Illness Exclusion

 

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Illness Exclusions

Chicken pox
            Symptoms/signs
            Fever and skin rash that comes in crops.  Rash begins on the chest,
            back, under arms, neck and face; starts out with red bumps, changes
            to blisters and then scabs.
            Incubation period

            
Usually 13-17 days; can be as long as three weeks
            
Daycare action and comments on communicability
            
Exclude from daycare until blisters have dried into scabs, usually six
            days after  the rash appears.
            Source of infection and mode of transmission

            
Virus spread by direct contact with the blisters or by droplets—small
            particles of  fluid that are expelled from the nose and throat of an
            infected person during sneezing and coughing.  Readily
            communicable.  One attack usually confers immunity.  DO NOT give
            aspirin as there is a risk of Reye Syndrome.  Children on
            immunosuppressive drugs are at high risk.

Cold sores
Respiratory
            Symptoms/signs
            
Cold sores (fever blisters) appear on the lips and face, less often in
            the mouth.  Sores usually crust and heal within a few days.  May be
            confused with impetigo.
            Incubation period
            
2-12 days
            Daycare action and comments on communicability
            
No exclusion necessary for mild oral herpes in children who are in
            control of their mouth secretions.
            Source of infection and mode of transmission
            
Virus is transmitted by direct contact with infected persons, a majority
            of whom have no apparent infections.

Common cold
Respiratory infections (viral)
            Symptoms/signs
            
Runny nose, sneezing, chills, tiredness, fever, muscle aches, sore
            throat, cough which may last 2-7 days.
            Incubation period
            
Colds:  1-3 days.  Other acute respiratory illness, up to 10 days.
            Daycare action and comments on communicability
            
Exclude from daycare until child is without fever for 24 hours and is
            well enough to participate in normal daily activities.
            Source of infection and mode of transmission
            
Different viruses spread directly through coughing, sneezing and
            explosive manner of speech in which droplets are cast; indirectly
            through articles freshly soiled by discharges of infected person.

Fifth disease
            Symptoms/signs
            
Rarely any symptoms other than a rash (“slapped cheek”) that begins
            on cheeks; later found on the backs of arms and legs.  Rash is very
            fine, lacy, pink and tends to come and go in sunlight and heat.
            Incubation period
            
4-14 days; usually 12-14 days
            Daycare action and comments on communicability
            
No exclusion necessary unless fever is present.
            Source of infection and mode of transmission
            
Human Parovirus B19 spread through contact with infected
            respiratory secretions; good hand washing decreases transmission.

Hand, foot and mouth disease
            Symptoms/signs
            
Sores occur toward the front of the mouth, on the sides of the tongue,
            inside the cheeks, and on the gums and may last 7-10 days.  In most
            cases, sores can be found on the palms of the hands, the fingers, and
            the soles of the feet.  A low-grade fever may last 1-2 days.
            Incubation period
            
Usually 3-5 days
            Daycare action and comments on communicability
            
Exclude from daycare until temperature is normal for 24 hours and
            child is well enough to participate in normal daily activities.  Sores
            may still be present.
            Source of infection and mode of transmission
            
Coxsackievirus spread through contact with nose and throat
            discharge and stool of infected person.  Hand washing is important.

Influenza
            Symptoms/signs
            
Sudden onset, fever, headache, muscle pain, generalized discomfort,
            cough, nausea, diarrhea, sore throat and nasal congestion.
            Incubation period
            
1-3 days
            Daycare action and comments on communicability
            
Exclude from daycare until temperature has been normal for 24 hours
            and child has been free of vomiting and diarrhea for 24 hours.   Child needs to
            be well enough to participate in normal activities.
            Source of infection and mode of transmission
            
Virus spread directly through coughing, sneezing, and contact with
            nose or throat discharges of patient.

Impetigo
            Symptoms/signs
           
Blister-like sores that form an oozing, sticky, yellow crust; itching.
            Incubation period
           
Usually 1-10 days
            Daycare action and comments on communicability
            
Exclude from daycare until child has been treated with antibiotics for
            at least a full 24 hours.  Encourage good hand washing.  Avoid open
            contact with sores or close contact with other children.
            Source of infection and mode of transmission
            
Bacteria spread by direct contact with persons or with articles freshly
            soiled with discharges from nose or throat of patient; airborne
            transmission also occurs.  Usually caused by staphylococcus or
            streptococcus.

Infectious mononucleosis
            Symptoms/signs
            
Fever, sore throat, tiredness and swollen glands, especially behind
            the neck.  Sometimes there is a rash.  Often children have no
            symptoms at all.
            Incubation period
            
4-6 weeks
            Daycare action and comments on communicability
            
Exclude from daycare until the child is well enough to return to
            normal activities.
            Source of infection and mode of transmission
            
Epstein-Barr virus spread person to person through saliva; also
            direct contact such as kissing.

