Health Practices

The Day Nurseries Act recommends that prior to a child starting in a Day Nursery, he/she should have a complete medical and up-to-date immunizations.  The parents must provide a copy of their child's immunization record prior to starting daycare.
Because children get sick without warning, parents are advised to have a back-up child care plan in place.  For everyone's well-being, ill children cannot be admitted to our daycare centre.  I have the right to refuse to take a sick child into care and determine when a child is too ill to remain in care.  Prompt treatment of any illness will facilitate the child's early return to health and our daycare centre.  In order to ensure the overall health and safety of all children, we ask you do not bring your child to our daycare centre if he/she has:
⦁    An elevated temperature over 100.3oF or 39oC
⦁    *Has a rash that has not been diagnosed by a health care professional.
⦁    Any communicable disease including: Impetigo, Meningitis, Measles, Mumps,

     Whooping Cough (Pertussis), Ringworm, Pinworm, Scabies, Roseola, Hepatitis A,

     Scarlet fever, Strep Throat, Tuberculosis, Bronchitis, Rubella (German Measles) or

     Pneumonia
⦁    Has pink eye

⦁    Has lice.  * Lice must be treated by the parents and completely gone before 

     returning to daycare.
If a child becomes ill at daycare, staff will notify the parent(s).  In the event we are unable to reach you, the staff will contact the emergency contact to pick up your child. 

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Guidelines for Communicable Diseases and Other Childhood Health Issues

 

How long must my child stay home when sick?

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Common cold

Reportable to public Health? -No

How is the illness spread?  It is caused by a virus.  It is spread through the air (coughing, sneezing).  It can also be spread by indirect contact through hands and objects contaminated with nose and throat secretions of an infected person.

What are the common symptoms?  Sneezing, headache, coughing, runny nose, fever, sore throat, lack of energy

How do you prevent spread of the illness?  Good hand hygiene, cover cough and sneezes

How long does a child need to be out of daycare?  Children may continue to attend child care if feeling well enough to take part in all program activities .

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Chicken pox

Reportable to public Health? Yes

How is the illness spread?  It is caused by a virus.  It is spread mainly through the air, by contact with nose and throat secretions of the infected person.  It can be spread indirectly through articles soiled by the fluid from lesions.  Chicken pox is most infectious 1- 2 days before the rash appears and up to 5 days or until all lesions have crusted over.

What are the common symptoms?  It may start with cold like symptoms (runny nose, fever, cough).  The rash of chicken pox resembles small blisters and usually appears on the chest and back first.

How do you prevent spread of the illness?  Good hand hygiene, cover cough and sneezes.

Parents may wish to speak with their health care provider about a chicken pox vaccine for children who have never had the illness.

How long does a child need to be out of daycare?

Children with mild chicken pox (fewer than 30 spots) can continue to attend daycare, provided they are well enough to comfortably participate in all program activities.  A child with a high fever and or enough spots to be uncomfortable, or who is feeling unwell, should be excluded until they feel well enough to participate in all program activities.

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Fifth disease

Reportable to public Health? No

How is the illness spread?  It is caused by a virus.  It is spread by direct contact with nose and throat secretions of an infected person (e.g.  sharing utensils and cups)

What are the common symptoms? Symptoms include a bright red "slapped cheek" like rash, followed by a lace-like rash on body, arms, and legs.

How do you prevent spread of the illness?  Good hand hygiene, cover cough and sneezes.

How long does a child need to be out of daycare?  Children may continue to attend daycare if they are feeling well enough to participate in all program activities.  (Exclusion is ineffective because transmission occurs before the start of the rash.)

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Hand, Foot and Mouth disease

Reportable to public Health? No

How is the illness spread? It is caused by a virus.  It is spread by direct contact with nose and throat secretions of an infected person.  *Please note the virus persists in an infected person's stool for several weeks.  Precautions must be taken when changing diapers and helping children with the potty.

What are the common symptoms?  Fever, sore throat, and sores in mouth.  May have rash on hands, feet and sometimes buttocks.

How do you prevent spread of the illness? Good hand hygiene, cover cough and sneezes.

How long does a child need to be out of daycare?  Children may continue to attend daycare if they are feeling well enough to participate in all program activities.

Those with fever, mouth sores or oozing lesions should not attend child care.

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Diarrhea

Reportable to public Health?  It depends on the cause of the illness.  *Call Public Health to discuss 905-688-8248 ext. 7330

How is the illness spread? It is caused by viruses, bacteria, and or parasites.  It can be spread by contaminated food or water.

What are the common symptoms?  Diarrhea, abdominal cramping, poor appetite, vomiting and or fever.

How do you prevent spread of the illness?  For one episode of diarrhea separate child from other children and watch for other signs of illness.  If there is no further diarrhea and the child doesn't appear ill, they may return the following day.

