Communicable Diseases

1
Communicable Diseases
Prevention/ Control

• Ohio State Regulations
• for Child Care Centers

2
How communicable disease is spread.

• Unit One

3
Microorganisms

• Small, living plants or animals
• Not visible with the human eye
• Microbes, organisms, germs
• Everywhere in environment
• Most harmless some beneficial

4
Pathogen

• Microorganisms which are capable of causing
  disease
• Bacterial Infections
• Viral Infections
• Fungal Infections
• Parasitic Infestations

5
Pathogen

• Microorganisms which are capable of causing
  disease
• Bacterial Infections
• Viral Infections
• Fungal Infections
• Parasitic Infestations

6
Chain of Infection
Pathogen
Reservoir
Exit
Transmission
Host
Entrance
7
Chain of Infection

• Reservoir
  Host

Host Reservoir
8
Modes of Transmission

• Direct Contact- e.g. skin to skin
• Mouth and Nose - e.g. coughs, sneezing
• Fecal-oral - e.g. the door knob
• Sexual
• Blood

9
Modes of Transmission

• Direct Contact- e.g. skin to skin
• Mouth and Nose - e.g. coughs, sneezing
• Fecal-oral - e.g. the door knob
• Sexual
• Blood

10
Transmission Patterns in Child Care Settings

• Fecal-Oral
• Respiratory
• Direct Contact

11
Contributing Factors

• Large numbers of children from different families
• Many children cared for by small number of
  caregivers
• Poor hygiene habits of young children

12
Contributing Factors

• Large numbers of children from different families
• Many children cared for by small number of
  caregivers
• Poor hygiene habits of young children

13
Contributing Factors
continued

• Mixing children in diapers with toilet-trained
  children
• Circulating staff from one group to other groups
• Caregivers who also prepare food for children

14
Contributing Factors
continued

• Probably most important
• Not practicing adequate hygiene measures
• Hand washing is the single most effective way to
  stop the spread of disease.

15
Prevention and Control

• Unit Two

16
Why is prevention and control important?

• Communicable diseases lead to serious
  consequences
• pneumonia, meningitis, vision/hearing loss
• death
• Communicable diseases spread to other people

17
Prevention

• Immunizations
• One of the best methods to prevent disease
• Not available for all diseases

18
Control

• Control measures must be practiced ALL the time
• Children may be contagious without symptoms
• It is impossible to know which children are
  contagious
• Asymptomatic children can still transmit disease

19
Control Measures

• Handwashing
• Diapering

Video
20
Control Measures
Continued

• Separating children into groups
• Proposed Regulations If groups of children
  include any child who is less than 21/2 years of
  age, the space where these groups receive care
  shall be separated from other groups
  (51012-12-13).

21
Control Measures
Continued

• Separation or exclusion of ill child
• Prevents transmission of pathogens
• Depends on the type of symptoms and/or their
  severity

22
Immediate isolation and exclusion (per
regulations)

• Diarrhea
• Severe coughing causing the child to become red
  or blue in the face
• Difficult or rapid breathing
• Yellowish skin or eyes
• Conjunctivitis

• Temp. of 100 F (axil) in combination with any
  other signs of illness.
• Untreated infected skin patches
• Usually dark urine and /or grey or white stool
• Stiff neck

23
Isolate and Observe(per regulations)

• Unusual spots or rashes
• Sore throat or difficulty swallowing
• Elevated temperature
• Vomiting
• Evidence of lice, scabies, or other parasitic
  infestation

24
Control Measures
Continued

• Disposal of soiled items
• tissues
• items used to soak up blood
• Disinfection
• Kills pathogens before they can enter another
  person

25
Cleaning and Disinfection

• Clean/Sanitize
• 1 tablespoon of bleach per gallon of water. Use
  on toys, utensils, play tables, food prep and
  eating surfaces. Rinse after two minutes of
  contact time

26
Cleaning and Disinfection

• Disinfection
• 1/4 cup of bleach per gallon of water. Use in
  the diapering area, bathrooms, floors and
  frequently touched areas such as doors. Rinse
  after two minutes of contact time.

