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Pregnancy and CMV Policy V2016.1
PREGNANCY AND CMV POLICY
SUB CATEGORY: Human Resources
POLICY GOAL
Provide a safe workplace for all staff and ensure that staff who are trying to conceive or who are
pregnant are provided with information to assist them in making safe work choices for themselves
and their unborn child. To provide an environment where risks associated with pregnancy in an
education and care environment are minimised.
RATIONALE
Under the Queensland Work Health & Safety Act 2011, the Employer is obligated to ensure the
workplace health and safety of any Pregnant Employee.
Your Role in ensuring a Safe Pregnancy
If you are considering becoming pregnant, you should speak with your Doctor about the kind of
work you do and your immunisation status. Ideally you should have all the vaccinations you require
for your work environment prior to becoming pregnant.
Most vaccinations should not be given during pregnancy but some are regarded as safe while
breastfeeding. If you have any concerns about immunisation that may be required for your work,
you should seek Medical advice straight away.
Notify your Supervisor as soon as possible about your pregnancy, so that an assessment and
appropriate modifications can be made immediately to your work to minimise risks to your
pregnancy. You can request that the information about your pregnancy is maintained as
Confidential.
Infection Risks and Pregnancy
The following information relates to infections which are both significant in pregnancy and have
some possibility being acquired through childcare.
Cytomegalovirus (CMV)
“Cytomegalovirus infection is a common viral illness. Most CMV infections cause either no symptoms
or only mild symptoms. The virus is spread by contact with infectious body secretions (especially
saliva and urine) which enter through mucous membranes (eyes, mouth and nose) and cuts in the
skin. Infection of infants can also occur before birth, at birth, or early in life. By adulthood 40% or
more of the adult population have been infected.
Women of child bearing age working with young children should always practice good personal
cleanliness and hygiene, especially – good hand washing after contact with body secretions, and
especially after changing nappies or assisting in toilet care. No kissing infants on the mouth (hugging
is acceptable). Disposable gloves should be worn where there is contact with urine and saliva and
hands washed after glove removal.
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Pregnancy and CMV Policy V2016.1
Women who are infected with CMV during pregnancy may infect their unborn baby. Infection of the
unborn baby occasionally leads to intellectual and physical disability such as deafness,
developmental delay. Re-activation of infection and re-infection can occur in a woman has
previously been infected with CMV, however the risk to the unborn baby is lower.
All Staff who are considering pregnancy or are pregnant should consult their Medical Practitioner on
the risk of the disease.
Staff will be required to see a Medical Practitioner to have a blood test to determine if they have
previously been infected with CMV. The Centre will supply a letter to give to the Doctor requesting
the test.
All Workers are to insure that they follow safe work practices including hand washing and hygiene
when there is contact with body or blood fluids (especially urine and saliva) and spills.
The Centre will relocate any pregnant worker to work with the over-two year olds to reduce risk
exposure. If this is not practical, you will be directed to seek advice from a Medical Practitioner
about whether you are able to work with children under two years old. The Centre will supply a letter
for you.” 1
“What is CMV?
CMV is a common viral infection that affects many people. The first time that a person is infected
with CMV is called a primary infection. After primary infection, the virus can live in the body in an
inactive or dormant state. It can periodically become active again causing a reactivation of infection.
This may occur when a person becomes ill or stressed. A previously infected person can also be
infected with a different strain of CMV, and this is called a re-infection.
How is it spread?
CMV is spread occupationally from person-to-person by contact with body substances, including
urine and saliva. An infected person can pass the virus to another person even though they do not
have symptoms. CMV can also be transmitted from a mother to her unborn child during pregnancy.
This is called congenital infection.
Who is at risk from infection?
People who have occupational contact with young children are particularly at risk of CMV infection.
Workers in child day care centres are at highest risk because of their frequent contact with children’s
urine and saliva when changing nappies, assisting with toilet care and feeding infants.
