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Children Are Susceptible Too Many Illnesses In Day Care.
Why Are Parents Not Being More Cautious?
The number of children spending time in day care grows each year. Health officials have estimated that approximately two-thirds of all preschool children and three-quarters of all school age children need some sort of child care while their parents work.
With this rise in day care usage comes and increased risk of illness to the children who participate.
Infants and toddlers in daycare settings are as twice as likely as those in home care to contract an illness that last more than 10 days, causes a fever of at least 102 degrees for three or more days, or requires medical attention.
For a variety of reasons, germs easily spread from child to child in the close quarters of the day care setting. A variety of infectious organisms have been isolated from day care workers and children.
Among the most common are:
- Giardia lamblia
- Escherichia coli
- Entamoeba histolytica
- Haemophilus influenzae
- Streptococcus pneumoniae
A friend of mine Dr. Stanley Schuman, of the medical University of South Carolina, blames day care centers for “outbreaks of illness – diarrhea, dysentery, giardiasis, and epidemic jaundice – reminiscent of the pre-sanitation days of the 17th century.
A study published in 1984 revealed that children in daycare centers were more than 12 times as likely to be infected with Hemophilus influenzae type b. Another showed that day care children are 15 to 20 times more likely to contract giardiasis than children under maternal home care.
Researchers at the University of Alabama found that 59 percent of day care children were shedding cytomegalovirus. Cytomegalovirus (CM) was found on toys and other items frequently handled by children in the day care center.
Based on antibody testing, it was estimated that between 70 and 100 percent of day care children were infected with CMV. A study reported in the American Journal Of Public Health in 1988 compared children raised at home, raised in another home, and placed in nursery school or day care.
The investigators in this study found that, compared to children reared at home, children in daycare spent 30 percent more sick days in bed, while those raised in another home spent 19 percent more sick days in bed.
Children in day care were also likely to spend more time in hospitals than children raised at home.
A number of studies have shown that otitis media occurs more frequently in day care children than in children minded at home.
It was also determined by specialist in the field of infections and hearing loss among young children, that when they compared the rate of otitis media in children minded exclusively at home with those spending time in day care centers, they found the occurrence of otitis media to be significantly higher.
A 1988 report in the Journal of Pediatrics revealed that hospitalization for myringotomy and tube placement occurred in 21 percent of the children in day care compared with only 3 percent of those in home care.
Day care is here to stay. Many families require two incomes in order to survive. Certainly, many single parents would find it impossible to work or go to school without available day care for their children. Even the federal government has expressed its need to have mothers in the workforce.
However, the health implications of the growing day care situation are enormous. Public health officials are working to stem the rising tide on infections in day care children.
At this stage there seems to be little progress. Some have recommended mass immunization of day care children, but this carries with it a host of social, philosophical, and medical implications.
Parents and day care providers should be aware of things they can do to reduce the spread of infectious diseases. For parents, it is necessary to be aware of times when your child should be kept out of daycare.
For providers, it is important to know which children should be excluded or sent home. These are only first steps since the nature of the day care environment contributes to the spread of illness among children.
Recognize that otitis media is not considered a communicable disease in the strict sense. Yet, many of the conditions that predispose children to the development of middle ear effusion are considered communicable.
The following guidelines are useful in determining when to exclude children from day care. Children who have the following symptoms should be excluded from the child care setting until 1) a physician has certified the symptoms are not associated with an infectious agent or the child is no longer a threat to the health of other children at the center, or 2) the symptoms have subsided.
For the mildly ill child, exclusion should be based on whether there are adequate facilities and staff available to meet the needs of both the ill child and other children in the group.
FEVER: Axillary or oral temperature: 100 degrees F. or higher, or Rectal temperature: 101 degrees F. or higher; especially if accompanied by other symptoms such as vomiting, sore throat, diarrhea, headache and stiff neck, or undiagnosed rash.
RESPIRATORY SYMPTOMS: Difficult or rapid breathing or severe coughing:
-child makes high-pitched croup or whooping sound after he coughs.
-child unable to lie comfortable due to continuous cough.
DIARRHEA: An increased number of abnormally loose stools in the previous 24 hours. Observe the child for other symptoms such as fever, abdominal pain, or vomiting.
VOMITING: Two or more episodes of vomiting within the previous 24 hours.
EYE/NOSE DRAINAGE: Thick mucus or pus draining from the eye or nose.
SORE THROAT: Sore throat, especially when fever or swollen glands in the neck are presented.
SKIN PROBLEMS: Rash – Skin rashes, undiagnosed or contagious. Infected sores – Sores with crusty, yellow or green drainage which cannot be covered by clothing or bandages.
ITCHING: Persistent itching (or scratching) of body or scalp.
APPEARANCE: Child looks or acts differently.
BEHAVIOR: Unusually tired, pale, lacking appetite. Confused, irritable, difficult to awaken.
UNUSUAL COLOR: Eyes or skin – yellow (jaundice), Stool – Gray or white, Urine – Dark, tea-colored.
These symptoms can be found in hepatitis and should be evaluated by a physician.
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