It is important for families to remember that staff/carers are not health care professionalsand are unable to diagnose an illness; this is primarily the responsibility of medical practitioners. To ensure that symptoms are not infectious and minimise the spread of an infection, medical advice should always be sought. For example, conjunctivitis is not responsible for all eye discharges. It may be due to a blocked tear duct, for which only a medical practitioner can diagnose and prescribe the appropriate medication or remedy.
Symptoms indicating an illness may include:
- behaviour that is unusual for the individual child, such as child who is normally active and who suddenly becomes lethargic or drowsy;
- high temperature or fever;
- loose bowels;
- faeces which is grey, pale or contains blood;
- discharge from the eye or ear;
- skin that displays rashes, blisters, spots, crusty or weeping sores;
- loss of appetite;
- dark urine;
- stiff neck or other muscular and joint pain;
- continuous scratching of scalp or skin;
- difficulty in swallowing or complaining of a sore throat;
- persistent, prolonged or severe coughing; or
- difficulty in breathing.
(Staying Healthy Preventing infectious diseases in early childhood education and care services Fifth Edition 2012 (Updated June 2013) p17
Shorebreakers Kindergarten understands that an exclusion ruling may place great pressure on parents to fulfill work, study or other family commitments.
Excluding sick children is one way of limiting the spread of infection in a child care centre. The spread of certain infectious diseases can be reduced by excluding a person that is known to be infectious.
The following guidelines are to help you, as parents, to decide whether or not your child is well enough to attend the Centre. You may need a doctor’s letter stating that your child is well enough to return to the Centre following infection from any of these illnesses. The Director or Nominated Supervisor will not be influenced by letters from doctors which allow the child back into care, unless the child’s condition fulfils the criteria for returning to care. Sometimes doctors make different diagnoses for children in the same Centre with illnesses that appear similar. A sign will be placed at the sign on desk in the event of a breakout of any of the listed infectious diseases.
The need for exclusion depends upon:
- The ease with which the infection can be spread
- The ability of the infected person to follow hygiene precautions; and
- The severity of the disease
(Staying Healthy Preventing infectious diseases in early childhood education and care services Fifth Edition 2012 (Updated June 2013)
Recommended exclusion periods are based on the time that a person with a specific disease or condition is likely to be infectious.
A child will not be permitted to attend when s/he:
- Is suffering from an infectious disease as outlined in the National Health and Medical Research Council (NHMRC)
- Has a fever. If a child has fever accompanied by abnormal behavior or symptoms or signs that indicate a possible illness (such as lethargy, drowsiness, severe or prolonged coughing, wheezing, difficulty breathing, unusual irritability or crying), or the child seems unwell and has a temperature of 37.5′ C or above, Paracetamol may be given and every attempt will be made to notify parents. Parents will be asked to collect the child if it is deemed necessary by the Director or Nominated Supervisor and the child must be collected as soon as possible.
- Is too tired or unwell to participate in normal activities without possible detriment to their care and safety, or the child will require extra supervision which may compromise the adequate supervision, care and safety of other children or the child needs to see a doctor for any reason.
- Vomiting & Diarrhoea. If a child has two or more unexplained episodes of vomiting or diarrhoea during the day they are to be excluded from the centre until there has not been a loose bowel motion or vomiting for 24 hours.
- Common Cold is caused by many different viruses that effect the nose and throat. It is the most common infectious illness, especially for young children. Young children may have 8 – 10 colds each year with the highest number usually being during the first two years in child care. A cold itself is not serious but colds can sometimes lead to other infectious such as ear infections and tonsillitis. A child with a common cold should stay home until they are well.
- Conjunctivitis is an inflammation of the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. The inflammation can have many causes, the most common being infection, allergy and irritation. Viral and bacterial conjunctivitis are infectious while there is discharge from the eye. The child should see a doctor for proper diagnoses and treatment. The child must be excluded until the discharge from the eyes has stopped, unless a doctor has diagnosed a non-infectious conjunctivitis.
- Giardiasis is a form of gastroenteritis caused by a parasite called Guardia lamblia. The child must be excluded until diarrhea has stopped for at least 24 hours.
- Glandular Fever. Exclusion is not necessary but it is recommended that the child stays home until the child is well enough to cope with the day at childcare.
- Ear Infections. Ear infections are not contagious, but the cold or other infection that has caused them is. Organisms can only be passed from one child to another if there is infectious fluid draining out of the ear. A child should not attend the Centre while there is fluid draining out of the ear. The child should stay at home until they are well.
- Hand Foot and Mouth Disease. This is a mild viral illness that causes slight fever. Loss of appetite, blisters in the mouth and on hands and feet, and a sore mouth for a few days before the ulcers or blisters appear. It has nothing to do with animal diseases with similar names (e.g. foot and mouth disease in livestock). The child must be excluded until all blisters have dried.
- Head lice (Pediculosis). Exclusion is not necessary if effective treatment is commenced prior to the next day at child care (i.e. the child doesn’t need to be sent home immediately if head lice are detected). An effective treatment is when a treatment is used and all the lice are dead.
- Hepatitis Simplex- Cold sores, fever blisters. Exclusion is not necessary if the person is developmentally capable of maintaining hygiene practices to minimize the risk of transmission. If the person is unable to comply with these practices they should be excluded until the sores are dry. Sores should be covered by a dressing where possible.
- Impetigo (school sores) is a bacterial skin infection. The child should be excluded until appropriate antibiotic treatment has been used for at least 24 hours. Any sores on exposed skin should be covered with a waterproof dressing.
- Measles is a highly infectious and serious viral illness. Children must be excluded for 4 days after rash appears.
Anyone who is not immune and has not received preventative treatment recommended by the Public Health Unit must be excluded for 14 days after the appearance of the rash in the LAST case of measles in the Centre.
- Ringworm is an infectious spreading area of fungal dermatitis. The child must be excluded until the day after appropriate treatment has been commenced.
- Scabies is an infectious disease of the skin caused by a mite. The child is to be excluded and may return to the Centre the day following treatment.
You are asked to keep your unwell child at home to aid recovery and to minimise risk to other children, to other parents and to staff.