Section 1: Illness in Child Care

Section 1: Illness in Child Care

1.1 Importance of Understanding Illness

Knowledge of Illness, Its Spread, and the Importance of Prevention

Illness in child care settings is a significant concern due to the close contact among children, their developing immune systems, and the potential for rapid spread of infectious diseases. Common illnesses include respiratory infections (such as colds and influenza), gastrointestinal infections (like norovirus), and vaccine-preventable diseases (e.g., measles, mumps).

How Illness Spreads: Illnesses can spread through several routes:

  • Direct contact: Person-to-person touch, such as hugging or holding hands.
  • Indirect contact: Touching contaminated surfaces or objects (toys, doorknobs).
  • Droplet transmission: Coughing or sneezing releases droplets that can be inhaled by others.
  • Fecal-oral route: Particularly with poor hand hygiene after diaper changes or toileting.

Why Prevention is Critical: Preventing illness in child care is essential because:

  • Young children are more susceptible to complications from infections.
  • Outbreaks can disrupt families, staff, and the broader community.
  • Preventive measures reduce absenteeism and promote a healthy learning environment.

According to the textbook Healthy Foundations in Early Childhood Settings (2019), effective illness prevention strategies—such as immunization, hand hygiene, environmental cleaning, and exclusion policies—are foundational to maintaining health in group care environments (Pimento & Kernested, 2019).

Toronto Public Health emphasizes that “preventing the spread of illness in child care centres protects not only the children but also staff and families” (Toronto Public Health, 2023).

1.2 Toronto Public Health Support for Illness Management

How TPH Supports Illness Management and Prevention in Childcare

Toronto Public Health provides comprehensive guidance and resources to support illness management and prevention in child care settings. Their supports include:

  • Guidelines and Protocols: TPH publishes the Child Care Centre Guidelines and Infection Prevention and Control in Child Care Centres, which outline daily health checks, exclusion criteria, cleaning protocols, and outbreak management procedures (Toronto Public Health, 2023).
  • Training and Consultation: TPH offers training for child care staff on infection control, proper hand hygiene, and cleaning/disinfection practices.
  • Reporting and Surveillance: Child care centres are required to report certain communicable diseases and outbreaks to TPH, who then provide further direction and support.
  • Resource Materials: Posters, fact sheets, and checklists are provided to reinforce best practices in illness prevention.

“Toronto Public Health works closely with child care centres to prevent and manage outbreaks, providing guidance on exclusion, cleaning, and communication with families.” (Toronto Public Health, Infection Prevention and Control in Child Care Centres, 2023)What is an Outbreak? TPH Recommendations and Requirements

Definition of an Outbreak: An outbreak in a child care setting is typically defined as two or more cases of the same illness (with similar symptoms) occurring within a specific time frame and location, suggesting person-to-person transmission (Toronto Public Health, 2023).

TPH Steps During an Outbreak:

  1. Immediate Reporting: The centre must notify TPH as soon as an outbreak is suspected.
  2. Case Identification: Staff identify and document all symptomatic individuals.
  3. Exclusion: Sick children and staff are excluded according to TPH recommendations (e.g., until symptom-free for 24 hours).
  4. Enhanced Cleaning: Increase frequency of cleaning and disinfection of high-touch surfaces and shared items.
  5. Communication: Inform parents/guardians about the outbreak and preventive measures being taken.
  6. Monitoring: Continue daily health checks and monitor for new cases.
  7. Collaboration: Work with TPH to implement additional control measures if needed.

Roles:

  • Staff: Monitor for symptoms, maintain records, enforce exclusion, enhance cleaning, communicate with families.
  • TPH: Provide guidance, investigate the outbreak, recommend control measures, and determine when the outbreak is over.

Timeline: Response begins immediately upon suspicion of an outbreak. TPH will follow up within 24 hours of notification and continue to monitor until no new cases are identified for a specified period (usually 48 hours after the last case).

“During an outbreak, child care centres must follow enhanced infection prevention and control measures as directed by Toronto Public Health, including exclusion of ill individuals, increased cleaning, and ongoing communication with TPH.” (Toronto Public Health, Outbreak Management Guide for Child Care Centres, 2023)

1.3 Documents/Forms Related to Illness in Child Care

1. Daily Illness Log / Symptom Record

  • Purpose: To track and monitor symptoms of illness among children and staff.
  • Requirements: Must be completed daily, noting any signs of illness (fever, cough, vomiting, diarrhea, rash, etc.), date/time, and actions taken (e.g., exclusion, parental notification).
  • Importance: Helps identify patterns, facilitates early detection of outbreaks, and provides documentation for TPH if reporting is required.

2. Line List / Outbreak Report Form

  • Purpose: Used during an outbreak to record details of each affected individual (name/initials, age, symptoms, onset date, exclusion dates).
  • Requirements: Updated daily and submitted to TPH as requested.
  • Importance: Enables TPH to assess the scope of the outbreak, monitor its progression, and guide control measures.

“Child care centres are required to maintain accurate illness logs and complete line lists during outbreaks, as these documents are critical for public health monitoring and response.” (Toronto Public Health, Outbreak Management Guide for Child Care Centres, 2023)