in infants).
INCUBATION PERIOD There is no distinct incubation period as it varies depending on the virus that caused it.
CONTAGIOUS PERIOD Varies depending on the virus causing the pneumonia.
EXCLUSION Until the child is fever-free for at least 48 hours without any medication, has no other symptoms, and can participate in usual activities.
RESPIRATORY INFECTIONS (viral)
BACKGROUND Different etiologic agents are responsible for respiratory viral infections. These infections are more commonly known as colds. Most infections occur during fall and winter.
SYMPTOMS Sneezing, chills, runny nose, fever, muscle and joint aching, sore throat, and coughing.
INCUBATION PERIOD Up to 10 days.
CONTAGIOUS PERIOD Shortly before symptoms begin to end of acute period.
EXCLUSION Until fever is no longer present for at least 48 hours without medication and child can participate in daily activities.
RESPIRATORY SYNCYTIAL VIRUS (RSV)
BACKGROUND Respiratory syncytial virus (RSV) is a viral disease affecting the respiratory tract. RSV is the most common cause of respiratory tract diseases such as bronchitis and pneumonia in early infancy, with most cases occurring within the first 2 years of life. RSV can seriously affect those that are born prematurely or those with heart, lung, or immune problems. RSV occurs seasonally in temperate zones, usually during winter and early spring, but can also occur in sharp outbreaks.
SYMPTOMS Fever, chills, headache, general aching, and anorexia.
INCUBATION PERIOD 1 to 10 days.
CONTAGIOUS PERIOD Several days before and after active disease is seen; this can be several weeks.
EXCLUSION After a child is diagnosed with RSV, they will be sent home for the remainder of the week. Before the child can return the next week, they must be symptom free for 48 hours without medication.
SPECIAL WARNINGS Children and infants with certain medical problems should not be exposed to the disease.
RINGWORM
BACKGROUND Tinea (pronounced: TIH-nee-uh) is the medical name for a group of related skin infections, including athlete's foot, jock itch, and ringworm. They're caused by several types of mold-like fungi called dermatophytes (pronounced: der-MAH-tuh-fites) that live on the dead tissues of the skin, hair, and nails.
SYMPTOMS Ringworm of the skin starts as a red, scaly patch or bump. Ringworm tends to be very itchy and uncomfortable. Over time, it may begin to look like a ring or a series of rings with raised, bumpy, scaly borders (the center is often clear).
INCUBATION PERIOD It takes 3 to 5 days for microscopic infection and 2 to 3 weeks for clinical manifestations to develop.
CONTAGIOUS PERIOD The condition can spread for 3 to 4 months, and then spontaneous regression may occur.
EXCLUSION Until effective treatment is started but no less than 24 hours. Area must be covered to return to school.
ROSEOLA
BACKGROUND Children ages six months to three years are most commonly affected by this disease. Roseola is a rash disease that is not highly communicable. Those that are exposed to roseola acquire immunity to the disease. Roseola appears mostly in spring or summer.
SYMPTOMS Sudden fever that can get as high as 104 F, convulsions, and a rash that appears around the 3rd to 5th day as the fever is disappearing. The rash resembles small, bumpy, rose-pink spots that start on the chest and abdomen. The rash usually lasts one to two days. Some people are asymptomatic.
INCUBATION PERIOD 5 to 15 days.
CONTAGIOUS PERIOD Unknown; the period during fever and before rash appears is suspected.
EXCLUSION Until fever is no longer present for at least 24 hours without medication.
STAPH INFECTION (of the skin)
BACKGROUND Staphylococcal infections are commonly associated with diseases of the skin.
SYMPTOMS Red, swollen, painful sores on the skin with discharge.
INCUBATION PERIOD 1 to 10 days
CONTAGIOUS PERIOD As long as there is drainage from the sore.
EXCLUSION For at least 24 hours after the initiation of appropriate antibiotics and until drainage of infected material has stopped or diminished to the point that barrier protection is effective. The infected area must be covered at all times.
STREP THROAT / SCARLET FEVER
BACKGROUND Both strep throat and scarlet fever are common illnesses among children. The majority of the time these illnesses are not serious; however, complications may develop if proper treatment is not administered.
SYMPTOMS Sudden fever, sore throat, headache, swollen glands, and abdominal cramps. Occasionally vomiting and nausea occur. Scarlet fever occurs with a rash appearing on the neck, chest, in the folds of the armpit, elbow, groin and inner thigh.
INCUBATION PERIOD 1 to 3 days.
CONTAGIOUS PERIOD Until 24 hours of treatment has been administered.
EXCLUSION Until fever is no longer present for at least 24 hours without medication and treatment has been in effect for at least 24 hours.
VOMITING
SYMPTOMS Vomiting 2 times or more or vomiting with other symptoms such as fever or diarrhea.
EXCLUSION Until there has been no vomiting, fever, or diarrhea for at least 48 hours without any medication.
