Daycare illnesses

The outbreak of hand, foot and mouth disease at several early childhood centres over the past few days has brought into focus the need for proper care and protection when it comes to kindergarten-aged children.

In Jamaica, children go out to daycare centres as early as four months old, and start the formal school system as early as two and a half. With many children with varying illnesses sharing the same space, with children not being toilet- trained, drooling, crawling and exploring, illnesses are sure to spread, and there is little parents can do to prevent the spread of viruses like the common cold.

Hand, foot, and mouth disease is fairly common, and parents should be wise about others that occur in similar settings.

Below are some of the common daycare and early childhood centre illnesses that your child is likely to come in contact with at some point.

Hand, foot, and mouth disease

This is a common childhood illness caused by a Coxsackie virus. The illness most often occurs in the spring and autumn months, and is most frequently seen in young children, infants, and toddlers. It is characterised by fever and a blister-like rash affecting the palms of the hands and soles of the feet along with blisters inside the mouth.

Children usually become infected with the virus from other children in an oral-faecal pattern; that is, from exposure to oral secretions (nasal discharge, saliva, etc) or to stool. It typically occurs in small epidemics in nursery schools or kindergartens.

The initial symptoms include fever and general malaise (poor appetite, aches and pains). These symptoms generally last one to two days before a blister-like rash develops on the hands, feet and in the mouth.

There is no specific treatment. Supportive care, including fever management and prevention of dehydration, are the primary goals. Preventive measures include limiting person-to-person contact and promoting hand washing and other hygienic measures. Children infected with the virus generally recover within one week of developing symptoms.

The common cold

Most children in child care settings will get the common cold a few times for the year. More than 200 different viruses are known to cause the symptoms of the common cold.

While many grandmothers believe that children grow up with colds, and that a sniffle here and a sneeze there is a normal part of childhood, this doesn’t always have to be the case. Sometimes it’s just a matter of proper hygiene habits — plain soap and water — and then making sure that if the child does get sick, she does not spread the infection to the others at home or at daycare.

Colds are caused by viruses, which are spread by droplets. So the cold becomes contagious when kids sneeze, cough and share toys, spreading the virus around.

If you can, doctors advise that you take the child out of the daycare setting once she gets a cold.

Otherwise, the parent should make sure that there are enough caregivers to children in the daycare setting and that they practise adequate hand washing, especially after cleaning secretions.

Here are the distinctions between a cold, the flu, and an allergy:

Cold: Runny nose with clear mucus that may thicken and turn grey, yellow or green over a week. It comes with a cough or a low-grade fever.

Flu: More likely to come on abruptly, accompanied by diarrhoea or vomiting.

Allergy: Itchy, watery eyes and nose, sneezing attacks and itchy skin that lasts for weeks or months.

Chickenpox

Chickenpox (varicella) is a viral infection that causes an itchy, blister-like rash. Chickenpox is highly contagious to people who haven’t had the disease or have been vaccinated against it.

The chickenpox (varicella) vaccine is the best way to prevent chickenpox. The vaccine provides complete protection from the virus for nearly 90 per cent of young children who receive it.

Gastroenteritis

Gastroenteritis is a disease spread mainly by contaminated water or food and by dirty hands or utensils. It is highly contagious. If left untreated it can cause death by dehydration, which may be as a result of the excess vomiting and diarrhoea associated with the illness if fluids are not replaced quickly. Children and the elderly are most at risk.

The best ways to reduce the spread of gastroenteritis include washing hands thoroughly with soap and water after using the toilet, before preparing and eating food and drink, and before breastfeeding or taking care of infants, children or the elderly.

Symptoms of gastroenteritis include vomiting, diarrhoea or running belly, fever and stomach gripes. The most important aspect in the care of persons with gastroenteritis is to replace the fluids lost by frequently giving small amounts of clear fluids such as coconut water, oral rehydration fluid or plain boiled water.

Pink eye

Conjunctivitis or pink eye can be a viral or bacterial infection that results in inflammation of the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. The most common form of pink eye is that caused by a bacterial infection. It is usually characterised by a gritty irritation and an opaque, grey or yellowish discharge that may cause the eyelids to stick together, especially after sleeping. It is highly contagious and can be prevented by frequent hand washing.

Ringworm

Ringworm(medically known as tinea), is not caused by a child’s contact with dirty water nor from walking outdoors without footwear, as many have come to believe. In fact, ringworm is really a mycotic (fungal) infection that is spread from pets to humans, then from one infected child to another.

Ringworm shows up in round patches on the surface of the skin and bald patches on the scalp. Because of the ancient belief that the infection was caused by worms, the name ‘ringworm’ has stuck.

The two more common types of ringworm are Tinea capitis and Tinea corporis. Tinea capitis is ringworm of the scalp, which appears as scalp scaling that is associated with bald spots and is very common in children. This condition is easily spread in schools and at barber shops.

Tinea corporis affects the skin. It often produces the round spots of classic ringworm. Sometimes, these spots have an “active” outer border as they slowly grow and advance.

Ringworm can be treated topically (externally) or orally.

Prevention and control

Child care centres are advised to adopt appropriate infection control practices. These include limiting person-to-person contact and promoting hand washing and other hygienic measures.

Children suspected of being ill should be immediately separated from the general school population and sent home on identification. Frequent disinfection of schools is especially important in order to prevent the spread of illnesses.

Schools should regularly clean all areas and items that are more likely to have frequent hand contact (for example, taps, toys, keyboards, door handles or desks) and also clean these areas immediately when visibly handled by ill people.