If a child has frequent diarrhea, appears ill, has a fever, is in pain, or blood appears, parents are to be notified immediately.  Ask them to pick up and seek medical advice.

Clean up child's surroundings (anything that may have been touched by the child's stool) as soon as possible.  Take special care with diaper change area and with hand washing.  Good hand hygiene.  Safe food handling.

How long does a child need to be out of daycare? Children should not return to daycare until 24 hours after diarrhea stops. Exclusion period may vary depending on the cause of illness, number of cases and source of the infection.

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Measles (Red Measles)

Reportable to public Health? Yes

How is the illness spread?   It is a virus.  It is spread by respiratory secretions (airborne) or direct contact with nose and throat secretions of an infected person. Less commonly, it is spread by indirect contact with objects contaminated by secretions.

What are the common symptoms? Fever, conjunctivitis or pink eye, white spots inside the mouth, cough, runny nose, and red blotchy rash on the 3rd to 7th day of illness (starts on face and spreads to the body).  It lasts 4 - 7 days.

How do you prevent spread of the illness?  All children should receive 2 doses of measles vaccine after their first birthday.  Good hand hygiene.  Cover coughs and sneezes.

How long does a child need to be out of daycare? Exclude from daycare for 4 days after the onset of rash.  Public Health staff will be in contact with the daycare facility to discuss exclusion of ill child and to discuss recommendations.

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Influenza (flu) - respiratory illness NOT stomach 'flu'

Reportable to public Health? Yes

How is the illness spread? It is caused by a virus.  It is spread by respiratory secretions from the nose and/or mouth (coughing/sneezing) or indirect contact with contaminated surfaces (door knobs, toys)

What are the common symptoms? Sudden onset of fever, chills, headache, sore throat, body aches, and cough

How do you prevent spread of the illness? Good hand hygiene. Cover your coughs and sneezes.  Environmental cleaning of high touch areas (door knobs, railings, etc.)

How long does a child need to be out of daycare?  Children should not attend daycare until 5 to 7 days after the start of symptoms, or until they are fever free and able to participate in all program activities.

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Meningitis (Bacterial)

Reportable to public Health? Yes

How is the illness spread?  It is caused by a bacteria.  It is spread by direct contact with mouth and/or nose secretions of an infected person.  It can also be spread by indirect contact with contaminated objects, (e.g. eating utensils, water bottles).

What are the common symptoms? Symptoms vary depending on the type of bacteria that is causing the illness.

How do you prevent spread of the illness?  Immunization is available to protect against the 3 forms of bacterial meningitis (streptococcus pneumoniae, neisseria meningitidis, haemophilus influenza type B)

Contacts of a case may be prescribed antibiotics.  Vaccinations may also be recommended for contacts of a case.  Good hand hygiene.  Cover cough and sneezes.  Avoid sharing personal items (e.g. eating utensils).

How long does a child need to be out of daycare? All cases must be discussed with Public Health on an individual basis. Recommendations will be based on the specific bacterial meningitis.

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Meningitis (Viral)

Reportable to public Health? Yes

How is the illness spread?  It is caused by a virus.  It varies depending on the specific virus.

What are the common symptoms?  Usually a complication of another infection caused by a virus.

How do you prevent spread of the illness? Good hand hygiene.  Cover cough and sneezes.

How long does a child need to be out of daycare? All cases must be discussed with Public Health on an individual basis.

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Impetigo

Reportable to public Health? No

How is the illness spread? It is caused by a bacteria.  It is spread by direct and indirect contact with the fluid in the sores.

What are the common symptoms?  A rash usually appears as a cluster of blisters or red bumps around the nose, mouth and parts not covered by clothing.

How do you prevent spread of the illness? Good Hand Hygiene.  Cover cuts and sores.  Keep skin healthy.  See a health care provider, medication will be prescribed.

How long does a child need to be out of daycare? Children should not attend daycare, until 5 days after the start of symptoms, or until they are fever free and can participate in all program activities.

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Pink-eye (bacterial)

Reportable to public Health? No

How is the illness spread? It is caused by a bacteria or a virus.  It is spread by direct contact with the eye(s) or indirect contact with the discharge from the eye(s) of an infected person.

What are the common symptoms?  The eye(s) may feel "scratchy" or the child may complain of pain.  There is a pus like discharge from the eye(s).  The whites of the eyes may be pink or red.

How do you prevent spread of the illness? Good Hand Hygiene.  Avoid sharing face cloths and hand/bath towels.  See a health care provider, medication will be prescribed.

How long does a child need to be out of daycare? A child should stay home until he/she is seen by a doctor . If it is bacterial pink-eye the child can return to child care after 24 hours of appropriate antibiotic treatment . If viral, child can return with doctor’s approval.

