Introduction
Common Types of Communicable Diseases
How Diseases are Transmitted
Precautions Against Diseases
Healthy Care Providers
Summary
Resources

Introduction

All providers need to learn and use universal health precautions. Infants and young children who spend time in group child care settings generally have a higher number of illnesses than children kept at home. Frequently, those caring for young children experience increased illnesses as well. As some diseases are contagious even before symptoms appear, care providers need to be aware of how diseases are communicated among children and between children and providers. By always observing caution, providers can do much to prevent the spread of disease.

Common Types of Communicable Diseases

A communicable disease is any bacterial, viral, or parasitic infection in the body that can be spread from one individual to another. This varies from the common cold and flu to more uncommon diseases like meningitis. Some of the more common diseases in young children are

• colds

• chicken pox

• diarrhea

• ring worm/head lice

• impetigo

Infectious diseases of a more serious nature include

• meningitis

• hepatitis

• HIV/AIDS

Clearly, the transmission of cold germs from one person to another does not carry with it the life-threatening implications of a disease like hepatitis or AIDS. On the other hand, some common diseases can be life-threatening if they are not treated appropriately. For example, bacteria and parasites that cause gastrointestinal illnesses, with symptoms of vomiting and diarrhea, can be quite serious in young children. Diarrheal diseases can even be fatal if a child becomes severely dehydrated.

How Diseases are Transmitted

Before looking at ways to prevent the spread of disease, it is helpful to know the ways diseases are transmitted. Diseases are caused by germs, which are transmitted from one person to another through

• the air

• urine and feces

• blood

• saliva

• skin

• drainage, such as nasal mucus or pus from open sores

Germs multiply rapidly in warm moist places. When objects or hands touch places where there are a lot of germs, they pick up the germs, which then enter the body through the nose, eyes, mouth, and/or broken skin.

Impetigo and ring worm are transmitted via direct physical contact with the infected areas of skin.

Diseases like colds, chicken pox, and some forms of meningitis are transmitted largely via the air through sneezes and coughs, although they can also be spread through saliva and nasal drainage.

Diarrhea, which generally is a symptom of some gastrointestinal virus, bacteria, or parasite, is transmitted through feces. Some forms of hepatitis can also be transmitted via feces or through urine and blood. Blood and blood products are the major carriers of HIV, the virus that causes AIDS.

Precautions Against Diseases

The precautions necessary to prevent the spread of one disease are the same for another, regardless of whether the disease is life-threatening. Because diseases can spread from child to child, from child to care provider, and from provider to child, the same precautions - known as universal precautions - should be used. This is also true whether care is being provided for one child or a group of children, and whether the care is in the child’s home, the provider’s home, or in a child care setting. Consistently following appropriate procedures also avoids the unpleasant task of singling out a particular child.

The single most important way to prevent infection is frequent hand washing by both the staff and the children. To minimize the spread of disease to everything that is touched, wash the hands with a liquid disinfectant soap for several minutes at the beginning of the shift, and for at least thirty seconds between each child. Hands should be washed

• after toileting/diapering

• before preparing or eating food

• after handling an animal

• after covering a sneeze or cough

• after blowing the nose

• before and after treating a sore or wound

It is also important to follow these general rules of hygiene:

• Personal grooming articles, such as combs and toothbrushes, and clothing, particularly hats, should never be shared and should be labeled and stored separately.

• Toys and equipment should be cleaned and sanitized frequently, particularly in programs that care for infants and toddlers, who tend to put everything in their mouths.

Diseases that are spread via the air, such as colds, are probably the most difficult to prevent. However, it is possible to control the spread of these germs by

• providing care in well-ventilated areas

• using disposable tissues and depositing soiled tissues in covered containers

• washing toys and eating utensils thoroughly and frequently

• laundering bed linens between use by different children

Because many diseases can be spread via urine and feces, it is important to

• Always wash hands prior to and after changing diapers or assisting a child with toileting.

• Wear disposable gloves whenever possible when changing diapers or assisting with toileting.

• Store soiled diapers in a covered container.

• Use a diaper service or disposable diapers whenever possible.

• Disinfect the changing table after each diapering.

• Locate the diapering area and sink away from the food preparation area.

To prevent the spread of skin infections or blood-borne pathogens like HIV

• Cover any open sore on either a child or a provider with a bandage.

• Dispose of soiled bandages or other dressings in a covered container inaccessible to others.

• Require permission from a physician before a child with skin eruptions can participate in a group setting.

• Sanitize bed linens before they are used by another child.

• Wear disposable gloves whenever possible when cleaning wounds and applying or changing bandages and dressings.

Healthy Care Providers

During the first six to twelve months of employment, most care providers get sick more than usual, because they are exposed to a wide variety of germs. Caring for others can also cause stress, which lowers resistance to illness.

Care providers can stay healthier by following these guidelines:

• Wash hands properly and frequently.

• Maintain current immunizations, especially tetanus.

• Take scheduled breaks and vacations.

• Observe good nutrition.

• Exercise regularly.

• Rest sufficiently each day.

• Engage in hobbies or other activities that do not involve caring for someone else.

Care providers who are ill should take care of themselves, not someone else, because they cannot provide the usual quality of care and they can spread germs to others. In addition, a person who is ill will take longer to get well if there is not the opportunity to recuperate properly. A healthy care provider is the key to a healthy, happy child care experience for children and their families.

Summary

Some bacterial, viral, or parasitic infections are contagious even before symptoms appear. Therefore, it is important for care providers to take the necessary steps to prevent the spread of these communicable diseases.

Precautions necessary to prevent the spread of germs are the same for all diseases and should be followed regularly and consistently for every child, in every setting. The single most important precaution is hand washing. Other universal precautions include properly caring for and cleaning toys, utensils, personal care items, clothing, and bed linens, wearing disposable gloves whenever possible, and properly disposing of articles soiled by bodily fluids.

Resources

American Academy of Pediatrics. (1994). "Children in Out of Home Child Care," in Peter G. (Ed.), 1994 Red Book: Report on the Committee for Infectious Diseases (23rd ed.) (pp. 79-92). Elk Grove Village, IL: American Academy of Pediatrics.

Washington State Department of Social and Health Services, Children’s Administration, Office of Child Care Policy. (1992). An adult-sized guide to child-sized environments: The child care center licensing guidebook DSHS 22-733(x). Olympia, WA.

Washington State Department of Social and Health Services, Children’s Administration, Office of Child Care Policy. (1991). An adult-sized guide to child-sized environments: The family child care home licensing guidebook DSHS 22-808(x). Olympia, WA.

About the Author: Maggie Edgar is both a registered nurse and a social worker. She has had years of experience in child care and respite and crisis care services. She is currently a Regional Coordinator for the ARCH National Resource Center.

ARCH Factsheet Number 42, April, 1996