Lice
            Symptoms/signs
            
Itching of the scalp. Look for: 1) crawling lice in the hair, 2) eggs
            (nits) glued to the hair near the scalp, and 3) scratch marks on scalp
            or back of neck at hairline.
            Incubation period
            
Nits (eggs) hatch in 6-10 days
            Daycare action and comments on communicability
            
Exclude from daycare until first treatment is completed and no live
            lice are seen.  Considered communicable until treated.  Advise
            exam of household contacts for nits and lice.
            Source of infection and mode of transmission
            
Louse transmitted primarily by direct contact with infested persons.
            Lice also can be transmitted through combs, brushes, bedding,
            wearing apparel, headwear including hair ornaments, helmets,
            sleeping bags.

Pink Eye
            (Conjunctivitis)
            Symptoms/signs
            
Bacterial:  pink or red conjunctiva with pus that causes matting
            of the eyelids; pain or redness of eyelids.  Viral:  pink conjunctiva
            with clear watery discharge and without pain or redness of eyelids.
            Incubation period
            
1-3 days
            Daycare action and comments on communicability
            
Refer for medical diagnosis and treatment; if bacterial, exclude from
            daycare until 24 hours after treatment begins.  If viral and without pus,
            no exclusion.
            Source of infection and mode of transmission
            
Spread through hand-eye contact.

Reye Syndrome
            Symptoms/signs
            
Sudden onset of violent vomiting, mental confusion, extreme
            sleepiness or fatigue, twitching or jerking movements, hostility, coma.
            Incubation period
            
1-7 days following viral infection (cold, flu, chicken pox)
            Daycare action and comments on communicability
            
1.       If one or more symptoms appear, call physician immediately.
            2.       Go to emergency room of hospital.
            3.       Do not give aspirin to a child with a viral illness.
            4.       Exclude from daycare until clinically well.
            Source of infection and mode of transmission
            
Usually follows a viral infection.  It is not contagious.  Causes
            unknown.  No prevention.  Requires immediate attention at onset
            of symptoms.  Most common in young children.

Ringworm
            Symptoms/signs
            
Body:  Ringworm appears as flat, spreading ring-shaped lesions.
            The edge of the lesion may be dry and scaly or moist and crusty.
            As the lesion spreads outward, the center often becomes clear.
            Scalp:  Ringworm may be hard to detect in the early stages.  It often
            begins as a small scaly patch on the scalp.  Mild redness and
            swelling may occur.  Infected hairs become brittle and break off
            easily.
            Incubation period
            
Body:  4-10 days
            Scalp:  10-14 days
            Daycare action and comments on communicability
            
Exclude from daycare until 24 hours after treatment has been started.
            Source of infection and mode of transmission
            
Fungus spread by contact with infected person, animal or
            contaminated articles.

Scabies
            Symptoms/signs
            
Rash and intense itching which may be more severe at night.
            Common location to see the rash are folds of skin between fingers,
            around wrists, elbows and armpits.  Other areas where rash may
            appear are knees, waistline, thighs, male genitals, abdomen, chest
            and lower portion of buttocks.  Infants may be infected on head, neck,
            palms, and soles of feet.
            Incubation period
            
2 weeks-2months; Symptoms may appear in less than 2 weeks if the
            person has had scabies before.
            Daycare action and comments on communicability
            
Exclude from daycare until 24 hours after treatment has been started.
            Source of infection and mode of transmission
            
Mite is transferred by direct contact with skin or through shared
            bedding, towels and clothing of a person with scabies.  Treat all
            members of the household at the same time.

Streptococcal (strep) sore throat/Scarlet fever
            Symptoms/signs
            
Sudden onset of fever, sore throat, swollen glands, headache,
            abdominal pain; nausea headache, abdominal pain; nausea
            and vomiting in severe cases.  With scarlet fever a very fine raised
            rash is present.  A fuzzy white tongue may occur.  The rash appears
            most often on the neck, chest, in folds of the armpit, elbow, groin,
            and on the inner thigh.  Later on there may be peeling of the skin on
            the fingertips and toes.
            Incubation period
            
Usually 1-3 days
            Daycare action and comments on communicability
            
Exclude from daycare until throat culture report is received.  If
            positive for strep, exclude from daycare until 24 hours after
            antibiotic treatment is started and until clinically well.
            Communicable until 24 hours after treatment is started.  Exclude
            from daycare until temperature has been normal for 24 hours.
            Source of infection and mode of transmission
            
Bacteria spread directly from nose and throat discharges of
            infected persons.

Yeast infection (in diaper rash)
            Symptoms/signs
            
When yeast is the cause of a diaper rash, small red spots may be
            seen.  Also, small patches of the rash may appear outside the area
            covered by the diaper, as far away as the chest.
            Daycare action and comments on communicability
            
No exclusion is necessary.  Prescription ointment is needed or
            over-the-counter Lotrimin AF cream is needed to clear up the rash.
            Source of infection and mode of transmission
            
Infection due to yeast (Candida).  More common in children who have
            had multiple or prolonged use of antibiotics.

 


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