The health effects
CMV infection does not usually cause illness in healthy people, and people may be unaware that they
have been infected. Occasionally it causes an illness with fever, sore throat and swollen glands. CMV
infection can however cause serious illness in people who have an impaired immune system, and
there can be adverse health effects for unborn children if they are infected during their mother’s
pregnancy. These can include damage to the brain, liver, eyesight and hearing.
CMV and pregnancy
The most severe form of the disease generally occurs in infants born to mothers who have a primary
infection during pregnancy. The risk to an infant from reactivation of infection or re-infection during
pregnancy is generally lower. A small number of babies who have been infected with CMV during
pregnancy have symptoms at birth. Many of these infants will have lifelong disabilities of varying
degrees. The majority of infants who have been infected with CMV during pregnancy do not have
1
“Pregnancy Policy Federal” Australian Community Services Employers Association 2012
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Pregnancy and CMV Policy V2016.1
symptoms at birth. However, some of these children may develop disabilities later in childhood, such
as hearing loss, learning difficulties and developmental delay.
Women working in the childcare industry who are pregnant, or expect to become pregnant, should
discuss the risks of CMV with their doctor, and inform their employer so that their individual risk can
be assessed and managed. There is no vaccine to prevent CMV infection during pregnancy, however
good hygiene practices, including hand hygiene, can reduce the risk.
How to prevent infection
There is currently no vaccine to prevent against infection with CMV. Good personal hygiene, including
hand hygiene, is the most important way to prevent CMV infection, as CMV is readily killed with soap
and detergent.
CMV infections are common among children in childcare settings, but most children will not have
symptoms and their infection will be unknown. Children known to have CMV do not need to be
excluded from child care because the virus may persist in their urine and saliva for months to years.
The occupational risks of CMV infection in childcare facilities should be managed using a risk
management approach.
The following control measures can be effective in preventing CMV infection:
 installing hand washing amenities close to nappy changing areas
 washing hands frequently, especially after contact with urine and saliva and after removing
disposable gloves
 using disposable hand wipes or alcohol hand rub for situations where hand washing facilities are
not readily available, such as when taking children on excursions
 covering cuts with water-resistant dressings
 using disposable gloves for activities that involve contact with urine and saliva and instructing
workers in their use
 providing information to workers about CMV risks and work practices to reduce the risk of
infection
 keeping training records
 purchasing equipment and toys that are easily cleaned
 instructing workers not to kiss children on the mouth and face
 implementing cleaning programs for surfaces and items that are soiled with urine and saliva,
including nappy change mats, potties and toys
 implementing procedures for hygienic nappy changing and the storage and disposal of soiled
nappies
 taking steps to prevent urine from spraying into the face of workers if infants pass urine during
nappy changing (especially infant boys)
 implementing laundry procedures for linen that is soiled with urine and saliva, e.g. make sure
that soiled personal clothing and linen are placed in a sealed bag and sent home with the child
for washing
 implementing procedures for cleaning up accidental spills of urine that could occur during toilet
training
 discussing CMV risks with a doctor if pregnant or considering becoming pregnant
 informing the employer if pregnant, or expect to become pregnant, so that steps can be taken to
minimise risk
 re-locating workers who are pregnant, or who expect to become pregnant, to care for children
aged over two to reduce contact with urine and saliva.”2
2
“ Cytomegalovirus (CMV) in Child Care” Workplace Health and Safety Queensland (2011)
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Pregnancy and CMV Policy V2016.1
“CMV infections can cause serious birth defects. The highest risk to the unborn child is during the first
half of the pregnancy. CMV infection occurs in 1% or less of pregnancies and, of these cases, less than
10% of infants are likely to have severe illness. CMV can spread through infected urine and saliva.
Women of childbearing age working with young children should pay particular attention to good
hand hygiene after contact with body secretions, especially after changing nappies or assisting in
toilet care.”3
“Rubella
 It is recommended that all women contemplating pregnancy are tested for immunity to rubella
and revaccinated if necessary before becoming pregnant.