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Pinworm

Reportable to public Health? No

How is the illness spread? It is caused by a parasitic worm.  Parasite eggs are transmitted by hand from anal area to mouth.  It can also be spread indirectly through clothing, bedding, food or other articles contaminated with parasite eggs.

What are the common symptoms?  Itching at the anal area is the most common symptom.

How do you prevent spread of the illness? See a health care provider, medication will be prescribed.  Good hand hygiene.  Children should be discouraged from sucking fingers, biting nails and scratching anal area.

How long does a child need to be out of daycare? Children can return to daycare after treatment.

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Ringworm

Reportable to public Health? No

How is the illness spread? Person to person by direct skin to skin contact.  Indirectly from contact with contaminated objects (e.g. shared combs, unwashed cloths) or surfaces (e.g. shower or pool surfaces).

What are the common symptoms?

Ringworm of the body- a flat, spreading ring-shaped lesion with a raised edge; as it progresses the centre of the lesion appears to clear; may be itchy and flakey

Ringworm of the scalp- starts with a red area on the scalp that spreads leaving a scaly patch and partial hair loss in that area.

Ringworm of the feet- itchy, scaly and cracking between the toes.

How do you prevent spread of the illness? See a health care provider, medication will be prescribed.  Children should be discouraged from sharing personal items (e.g. combs, brushes, hair accessories).

Children should be encouraged to wear footwear in public showers and pool areas.

Good hand hygiene.

How long does a child need to be out of daycare?  Children can return to daycare after treatment has started.

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Roseola

Reportable to public Health? No

How is the illness spread? It is caused by a virus.  The spread is not well known.  It may be spread by direct contact with saliva of an infected person.

What are the common symptoms? High fever with crankiness for 3-5 days.  Fever is followed by a rose-pink coloured rash on the face and body, lasting a few hours to two days.

How do you prevent spread of the illness? Good hand hygiene.  Cover cough and sneezes.  Children should not share personal items (e.g. drinking glasses).

How long does a child need to be out of daycare? Children can return to daycare when fever resolves and they are well enough to participate in all program activities.

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Rubella (German Measles)

Reportable to public Health? Yes

How is the illness spread? It is caused by a virus. It is spread by direct contact with respiratory secretions of an infected person.

What are the common symptoms? It may begin with mild symptoms of a cold, but usually the first symptom is a rash.  The rash starts on the face and then spreads to the rest of the body.  Glands are usually swollen along hairline in the back of the neck and below the ear.

How do you prevent spread of the illness? All children should receive 2 doses of the Rubella vaccine after their first birthday.  Cover coughs and sneezes.  Good hand hygiene.

How long does a child need to be out of daycare? Exclude for 7 days after the rash is first noticed.  Public Health staff will be in contact with daycare facility to discuss exclusion of ill child and children who are not immunized or inadequately immunized.

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Scabies

Reportable to public Health? No

How is the illness spread? It is caused by a mite burrowing under the skin.  Direct skin-to-skin contact with infested person.  Indirect contact with clothing or articles used by an infected person (e.g. bedding & towels).

What are the common symptoms? Itchy red rash, usually between fingers and toes or the wrists or in the groin, with thread-like lines and scratch marks.

How do you prevent spread of the illness? See a health care provider, medication will be prescribed.  Cases must be treated.  All members of the family who had direct skin to skin contact with a case should be treated at the same time.

How long does a child need to be out of daycare? Exclude from daycare until the first treatment has been applied.

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Molluscum Contagiosum

Reportable to public Health? No

How is the illness spread? The virus spreads from person to person, by direct contact (skin to skin) with lesions or indirect contact (e.g. bed linens).

What are the common symptoms? Smooth, shiny, pinkish-white bumps with a sunken centre.  Bumps can appear anywhere on the child's body.

How do you prevent spread of the illness? Good hand hygiene.  Do not share towels or clothing with others.  Do not touch, pick or scratch the bumps.  Parents may want to speak with a health care provider about treatment.

How long does a child need to be out of daycare? No exclusion necessary.

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Mononucleosis

Reportable to public Health? No

How is the illness spread? It is caused by a virus.  Direct contact with mouth and/or nose secretions of infected person.  Indirect contact with contaminated objects (e.g. eating utensils).  Virus can be spread for many months after the start of symptoms.

What are the common symptoms? Headache, fever, sore throat, enlarged glands, feeling tired

How do you prevent spread of the illness? Good hand hygiene.  Cover cough and sneezes.  Avoid sharing personal items (e.g. eating utensils).

How long does a child need to be out of daycare? No exclusion.

