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Chapter 12: Prevention of Illness
in Early Childhood Education
Environments Through
Infection Control
© 2007 by Thomson Delmar Learning
Health Policies Needed
• Early childhood education environments
that have detailed routines to clean and
disinfect can significantly cut the
number of illnesses reported because
the cycle of germ transmission gets
interrupted
• 11 percent of all children in the United
States have no health insurance
© 2007 by Thomson Delmar Learning
Health Policies for Infection
Control
•
•
•
•
Prevention
Protection
Promoting good health
Implications for teachers
© 2007 by Thomson Delmar Learning
Health Policies for Infection
Control (continued)
• Health policies should include:
– mechanisms of disease spread
– immunizations
– sanitation
– environmental quality control
– teacher’s methods and practices for
minimum risk and maximum health
protection
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread
• Via germs and bacteria—organisms that
cause diseases
• Specific child care practices that
contribute to the spread of infectious
disease (Table 12.1)
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
Four mechanisms of disease spread
• respiratory tract
• fecal-oral
• direct contact
• blood
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
• Respiratory tract transmission
– Most common
– Tiny droplets from eyes, mouth, and nose
are in air when child sneezes, coughs,
drools, or talks
– Transmitted through air when another
person breathes it in
– They can multiply and cause illness
– Hand washing is major deterrent to spread
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
• Fecal-oral transmission
– Germs from one person’s feces find their
way into another person’s mouth, are
swallowed, and get into the digestive
system
– Most common way is when hands are not
washed after toileting before eating, or
before preparing food
– Water tables are another method
– Hand washing is major deterrent to spread
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
• Direct contact transmission
– Occurs when one person has contact with
secretions from an infected person
– Secretions can be left on doorknobs, toys,
and other objects
– Also occurs with parasites, such as lice 
infestation occurs with contact
– Good hygiene including hand washing and
sanitizing are deterrents to spread
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
• Blood contact transmission
– Occurs when infected blood of one person
enters bloodstream of another person
– Spread occurs when infected person has
cut, scraped skin, or bloody nose and
person interacting with infected person has
open sore, chapped hands, and the like
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
• Blood contact transmission (continued)
– Can also occur when mucous membranes
come into contact with infected blood
– Disposable gloves should be worn when in
the presence of blood
– Child-biting becomes a serious issue
© 2007 by Thomson Delmar Learning
Mechanisms of Infectious
Disease Spread (continued)
• Five fabulous forestallers of disease
transmission
– Keep immunization records up to date
– Use proper hand washing
– Use universal sanitation procedures for
diapering
– Sanitize and disinfect bathrooms and food
preparation areas
– Check out daily quick health check
© 2007 by Thomson Delmar Learning
Reality Check—The Issue of Head Lice
in Early Childhood Education
• Direct contact
• Historical connotation
• More children in care, happens more
frequently
© 2007 by Thomson Delmar Learning
Reality Check—The Issue of Head Lice
in Early Childhood Education (continued)
• No-Nits Policy
– Is it realistic?
– Is the expertise for it present everywhere it
is used?
• Larger number of children who build up
immunity to regular treatment
– can be a frustrating experience if
everything appears to have been done
© 2007 by Thomson Delmar Learning
Reality Check—The Issue of Head Lice
in Early Childhood Education (continued)
• Consider policy carefully
• Review as guideline for exclusion
• Develop a policy that everyone can live
with
© 2007 by Thomson Delmar Learning
Immunizations for Disease
Prevention
• Keep with recommended immunization
schedule for all children
• Make sure all present in child care are
immunized properly
• If a child has not followed the normal
immunization schedule, make sure the
child gets all immunizations needed
• Review records periodically to assess
that everyone is in compliance
© 2007 by Thomson Delmar Learning
Universal Sanitary Practices
for the Early Childhood Education
Environment
• Hand washing
– Outline procedure Table 12-4
• Diapering
– Outline procedure Table 12-6
• Toileting
– Outline procedure Table 12-7
© 2007 by Thomson Delmar Learning
Universal Sanitary Practices
for the Early Childhood Education
Environment (continued)
• Cleaning, sanitizing, and disinfecting
– Define the difference
– What constitutes contamination?
© 2007 by Thomson Delmar Learning
Environmental Quality Control for
Disease Prevention
• Water table guidelines
– Outline procedure Table 12-9
– How often should they be cleaned?
• Play dough guidelines
– Outline procedure Table 12-10
• Air quality guidelines
– What are guidelines? Table 12-11
• Contamination guidelines
– Outline procedure Table 12-12
© 2007 by Thomson Delmar Learning
Reality Check—At Risk for
Preventable Diseases
• Recent studies show that large numbers
of children are at risk for these
preventable diseases because they
have not been immunized
– There have been an increase in reported
cases of
• measles
• mumps
• whooping cough
© 2007 by Thomson Delmar Learning
Reality Check—At Risk for
Preventable Diseases (continued)
• The first reason children may not be
immunized is that some children may
have less access to immunization
coverage than others
– Children with private insurance were more
likely to be up-to-date (UTD) than those
with public insurance or no insurance
© 2007 by Thomson Delmar Learning
Reality Check—At Risk for
Preventable Diseases (continued)
• The second more controversial reason may
be because of the alleged relationship
between
– increase in autism and vaccinations given for
measles, mumps, rubella, diphtheria, pertussis,
and tetanus, which has caused concern among
parents in both the United States and Great Britain
– Thimerosol—a mercury derivative
• has not been used since 2003 in vaccinations, except for
flu shots
© 2007 by Thomson Delmar Learning
Reality Check—At Risk for
Preventable Diseases (continued)
• Vaccines rarely cause life-threatening or
life-changing reactions
• A child is at far greater risk if not
immunized properly
• Teachers require that immunization
schedules be UTD before children go to
school
– Track and remind to keep UTD
© 2007 by Thomson Delmar Learning
Reality Check—At Risk for
Preventable Diseases (continued)
• Some children may be exempt
– Allergy to eggs; religious or personal reasons of
parents
– This can cause concern to those children too
young to be immunized and those that are not
immunized due to the reasons above
– Children who do not have immunizations should
be excluded when an infectious disease that other
children have been immunized for is present
© 2007 by Thomson Delmar Learning
Implications for Teachers
• Education
• For Families
• Role-Modeling
– Hand washing especially important
• Cultural Competence
– Immunization
– Provide resources for connection to source
for immunization
© 2007 by Thomson Delmar Learning
Implications for Teachers (continued)
• Supervision
– Prevent spread
– Require and monitor immunizations
– Report some illnesses
– Exclude some children
– Be prepared to help an ill child
© 2007 by Thomson Delmar Learning