 The rubella virus generally produces a mild disease in the adult or child, often only causing a
transient skin rash. However, the disease during pregnancy may produce serious congenital
defects in the unborn baby. Infection during the first trimester is the period of greatest risk for
the foetus but there is also a risk of hearing defects and delayed development following maternal
infection up to the 20th week. Rubella is spread by droplet infection and the incubation period is
14-21 days.
 If a pregnant employee has not been vaccinated for Rubella and an outbreak occurs at the
centre, the employee will be excluded from work and, will be required to obtain Medical advice
in relation to her suitability to work at this time.
Varicella (Chickenpox)
 Chickenpox is a viral illness that comes on suddenly. Symptoms include fever, runny nose, cough,
fatigue and a general rash. Each sore begins as a small bump which becomes blister-like for 3-4
days then leaves a scab. Chickenpox is highly contagious. It is spread by coughing and contact
with a moist rash. One infection gives long-lasting immunity.
 Any Staff member who has never been infected with chickenpox and is considering becoming
pregnant should consult their Medical Practitioner for vaccination before becoming pregnant.
 Non-immune pregnant women should avoid contact with chickenpox or shingles. In an event of
an outbreak any non immune pregnant staff shall be referred immediately to a Medical
Practitioner for assessment of post-exposure prophylaxis (PEP of Varicella zoster immunoglobulin
within 96 hours of exposure).
 If an outbreak of Chickenpox occurs at the centre, the employee will be excluded from work and
required to obtain Medical advice.
Parvovirus B19
 Parvovirus B19 infection is also known as Fifth Disease, erythema infectiosum and slapped check
syndrome. It is a viral infection that is caused by a human parvovirus B19 and is not found in
animals.
 While there is no evidence that parvovirus B19 infection is a significant cause of foetal defects,
some studies have shown that infection may increase the risk of miscarriage in pregnant women.
 Parvovirus B19 is spread by exposure to respiratory droplets from the nose and throat of infected
people.
 Children who are infected with Parvovirus B19 are not considered infectious once the rash
appears. However, during an outbreak there may be other children at the facility who are
infectious but who have not yet developed a rash.
3
“5th Edition Staying Healthy Preventing Infectious Diseases in Early Childhood Education and Care
Services” Australian Government National Health and Medical Research Council 2012.
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Pregnancy and CMV Policy V2016.1

If an outbreak occurs, all pregnant workers will be required to consult with a medical practitioner
to assess immunity via a blood test. Previous infection will protect against further infection. If
the pregnant worker is not immune, you will be directed to seek advice from a Medical
Practitioner about whether you are able to work with children. The Centre will supply a letter for
you.” 4
IMPLEMENTATION
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Upon employment educators will be advised of this policy. This will be recorded on the Educator
Induction Checklist and educators are asked to signed the Acknowledgement Form (attached)
It is each employee’s responsibility to inform the employer as soon as they are aware that they
are pregnant or planning on becoming pregnant.
When employees advise their employer that they are pregnant or planning on becoming
pregnant they should be provided with information regarding their health during pregnancy
including CMV.
Pregnant workers are required to seek medical advice on working with children during
pregnancy and to be tested for CMV. The centre will provide you with a letter. The centre
requests a copy of the results of the CMV immunity test.
The Centre will relocate any pregnant worker to work with the over-two year olds and
where they are less likely to be exposed to cytomegalovirus through nappy changing and
feeding to reduce risk exposure.
If this is not practical or you wish to continue working with children under 2yrs, you should
seek advice from an immunology specialist about whether you are able to work with children
under two years old. The Centre will supply a letter for you and your doctor. All costs
associated with this appointment will be at the employee’s expense.
It is our duty of care to do everything in our power to protect our workers. We do also
recognize their rights to make their own decisions regarding their own health and will consider
each case individually based on specialist opinion.
Educators must comply with health and hygiene instructions given by their employer to
manage CMV risks including, but not limited to;
o Wash their hands frequently, especially after contact with urine and saliva.
o Use personal protective equipment provided by the employer.
o Inform their employer if they are pregnant or expect to become pregnant
We take the risk of CMV very seriously and as such there will be no exception to this policy and
its position.