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Mumps

Reportable to public Health? Yes

How is the illness spread? It is caused by a virus.  It is spread by respiratory secretions or direct contact with nose and throat secretions of infected person.  Less commonly, it is spread by indirect contact with objects contaminated with secretions.

What are the common symptoms? Fever, followed by swelling and tenderness of the salivary glands (along the jaw line).

How do you prevent spread of the illness? All children should receive 2 doses of mumps vaccine after first birthday.  Good hand hygiene.  Cover coughs and sneezes.

How long does a child need to be out of daycare? Exclude for 5 days from the onset of swelling.  Public Health staff will be in contact with the daycare facility to discuss exclusion of ill child and children who are not immunized or inadequately immunized.

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Pertussis (Whooping Cough)

Reportable to public Health? Yes

How is the illness spread? It is caused by a bacteria.  It is spread by droplets from the mouth and nose of an infected person.

What are the common symptoms? It begins with mild symptoms, similar to a common cold.  Cough progresses and the characteristic "whoop" may or may not be heard.  Coughing may end in vomiting.  Symptoms may last weeks to months.

How do you prevent spread of the illness? All children should be immunized.  Good hand hygiene.  Cover cough and sneezes.  See a health care provider, medication will be prescribed.

How long does a child need to be out of daycare? Exclude for 3 weeks after the onset of cough or until completion of 5 days of antibiotics.  Public Health staff will be in contact with the daycare facility to discuss recommendations for contact of a case.  (e.g. antibiotics, vaccination).

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Streptococcal Infections (Scarlet Fever/Strep Throat)

Reportable to public Health? No

How is the illness spread?  It is caused by a bacteria.  It is spread by respiratory droplets or direct contact with infected person (e.g. kissing)

What are the common symptoms? 

Strep Throat:  fever, sore throat, swollen neck glands are common.

Scarlet Fever: is strep throat with a red sunburn-like rash covering the entire body.

How do you prevent spread of the illness? See a health care provider, medication may be prescribed.  Children should not share personal items, (e.g. eating utensils, toothbrushes).  Good hand hygiene.

How long does a child need to be out of daycare? Children should not return to daycare until the antibiotic prescribed by a health care provider has been taken for at least one full day (24 hours), and the child is well enough to participate in all program activities.

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*If your child is feeling ill and not able to participate in all program activities, it is best they stay home and rest.  If your health care professional recommends they remain home or have additional treatment, I strongly suggest you follow their medical advice.

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Important Phone Numbers:

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Niagara Region Public Health

Phone: 905-688-8248 or 1-888-505-6074

To report or ask questions about:

A disease....................................................ext.7330

An outbreak................................................ext.7330

An animal bite.............................................ext.7767

Environmental cleaning.................................ext.7767

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Telehealth Ontario 1-866-797-0000 TTY: 1-866-797-0007

Free Access to a Registered Nurse — 24 Hours a day, 7 days a Week.

Telehealth Ontario is a free, confidential telephone service you can call to get health advice or

general health information from a registered nurse. The nurse can assess symptoms and help you

decide whether to take care of your child yourself, make an appointment with your health care

provider, go to a clinic, contact a community service or go to a hospital emergency room. You do

not need to provide your health insurance number and all information is confidential.

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Ontario Poison Centre  1-800-268-9017

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Your Child's Health

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Call your health care provider or go to the hospital if your child:

• Appears unusually ill

• Has a fever that doesn’t get better within 48 hours

• Is more cranky or fussy than usual

• Seems sleepier than usual, is lethargic or does not respond to you

• Has a rash or any other signs of illness that worry you

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Fever

• Fever is a symptom, not a diagnosis

• Fever is defined as a temperature greater than 37.2 C or 99 F when taken under the arm

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If your child has a fever:

• Keep your child comfortable and offer lots of fluids

• Remove extra blankets and clothing so heat can leave the body and help lower their body temperature

•Don’t undress your child– they may become too cold and start shivering, making more body heat and

  causing their temperature to rise again

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Thermometer Facts

•  A digital thermometer can be used for oral (under the tongue) or axilla (armpit) temperature taking

• Taking your child’s temperature in the armpit is the safest and easiest method

• Fever strips are NOT recommended because they do not give accurate readings

• Mercury thermometers are NOT to be used – if it breaks you and your child may be exposed to toxic material

• Follow the instructions on the package

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* A child with a fever should NOT be given aspirin. Taking aspirin can increase the risk of Reye’s Syndrome – a very serious condition that can damage the liver and brain.

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Free dental services

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Niagara Region Public Health provides FREE dental programs and services to eligible children and youth

(17 years of age and younger) .

To see if your child qualifies or for more information please call the Dental Health Line at:

905-688-8248 or 1-888-505-6074 ext . 7399 or visit www.niagararegion.ca/health

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