Teaching parents and educators about infection control practices can improve prevention and decrease risk of disease transmission to help keep kids in school.
Two common questions asked of pediatricians by parents of children with infections are "When can my child return to school?" and "How long will I be staying home with my child?" Understanding when, how long, and under what conditions a pediatric patient with an infection is contagious to others is an important part of disease prevention and treatment. Similarly, the pediatrician needs to educate parents and educators about infection control practices that improve prevention and decrease risk of disease transmission.
These practices are particularly important in regard to school-aged children because inappropriate exclusion can lead to a significant number of school days missed. At times, the pediatrician may need to contact a school if a child is inappropriately excluded and provide sound reasoning as to why exclusion is not appropriate.
This article is not a complete review of communicable diseases or prevention control measures. Rather, the article reviews a number of diseases that do not require exclusion; common diseases and problems that may require some aspect of exclusion; and a number of prevention control measures.
Infections spread via respiratory routes
When children cough or sneeze, aerosolized droplets can be inhaled by individuals who are nearby, placing them at risk for an infection. A person is more commonly infected, however, when the droplet comes to rest on a surface that he or she touches, and then touches that hand to face, nose, or mouth. As a result, if a child covers a cough or sneezes into his/her hands, this may increase the risk of transmission by contaminating surfaces with mucus from his/her nose, eyes, or throat. (1)
Children should be taught to sneeze or cough into a tissue or paper towel. If this is not available, they should be instructed to sneeze into the crook of the elbow. Children should then perform good hand-washing hygiene.
Preventing infections via direct contact
Children touch everything and often touch their nose, face, and mouth. Good hand hygiene prevents the risk of transmission of diseases through direct contact.
The Centers for Disease Control and Prevention (CDC) recommends a 5-step hand-washing process to avoid getting sick and spreading germs to others: (2)
Wet. Wet hands first with clean, running water and apply soap.
Lather. Rub hands together to lather up, focusing on the backs of the hands, between the fingers, and under finger nails.
Scrub. Scrub hands for at least 20 seconds. Asking children to sing "Happy Birthday" to themselves twice will be about the right amount of time.
Rinse. Hold hands under running water and not standing water. Standing water potentially increases risk of reinfection with the germ or virus. Tell the child to think of the germ/virus as circling the drain away from him.
Dry. Dry hands with a clean towel or let them air dry.
If access to hand-washing is not available, hand sanitizer is an option.
Infections not requiring...
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