27
Bleach

• Dont mix with anything except WATER
• Keep away from children
• Make fresh solution EVERYDAY
• After 24 hours, solution is no longer effective
• Label the bottle with the name of the contents

28
Management of the ill child

• Unit Three

29
Centers Responsibility

• Observation of the child
• Daily health checks
• Child Observation Form
• Take an axillary temperature

30
Centers Responsibility
continued

• Determine if isolation of child is indicated
  prior to discharge
• Decisions regarding whether the child should be
  discharged immediately and/or isolated for
  further observation shall be determined by the
  child care administrator

31
Centers Responsibility
continued

• Notification of parent/guardian regarding
  discharge
• Designated personnel to contact parent/guardian
• If symptoms become severe and/or life threatening
  EMS should be called

32
Centers Responsibility
continued

• Precautions for Center personnel caring for ill
  child
• Correct hand washing technique
• Correct cleaning/disposal of linens etc.
• Assure that center personnel are adequately
  protected against childhood diseases

33
Health Risks for Pregnant Staff

• Chickenpox or Shingles
• Cytomegalovirus (CMV)
• Fifth Disease
• Rubella

34
Centers Responsibility
continued

• Notification of Local Health Department of
  communicable diseases
• Reportable Diseases
• For information
• Free testing
• Recommendation for control of spread to other
  children and to staff
• Notification of parents of exposure

35
Parental Responsibility

• Provide Center with phone numbers
• Where the parent can be reached
• Health care provider
• Hospital of choice
• Alternate emergency contact persons

36
Parental Responsibility
continued

• Provide Center with childs medical history
• past serious illness
• medication currently taking
• any known allergies
• copy of immunization record
• chronic conditions
• history of hospitalization
• update annually and when changes occur

37
Parental Responsibility
continued

• Pick up ill child as soon as possible when
  notified of discharge
• Notify personnel if child has been exposed to any
  contagious disease
• Keep child at home if they develop any symptoms
  of contagious diseases

38
Parental Responsibility
continued

• Follow through with appropriate medical
  intervention for ill child
• Provide center with signed authorization for
  emergency transportation

39
Caring for the Ill Child
Video
40
Child Care Center Health Policies

• Unit Four

41
Minimum Policy Statements

• Medical and dental emergency plans
• Management of communicable diseases
• Maintenance of health records
• Administration of medication
• Employee health records
• Handwashing
• Child with special health needs

42
Minimum Policy Statements

• Medical and dental emergency plans
• Provision of first aid and instruction to staff
  in emergency situations
• Emergency transportation
• Parental notification
• Posting emergency phone numbers
• Location of first aid kit, dental first aid
  chart, childrens records, and names of staff
  currently trained in first aid and communicable
  disease
• Purpose and completion of Incident Report

43
Minimum Policy Statements

• Management of communicable diseases
• Requirements for health check upon childs
  arrival and procedures to follow if child becomes
  ill
• Procedures for parent notification
• Posting of Child Day Care Center Communicable
  Disease Chart

44
Minimum Policy Statements (Continued)

• Management of communicable diseases
• - Management of the ill child
• - Handwashing
• - Release of ill employees

45
Minimum Policy Statements

• Maintenance of health records
• Childs Medical Statement
• Childs Health Record (disease history,
  allergies, chronic physical problems,
  immunizations)
• Child Observation Form
• Medication Administration Form
• Emergency Transportation Authorization
• Incident Reports
• Children with special health care needs require
  an individual health plan in addition to the
  above

46
Minimum Policy Statements

• Administration of medication
• Safe storage, out of reach of children
• Administration Procedures
• Records
• Documentation
• Communication with physician and parents
• Observation for side effects

47
Six Rights of MedicationAdministration

• The Right Child
• The Right Medication
• The Right Time
• The Right Dose
• The Right Route
• The Right Documentation

48
For More Information about Administration of
Medication

• Call your Regional Licensing Office
• _________________________________
• For reference only check the website for Caring
  For Our Children (National Health and Safety
  Performance Standard for Child Care)
  nrc.uchsc.edu on pages 137-38, 346,and 363.

