Diseases Spread Through Direct Contact (Touching)

Direct contact may easily spread infections in child care settings. A child or staff member can get these diseases simply by touching the infected area of another person’s body, secretions, or personal objects. Because of the inquisitive nature of young children, these infections spread easily in a child care setting.

Some simple rules to stop the spread of diseases that are spread by direct contact are:

  • Thoroughly wash hands after contact with possibly infectious secretions.
  • Dispose of tissues properly.
  • Use soap; disposable liquid soap dispensers are preferred.
  • Never use the same tissue, towel or washcloth for more than one child.
  • Wash, then disinfect toys at least daily.
  • Each child should have his/her own sleeping mat and sheets.
  • Do not allow children to share personal items such as brushes, combs, blankets, hats or clothing.
  • Store each child’s dirty clothing separately in plastic bags. Do not launder children’s clothing at the center.
  • Wash and cover all sores, cuts or scrapes promptly.
  • Report anything abnormal to the parents.

LICE

What are they?

Lice are small insects that live on the scalp and hair. The adult louse lays its eggs (nits) at the root of the hair where they become firmly attached. Lice may not be visible, but the eggs (nits) can be seen sticking to the hair shafts.

How do they spread?

By direct contact with the infected person or with personal objects such as hats, combs, bedding or clothing. Lice are not spread by pets, and cannot jump or fly.

What are the symptoms?

Itching is the most common symptom of head lice. Tiny pear‑shaped white eggs covering the roots of the hair may be seen. Often, red bite marks or scratch marks can be seen on the child’s scalp and neck. In some cases, there could be excoriations, secondary infections and lymphadenopathy present.

What is the incubation period?

Seventeen to twenty-five days

What is the period of communicability?

Until treatment has begun

How can I prevent or control the spread of the infection?

  • Infected children should be excluded until the morning after their first treatment. The risk of transmission is promptly reduced by treatment.
  • Proper treatment consists of shampoos or special lotions made for the purpose of killing lice. These products are available over the counter. A second treatment, 7‑10 days later, is usually recommended. Follow recommendations made by the shampoo instruction label.
  • Learn to recognize nits and regularly check children’s hair.
  • Avoid sharing hair care items such as brushes or combs, and items such as towels, bedding, clothing and hats.
  • Hang children’s clothing in individual lockers or on assigned coat hooks.
  • Check children for nits frequently throughout the year. Families of those children who were infected should also be checked.
  • All combs and brushes should be boiled for 10 minutes or soaked for 1 hour in 2 percent Lysol solution or pediculicide shampoo.
  • Vacuum floors, furniture and mattresses to get rid of lice.

SCABIES

What are they?

Scabies is a skin infection caused by a mite (a small insect of the spider family).

How does it spread?

By direct contact with an infected person. The mites can survive only a few days off the body and cannot jump or fly.

What are the symptoms?

A rash with severe itching, mostly at night, is the most common symptom of scabies. In children, the rash is most likely to appear on the head, neck, palms and soles of the feet, or between the fingers. The characteristic mite burrow consists of a short, wavy, dirty line on the skin.

What is the incubation period?

Two weeks to two months, depending on whether the infected person has had scabies before.

What is the period of communicability?

Scabies can be spread from the time a person acquires the mites until 24 hours after treatment begins.

How can I prevent or control the spread of the infection?

  • Temporarily exclude the child from the center until the day after treatment begins.
  • Treat infected children with medications that are effective against mites.
  • It might be necessary to treat the other children and caregivers in the child’s group as well as family members.
  • Wash in hot water all washable items belonging to the center that came into contact with the child’s skin 72 hours prior to treatment. Dry on hot cycle.
  • Place difficult to wash items in tightly closed plastic bags for four days
  • Vacuum any carpet or upholstered furniture.

IMPETIGO

What is it?

Impetigo is a contagious bacterial skin infection. It often occurs on the lips or nose but can occur anywhere on the body.

How does it spread?

By direct contact with the sores; sometimes it can be spread from secretions from the nose and throat.

What are the symptoms?

Common symptoms of impetigo are honey-crusted sores and a rash that looks oozy, red, round and itches. Tiny blisters form around the nose or mouth that ooze and then form scabs.

What is the incubation period?

One to ten days (usually five days)

What is the period of communicability?

Impetigo can be spread until sores are healed or the child has been on antibiotics for 24 hours.

How can I prevent or control the spread of the infection?

  • Parents should contact their physician for diagnosis and treatment.
  • Exclude the child until 24 hours after treatment has begun or until sores are healed.
  • Wash the child’s rash with soap and water. Put some type of covering over it in order to prevent spread.
  • The child’s hands should be washed frequently (especially after contact with the sores) with soap and water.
  • Change towels, linens and clothes at least daily.
  • Avoid using towels and linens used by the child.

RINGWORM

What is it?

Ringworm is a fungal infection of the skin and hair. Although ringworm is not serious and is easily treated, it is unattractive and irritating.

How does it spread?

By direct contact with infected skin or when a person comes in contact with contaminated objects. This can include animals, soil, towels, bedding, etc.

What are the symptoms?

The characteristic rash, or ringworm, is round with red or gray scaly patches. The edges may be raised, reddish and itchy. The center often looks like normal skin. On the scalp, the infection often begins as a small patch and eventually causes temporary hair loss. It may progress to patches of scaling and baldness.

What is the period of communicability?

Ringworm can be spread as long as the infected lesions are present.

How can I prevent or control the spread of the infection?

  • Refer the child to the physician for a diagnosis and treatment.
  • An infected child should be excluded only until treatment has begun.
  • Parents and staff members should be notified if more than one person develops ringworm.
  • The child care should be kept clean, dry and cool, since ringworm fungi grow in a moist, warm environment.
  • Children should not share personal items such as hats, combs, towels or bedding.
  • Good personal hygiene should be practiced.

CONJUNCTIVITIS (PINKEYE)

What is it?

Conjunctivitis is an inflammation of the conjunctiva (membrane covering the eyeball). It can be caused by either a virus or bacterial infection.

How does it spread?

Through direct contact with infected secretions of the eye, nose and throat. It can also be spread when staff members wash or dry an infected child’s face and use the same towel on another child.

What are the symptoms?

The most common symptom of conjunctivitis is pink around the white parts of the eyes. The infected eyes also produce tears and discharge, pus and may itch or be swollen. Often the child’s eyelids stick together in the morning because of the secretions during sleep.

What is the incubation period?

One to three days

What is the period of communicability?

Pinkeye can be spread until the active infection passes (for viral) or until 24 hours of treatment (for bacterial).

How can I prevent or control the spread of the infection?

  • Refer the child to the physician for proper diagnosis, particularly if there is yellow or heavy eye discharge.
  • If pinkeye is caused by a bacterial infection *and requires antibiotic eyedrops, exclude the child until after treatment begins.
  • Use a separate cloth and towel to wash each child’s face.
  • Practice good hand washing after every contact with children’s eyes.
  • Dispose of contaminated tissues properly.
  • Clean with soap and water, and disinfect mouthed toys or toys that come in contact with the children’s eyes daily or when soiled.
  • Keep the child’s eyes wiped free of discharge and wash hands after contact with the child’s eyes.
  • Teach children to wash their hands after wiping their eyes and to try to avoid rubbing their eyes.

Note: The AAP says specifically NOT to exclude a child with nonpurulent conjunctivitie.
 

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