Exclusion from Work
 A non-immune staff member may be excluded from work or have work restrictions placed on
them if there is an outbreak of a vaccine-preventable disease at the centre.
 In the event of an outbreak of a vaccine preventable disease the director will contact the Public
Health Unit for advice.
 The Centre will be guided by the Public Health unit about whether exclusion, work restrictions
Leave Arrangements
 Once an outbreak is identified the local Health Authority will have an officer in control of
managing the outbreak. The employer would invoke the stand-down provisions of the Fair Work
Act 2009 Section 524;
4
“Pregnancy Policy Federal” Australian Community Services Employers Association 2012
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Pregnancy and CMV Policy V2016.1
1. An employer may, under this subsection, stand down an employee during a period in which
the employee cannot usefully be employed because of one of the following circumstances:
(c)
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a stoppage of work for any cause for which the employer cannot reasonably be
held responsible.
Where educators must be excluded due to the outbreak of a disease the educator is not able to
take paid personal/carer’s leave unless the employee is sick or injured. Annual or long service
leave accruals may be used if mutually agreed upon where available.
Staff will be responsible for cost of all immunizations, and other associated medical expenses.
If the staff member has not been medically vaccinated (‘not medically vaccinated’ includes
adults who may have been naturopathically or homeopathically vaccinated), exclusion from the
service during outbreaks of some infectious diseases (such as measles and pertussis), are still
required even if the employee presents as well. This is because the effectiveness of
naturopathic or homeopathic vaccinations has not been scientifically proven (refer to 5th edition
Staying Healthy).
COMMUNICATION AND CONSULTATION
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Educators will be advised at the time of employment through the induction process. Further
communication with be provided when employees advise of their pregnancy or intent to
become pregnant.
Educators and Families will have access to this policy at all times.
Educators and families will be provided with opportunities to be involved in the review of this
policy.
RELATED FORMS AND DOCUMENTS
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Educator Induction Checklist
Employee Acknowledgment Form
Recruitment, Selection and Employment Policy
Pregnancy related Information from Recognised Authorities
Letter to medical practitioner re pregnancy (attached to this policy to be printed on letterhead)
Letter to employee wishing to remain working with children under 2yrs (attached to this policy
to be printed on letterhead)
Letter to Immunologist to remain working with children under 2yrs (attached to this policy to be
printed on letterhead)
Employee Authorisation to share medical information form
SCOPE AND ENFORCEMENT
The Failure of any person to comply with this policy in its entirety may lead to;
 Performance Management of an employee which may lead to Termination
RECOGNISED AUTHORITIES AND DOCUMENTS WHICH GUIDE POLICY
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“ Cytomegalovirus (CMV) in Child Care” Workplace Health and Safety Queensland (2011)
(accessed on-line May 2016 https://www.worksafe.qld.gov.au/injury-preventionsafety/workplace-hazards/child-care/cytomegalovirus-cmv-in-early-childhood-education-andcare-services)
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“Pregnancy Policy Federal” Australian Community Services Employers Association 2012
Fair Work Act 2010
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Pregnancy and CMV Policy V2016.1
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“5th Edition Staying Healthy Preventing Infectious Diseases in Early Childhood Education and Care
Services” Australian Government National Health and Medical Research Council 2012.
DATE CREATED:
November 2011
REVIEW DETAILS:
Review Date Details of Changes
July 2012
January 2013
March
January 2014
June 2015
June 2016
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Changes to transfer to work with children over 2yr evidence
requirements including immunologist advice to continue working with
under2yrs.
 Clarification of leave arrangements and stand down provisions
 Replacement letter to educators regarding pregnancy
 Insertion of letters to medical practitioner samples
No changes made, sources updated where applicable.
 Updated sources and information to align with “5th Edition Staying
Healthy Preventing Infectious Diseases in Early Childhood Education and
Care Services” Australian Government National Health and Medical
Research Council 2012.
