CDC Issues Swine Flu Day Care Advice

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Day Care Centers Should Do Daily Health Checks, Extra Cleaning

By Daniel J. DeNoon
WebMD Health News

Reviewed By Brunilda Nazario, MD

Sept. 3, 2009 -- To slow swine flu, the CDC says day care and preschool centers should do daily health checks and extra cleaning while telling parents to keep sick kids home.

Possibly the most important message in the CDC's new guidance for early childhood programs: If you think any policy can totally prevent flu transmission in day care and preschool programs, forget about it.

"Even under the best of circumstances, transmission of infectious diseases such as flu cannot be completely prevented in childhood or other settings," notes today's CDC guidance document. "No policy can keep everyone who is potentially infectious out of these settings."

That having been said, the CDC offers advice on how to keep day care, preschool, and other programs for young children running during a swine flu outbreak.

Here's the CDC's advice:

• Get flu shots or sniffs. Vaccines safely protect kids age 6 months and older from flu. Get the seasonal flu shots or, for older kids, the intranasal mist. And get the swine flu vaccine, when available.
• Stay home when sick. Most kids who get swine flu have fever for two to four days. Keep kids home for 24 hours after their fever goes away. Day care centers may wish to exclude sick kids for a longer period.
• Conduct daily health checks. Providers should talk with parents and check each kid on arrival. During the day, staff should look for kids -- or other staff members -- who seem ill. Those who seem ill should be further screened by taking their temperature and asking about symptoms.
• Separate ill children and staff. Promptly separate kids and staff members who have flu symptoms from others. A space should be provided where sick kids can be supervised at all times.
• Encourage hand washing and cough/sneeze etiquette. Keep an eye on kids still learning these techniques, and remind them not to share cups or eating utensils.
• Perform routine cleaning. All areas should be cleaned regularly. Any items kids touch or put in their mouths should be cleaned. No special disinfectants are needed.
• Encourage early treatment for kids and staff at risk of flu complications. Encourage parents and staff to ask their health care providers if they or any of their family members are at high risk of severe flu disease. Those with these risks -- or parents of kids under age 5 years -- should call their doctors as soon as they get a flu-like illness.
• Consider selective closures. If a lot of kids or staff members are sick, it might be a good idea to close temporarily. Such decisions should be made after consulting local public health officials and should consider the social and economic disruptions that closing will cause.

If the flu becomes more severe, more stringent measures are recommended. So far, H1N1 swine flu has not become more severe. But the only predictable thing about flu -- whether its seasonal or pandemic flu -- is that it's unpredictable.

SOURCES: CDC web site: "Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009-2010 Influenza Season," and "Technical Report for State and Local Public Health Officials and Child Care and Early Childhood Providers," Sept. 3, 2009.

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