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The following list of illnesses, symptoms and policies have been compiled with consultation from our Pediatric

Consultant, Lewis Pediatrics, as well as the publication "Infection Control in the Child Care and Preschool" by Leigh G. Donowitz, M.D. Although the list is quite comprehensive, you should consult with the Director if your child exhibits symptoms of or is diagnosed with an illness that is not addressed in these pages.
Illness Bacterial Illnesses Symptoms Center Procedure Return to Care

Such as: Ear Infection Bronchitis Chicken Pox

Ear Pulling, earache pain, fever Coughing Fever Small water blisters that break easily & crust over, itchy, fever, crankiness
Eye inflammation

With one symptom or low grade fever, observe child Multiple symptoms or fever of 101 or higher, call parent to pick up

After 24 hours of antibiotics OR note from Doctor stating child may return to daycare AND when free from fever After diagnosis that child is not contagious OR until all blisters break and scab (usually 6 days after onset of rash) AND free from fever of 101 degrees or above AND able to participate fully Bacterial - after 24 hours of antibiotics Viral - until symptoms disappear When free from fever of 101 or higher for 24 hours AND able to participate fully

Call parent to pick up

Conjunctivitis

With one symptom, observe child


Multiple symptoms, or fever of 101 or higher, call parents to pick up

redness, pus Croup


Hoarse, barking cough

Hand-Foot-Mouth
Disease (Coxsackie)

Respiratory strider Strider with inspiration Fever Lesions that may occur on inside of
mouth, hands, feet,

If free from fever and able to participate, observe child If fever is present, child is having respiratory difficulty or child has difficulty participating in program, call parent to pick up
When lesions are observed, continue to observe child and alert parent

When fever is present, call parent to pick up

When free from fever AND able to participate fully

Head Lice * (Pediculosis)

buttocks, fever Itching, scratching of scalp, appearance of live louse, eggs (nits) attached to hairs

Conduct head check to determine the cause of the discomfort Call parent to pick up if nits or lice are present

Once treatment has been completed and nits removed

*It is essential that all clothing, bedding and other vehicles of transmission (car, stuffed animals, etc.) be laundered in hot water and dried on high heat and that all family members be checked and treated when indicated. Items that cannot be laundered should be sealed in a plastic bag for two weeks.

Impetigo

Multiple skin lesions usually around face &


mouth. Sometimes

Call parent to have child seen by medical professional

If diagnosed with a non-contagious skin condition, child may return with doctor's note. If diagnosis is impetigo, child may return 24 hours after treatment begins

Influenza

elbows, knees & legs. Blisters that rapidly change to yellow crusted areas Headache, chills, muscle aches, sore

Call parent to pick up

Symptom free for 24 hours AND able to resume full activities

throat, fever
Illness Symptoms Center Procedure Return to Care

Meningitis

Non-specific Respiratory Infection Diarrhea

Sudden onset of fever, intense headache, nausea, stiff neck, possible rash Runny nose, cough sneezing, malaise low grade fever Increase in frequency & consistency of bowel movements bloating, gas, abdominal pain, blood, lethargy, dehydration, fever of 101 or above Rose-red rash Slapped face appearance may spread to limbs & trunk Vomiting once, with no other symptoms of illness Vomiting once with additional symptoms such as diarrhea abdominal pain or fever or vomiting more than once

Call parent for immediate examination by doctor

After course of treatment (usually 24 hours after treatment begins) AND doctor's written permission to return No exclusion as long as free from fever of 101 or higher AND able to participate When diarrhea is manageable with regular diet AND child is free from fever of 101 degrees or higher

Observe child, may alert parent if symptoms begin while in care

For 1-3 liquid bowel movements, observe child, alert parents For more than 3 liquid bowel movements or movements that cannot be contained to diaper or toilet, call parent to pick up

Diarrhea with one or more of the following:

Call parent to pick up

Fifth Disease

Inform parent. There is no need to exclude the child unless s/he is uncomfortable and not able to participate in group care

No exclusion necessary - once rash appears, child is no longer contagious If child was sent home due to discomfort, s/he may return as soon as able to participate in group activities Free from symptoms, able to eat solid foods, and free from fever of 101 or higher

Gastroenteritis

Observe child, alert parent

Call parent to pick up

No exclusion necessary IF a doctor determines that


vomiting is caused by a non-communicable condition and the child is not in danger of dehydration

Illness

Symptoms

Center Procedure

Return to Care

Pinworms

Roseola

Rotavirus

Scabies

Streptococcal Infections (Strep Throat, Scarlet Fever) Thrush Candida

Itching around rectum, possible wheezing, coughing, fever, diarrhea, abdominal pain Sudden, high fever, rash on chest and abdomen Sporadic, severe diarrhea & vomiting Itchy, raised areas or burrows around fingers, wrists, elbows arm pits and waistline Extensive scratching, especially at night Sudden illness with vomiting, fever, sore throat, headache, stomach ache, bright red rash Acute inflammation of tongue and mouth White or grayish plaques on mucous membranes Fiery red rash may contain lesions that range from slightly raised red papules to eroded lesions

Call parent to pick up

After exam by doctor and start of treatment if indicated

Call parent to pick up

When rash disappears or with note from doctor indicating child may return to daycare When asymptomatic

Call parent to pick up

Call parent to have child evaluated

until 24 hours after treatment begins

Call parent to have child evaluated

24 hours after treatment begins

Mobile infants and toddlers need to be evaluated and treated

Since person to person transmission occurs rarely, child may return once treatment begins

Diaper Dermatitis

Alert parent and recommend visit to a medical professional

No exclusion required