Showing 15 posts in Illness.
We are seeing significant changes in protocols for dealing with children with allergies. Traditionally, doctors advised completely avoiding allergens such as peanuts and pet fur. Now research indicates that, in some cases, limited exposure may actually help prevent allergies. The American Academy of Pediatricians issued an interim statement recommending that babies at risk for developing peanut allergies be given peanuts. Specifically, “Health care providers should recommend introducing peanut-containing products into the diets of high-risk infants between ages 4 and 11 months.” Of course, parents should consult an allergist to be sure that the child has not already developed an allergy.
Similarly, another study indicates that household pets can help boost children’s immune systems. The results are still tentative, but the study cites other research showing that early exposure to animals helps protect against respiratory allergies. The study’s coauthor concluded, that, at a minimum, avoiding animals does not prevent allergies. “If a family with a pregnant mother or an infant wants to have a pet, the family can be encouraged to have one, because the development of allergic disease cannot be prevented by avoiding pets.”
Day care centers, of course, cannot make these decisions on their own. But we can encourage our parents to be aware of the recent research, and to realize that mildly stressing a child’s immune system is an essential part of lifelong good health.
The recent news about measles outbreaks has prompted several clients to ask me whether they can require children to be vaccinated before enrolling them in their facility. The short answer is, "Yes, probably." I know, lawyers can never give a straight answer, but in this case, the law is not all that straight.
Georgia law requires vaccinations for all children entering school or attending a day care center. It allows only two exceptions -- medical necessity and religious objections. Other states allow an exception for philosophical objections to vaccines. However, most of those laws only require public schools to accept the exceptions. The laws allow private schools and day care centers to accept the exemptions, but do not require them to do so. In general, then, private facilities can place whatever requirements they want on the children they enroll.
There are, however, important limits on that general rule.
Our recent bout with swine flu (well, technically "flu-like symptoms") made this new study catch my eye. Researchers publishing with the American Society for Microbiology found that hand sanitizers are less effective at killing the Norwalk virus than antibacterial skin cleansers.
Hat tip: Food Poison Journal
The CDC has issued an updated bulletin for early childhood programs on how to respond to an outbreak of the H1N1 virus. At the head of the list is vaccinations, both ordinary flu and H1N1 (when available) for staff. Next, the CDC recommends having staff and children stay home for at least 3-5 days after exhibiting flu symptoms. The CDC also recommends frequent health checks, separating staff and children who exhibit flu symptoms, and renewed attention to environmental cleanliness and handwashing.
The most difficult recommendation to follow is likely to be having staff stay home for at least 3-5 days, or longer if the flu symptoms persist. Few schools or child care centers have extra staff sitting around, and finding substitutes on short notice for sick staff members will be a constant challenge. Groups will have to find creative solutions this flu season, whether banding together to share a pool of on-call, trained substitute teachers, or just hiring an extra staff person or two in anticipation of the inevitable illnesses over the next few months.
A teenager in Texas died last month from swine flu. What struck me about this particular report is that he also had an MRSA infection at the time. Last year, a report in Pediatrics magazine noted a five-fold increase in flu deaths where a child also had MRSA. Given the prevalence of MRSA in many communities, youth-serving organizations need to be as alert to the symptoms of MRSA as to flu symptoms.
There are some very good new resources for dealing with swine flu. The CDC has published a new website for child care providers. The Department of Health and Human Services and the CDC have combined to create a checklist for day care centers and preschools. The American Academy of Pediatrics has a similar publication.
Although these resources are geared toward child care centers, every youth-serving organization should review them. They offer good advice and common-sense suggestions that will help you continue your program while protecting your clients.
The latest problem that day care centers, schools, and camps need to know about is swine flu. The illness is spreading, and may become our next epidemic. Like so many illnesses, children are at high risk. There is no effective vaccine, and only limited treatment options.
You can take some common-sense precautions to hep protect your clients:
* Enforce rigorous hand-washing protocols.
* If children are sneezing and coughing, anyone who comes into contact with them must wash their hands before touching anyone or anything else.
* Children who exhibit flu-like symptoms should be isolated from the general population and sent home with parents as soon as possible.
* Check with your local or state health department to learn what specific precautions authorities are recommending for your area.
* Monitor the CDC website for updated recommendations
* Watch websites related to your industry, such as the American Camping Association's summary of precautions.
You never want an article about your day care center to begin, "Twenty-one children and one adult have contracted E. coli." You particularly don't want it to note that the outbreak was "linked to a lack of handwashing."
At least the day care has taken responsibility for sanitizing the center, and is trying to reimburse parents for out-of-pocket medical costs and expenses of having to stay home with their children. Even if it were only a PR move, it would still be the right thing to do.
A court has dismissed all criminal charges stemming from a teenager's death in a "boot camp" program. The 15-year-old died from an untreated staph infection. I missed earlier reports about this case, including this one giving some unverified details of the the child's death. If the allegations are true, it seems that someone should have at least checked his temperature. I am sympathetic to the difficulty in determining whether a child "feels bad," but fevers are hard to fake.
I have not seen any reports showing that any of the staff had the intent necessary for a criminal conviction. The civil case that remains, however, will have a lot of jury appeal.
MRSA (methicillin-resistant staphylococcus aureus) is quickly becoming a common, almost epidemic, occurrence in youth camps, schools, and day care centers. We are long past the time when caregivers could claim that it is an unusual disease that never would have occurred to anyone as a possibility. MRSA is too dangerous a disease to leave untreated. The CDC, for example, has found a fivefold increase in deaths where a child had both the flu and MRSA.
Since September 2008, the CDC has been investigating salmonella outbreaks throughout the U.S. Researchers have traced many of those cases to peanut butter distributed to food service institutions. One manufacturer, King Nut Company, has issued a voluntary recall of its peanut butter.
The CDC salmonella website has more information, as does the blog Minor Troubles.
UPDATE: I had an error in my post -- have I mentioned that I'm not a detail person? King Nut Company is a distributor of the peanut butter at issue. The manufacturer is Peanut Corporation of America.
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