49
Minimum Policy Statements

• Employee health records
• History
• Physical exam before starting including TB
  (proposed rule revision requires update every 3
  years including TB)
• Immunizations
• OSHA ruling
• Allergies, chronic illnesses

50
Common Illnesses of Children in Centers

• Unit Five

51
Diabetes Mellitus

• Chronic disorder resulting from a deficiency of
  insulin, leading to impairment of metabolism
• Hyperglycemia
• Hypoglycemia

52
Diabetes Mellitus
continued

• Symptoms of Hypoglycemia
• Headache
• Blurred vision
• Confusion
• Slurred speech
• Aura
• Shaky

53
Diabetes Mellitus
continued

• Hypoglycemic Emergency
• Immediate treatment is imperative to avoid
  potential brain damage
• Immediate intake of a concentrated sugar
• If in doubt, treat as hypoglycemia
• Follow sugar intake with protein snack,
• Approximately ½ hour later

54
Diabetes Mellitus
continued

• Treatment is a balancing of
• Insulin
• Diet
• Exercise

55
Diabetes Mellitus
continued

• Center personnel should
• Follow diet that is prescribed for the child
• Tell the parent if there has been a variation in
  the diet
• Provide meals and snacks on time

56
Diabetes Mellitus
continued

• Center personnel should
• Schedule strenuous exercise after meals not just
  before meals
• Know the symptoms of hypoglycemia

57
Asthma

• Definition
• Hyper-reactivity of airway in response to varying
  stimuli making breathing more difficult

Video
58
Seizures

• Definition
• Chronic condition consisting of episodic
  disturbances of consciousness, often involving
  involuntary motor movements
• Sometimes referred to as
• convulsions or fits

59
Seizures
continued

• Chronic Management
• Goal is maintenance of normal lifestyle for age
• anticonvulsant medication
• Given daily
• Side effects drowsiness, hyperactivity, rashes
• Good oral hygiene

60
Seizures
continued

• Emergency Management
• Protect child from injury
• Place child on their side
• Do NOT put anything into childs mouth
• Prepare a written record of seizure
• Length of seizure (clocked time)
• Extent of involvement
• Intensity
• Allow child to rest following seizure

61
Sickle Cell Disease

• Definition
• An inherited, chronic blood disease in which the
  red blood cells become crescent shaped and
  function abnormally

62
Shapes of Red Blood Cells
Normal Red Blood Cell
Sickle Cells
63
Sickle Cell Disease

64
Sickle Cell Disease
continued

• Inherited as an autosomal recessive trait
• Overall incidence is 8 out of 100,000 people
• Primarily in people of African Heritage
• 1 out of 500 African-Americans affected
• 1 out of 1,000-1,400 Hispanic-Americans

65
Sickle Cell Disease
continued
66
Sickle Cell Disease
continued

• Symptoms
• Swelling and pain in the hands and feet
• Fatigue, paleness, and shortness of breath
• Pain, unpredictable, in any organ or joint
• Yellowing of the skin and eyes
• Delayed growth and puberty
• Infections

67
Sickle Cell Disease
continued

• Center personnel should
• If crisis begins, encourage child to drink
  fluids
• Administer pain medications as directed
• Notify parents at first sign of infection

68
Communicable Diseases

• Upper Respiratory Infections
• Colds
• Conjunctivitis
• Strep throat

69
Communicable Diseases
continued

• Diarrheal Diseases
• Outbreaks
• 2 or more cases within 48 hours
• May be defined as more than the center usually
  sees
• Over-the-counter medications not usually
  recommended for young children

70
Communicable Diseases
continued

• Serious Viral Diseases
• Chickenpox (Varicella)
• Croup
• Hepatitis A
• Influenza
• Measles, Mumps, Rubella
• RSV

71
Communicable Diseases
continued

• Serious Viral Diseases
• Chickenpox (Varicella)
• Croup
• Hepatitis A
• Influenza
• Measles, Mumps, Rubella
• RSV

72
Communicable Diseases
continued

• Potentially life threatening diseases
• Meningitis
• Whooping cough (Pertussis)

73
Communicable Diseases
continued

• Other diseases
• STD
• Impetigo
• Pinworms
• Ringworm
• Head Lice (infestation)
• Herpes simplex (cold sores)

74
Communicable Diseases
continued

• Other diseases
• STD
• Impetigo
• Pinworms
• Ringworm
• Head Lice (infestation)
• Herpes simplex (cold sores)