 Changed relocation of pregnant women work with children over 2yrs of
age and where they are less likely to be exposed to cytomegalovirus
through nappy changing and feeding.
 Included information on non-medically immunised adults and exclusion
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No changes made, sources updated where applicable
No changes made, sources updated where applicable
No changes made, sources updated where applicable
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Pregnancy and CMV Policy V2016.1
Employee Acknowledgement
I ________________________________________ have been provided with a copy of the
Pregnancy and CMV Policy.
I have read and understood the material contained with the Pregnancy and CMV Policy, and
I have had the opportunity to ask questions about any of the material set out in that policy.
I understand the ramifications of failure to adhere to the policy.
Sign: __________________________________
Date: ______________
Print Name: ___________________________________________
Witness: ________________________________
Date: _____________
Print Name: _____________________________________________
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Pregnancy and CMV Policy V2016.1
Letter to Medical Practitioner
Pregnancy Letter
Date: ___________
Dear Medical Practitioner,
Our staff member,______________________________, is considering pregnancy or is pregnant
(circle).
We are asking her to discuss with you the implications of relevant diseases including, but not
limited to, Cytomegalovirus (CMV).
We wish to ensure that they are aware of what risk to their health these diseases could pose.
Contracting one of these diseases would also mean time off work (perhaps extended) as will
exclusion from work for their own protection if there is an outbreak in the centre.
It is our duty of care to do everything in our power to protect our workers. Having said this, we do
also recognize their rights to make their own decisions regarding their own health.
We also request that a blood test be perform to test if this staff member is immune relevant
diseases inlcuding Cytomegalovirus (CMV).
Could we also ask you to give us written assurance that you have discussed this with
____________________________ and that they understand the implications of any relevant
diseases including, but not limited to Cytomegalovirus (CMV).
Yours sincerely,
_____________________
Manager/Supervisor
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Pregnancy and CMV Policy V2016.1
Letter to Employee regarding remaining working with children under 2yrs
Date _____________
Employee Name
Address
Address
_______________________
_______________________
_______________________
Dear _______________________,
Re: safe to work with children under the age of two years while pregnant
We take seriously our responsibility under the current Work Health and Safety legislation to ensure
that all persons at the workplace are safe from harm. In the instance of pregnant employees or
those employees intending to become pregnant, management have adopted policies and
procedures that reflect contemporary practices to minimise or eliminate risk to our employees
regarding Cytomegalovirus (CMV).
The management understand your desire to remain with your group of children which are under the
age of two (2) years. To assist management in determining the risk to you and your unborn child we
request that you be referred to a specialist practitioner in the field of immunology and have that
specialist practitioner provide advice to us that it is safe for you to continue work with children
under the age of two (2) years for the remainder of your pregnancy as CMV no longer poses a risk to
either yourself or your unborn child.
Please provide the attached letter to the specialist practitioner for their response. Also, find
attached an authorisation form allowing the doctor to speak with your employer regarding this
request.
Your sincerely
_____________________
Manager/Supervisor
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Pregnancy and CMV Policy V2016.1
Letter to Immunologist regarding remaining working with children under 2yrs
Date ______________
To Sir/Madam
Re: _____________________(insert employee’s name)
Our Centre has a policy which restricts pregnant women from working with children under the age
of two (2) years of age. Our employee, whom is currently pregnant, has requested of management
to be allowed to remain with her group of children which are under two (2) years of age.
Our Management take seriously their responsibilities under Work Health and Safety legislation with
regards to ensuring all persons at the workplace are safe from harm. To assist in the decision on
whether to allow our employee to work with children under the age of two (2) we ask that you
provide advice in writing whether it is safe for her and her unborn child to remain working with
children under the age of two (2) years for the remainder of her pregnancy and/or provide details of
any restrictions that should apply to our employee during the course of her employment while
pregnant.
Should you wish to contact the employer to clarify any of the information provided, do not hesitate
to contact ____________________________________________.
Yours sincerely
_____________________
Manager/Supervisor
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