Communicable Illnesses?

Hey there,

Anyone experience any outbreaks in their day home? I had a dck come on Thursday with a rash on his leg and a runny nose. The mother assured me that it was from his MMR, but as the day went on, it spread to his hands and face. I called her to pick him up, but she was unable to leave work, so I had him for the rest of the day.

Turns out it is hand foot and mouth disease! This childhood illness presents with runny nose, fever, rash, sore throat and mouth lesions, or any combination of the above. I informed all the other parents, and called my own kids' principal to let them know, then took lysol and soap and water to my entire house! Now another dck is presenting with fever and runny nose - her mother just texted me. Her mother seems annoyed and is asking me questions about when the infected child was here and for how long, etc. Her child is full time, and the other boy was here all week, so there was nothing I could do to prevent it. I still feel guilty though. Shrug.

Anyone have this? How did you handle it? How did the parents react?

Hello!
I am a pretty new day home provider (opened Aug. 15/11) so I don't have a ton of experience but my own mom ran a day home out of my childhood home for twenty years. On her advice when I opened my day home I had a contract like most day home providers which included a very strict illness policy. Basically your child cannot come to my day home sick and especially with a communicable disease. So far in the last 3 months I did have a child get sick while in my care (They arrived seeming well). I called the little's guys mom and she gave me the same line, "I can't leave work right now". I then asked her who WAS coming to pick up her child. I did not give this parent the option of allowing her child to remain care. When I made the call to the mother I also was careful in my wording. I didn't ask her if she COULD pick up her child. I TOLD her child could not remain in care. In the end the mother came and got her son and all has been well with this family. Going forward I would suggest having a very strict illness policy for your day home as well and outline your changes to your existing families. I do sort of understand the other mother in this situation whose child has now gotten sick. I think I would be annoyed as well. I am really glad I have my illness policy in effect so I would recommend an illness policy to any provider. Good Luck!

I agree with bugaboo that you can't give the option of not coming to pick up the child. I liked her suggestion of asking who is comign if not the mother. Although it may not have prevented the outbreak because often things are contagious before the symptoms appear, at least you would be able to assure the other parents that the child was sent home as soon as you noticed symptoms. A rash is definitely one of the things listed in my contract as a reason to be sent home immediately.

Yucky... :(
There are 2 things that I want to mention here; firstly, I have a paragraph dealing with illness that says that if a child becomes ill in my care they must be picked up within 1 hour of my communicating with the parents. Now, of course, I would have some flexibility. But the point is: the child is NOT allowed to stay. In future, I would maybe be more tough on that point.
HOWEVER, my second point is: that's how it is in multi-child care sometimes!! If you want to ensure that your child will never come in contact with these germs, keep them at home. All the time. In a bubble. LoL
I would not worry about that mom. Explain to her that you did what you could, as soon as you could. Chances are, the kid was communicable well before you knew he was ill.

Quote:

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Originally Posted by Alphaghetti

Hey there,

Anyone experience any outbreaks in their day home? I had a dck come on Thursday with a rash on his leg and a runny nose. The mother assured me that it was from his MMR, but as the day went on, it spread to his hands and face. I called her to pick him up, but she was unable to leave work, so I had him for the rest of the day.

Turns out it is hand foot and mouth disease! This childhood illness presents with runny nose, fever, rash, sore throat and mouth lesions, or any combination of the above. I informed all the other parents, and called my own kids' principal to let them know, then took lysol and soap and water to my entire house! Now another dck is presenting with fever and runny nose - her mother just texted me. Her mother seems annoyed and is asking me questions about when the infected child was here and for how long, etc. Her child is full time, and the other boy was here all week, so there was nothing I could do to prevent it. I still feel guilty though. Shrug.

Anyone have this? How did you handle it? How did the parents react?

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I agree with other posters about not letting the Mom say "no" to picking up her child that must have bee very stressful for you:(

I'm sorry you're having to go through this as it is an extremely contagious disease. I would use bleach and peroxide to dissenfect everything.

You need to to have a private conversation with the mother and let her know the seriousness of her not picking up right away. How incenstive of her to not take you seriously. You may also need to ammend your contract to clearly outline your poilcies.

Good luck!

Hugs

Hi all, thanks for your replies, and I completely agree that I should not have given the mother an option. She is normally very good to me, and respectful of my policies, but not this time. After I spoke with her, I felt like I was overreacting, but in retrospect, I will not have a child in care (as TOTALLY outlined in my policy, btw ugh!) who has a rash. I have really been making a lot of illness-related exceptions in the past 7 months, and I am going to simply start putting my foot down. I think, actually, that I may send out a group email, reminding parents to review my sick policy.

Posting about this again because I need to vent a bit...

Sigh. I accepted kids today and sent my younger two to school as well, because we have gone from Thursday (dck's diagnosis) until this am with no other dck or my own kids showing symptoms. I got a call from my son's school at 11 am saying that he was not feeling well, and sure enough, I went to get him and he has a fever and two little sores on the inside of his lower lip.

I feel terrible. I have to close for at least tomorrow until my son's temp has returned to normal. Almost all of my parents were understanding, except for the mother who brought her sick son to me in the first place. I am now just waiting for her to say something else...this just reinfores the fact that I will no longer be accepting kids with a fever or rash of any kind EVER AGAIN.

Guys, what is your fever policy? Mine was that I would accept kids so long as they weren't over 101 F. I am thinking of changing it to NO fever...how realistic is that? I am tired of parents bringing their sick kids here.

I don't accept kids with any fever! And I don't think that is at all unreasonable! When my kids were in daycare, that was the rule. If a child has a fever, it means they are not well. If they are not well, they should not be at daycare...period! That is also why I will not give kids tylenol or advil. If they are sick enough to need it then they should stay home.

With the lack of other symptoms I don't worry about fever too much as long as the child does not need medication. If they do then they need to be home. A child will run a low grade fever for lots of reasons including overtired, stress, teething, etc. and yes it can be the body's way of fighting off an infection before it gets a strong hold. A healthy child will run a fever to fight off a cold or whatever. When other symptoms appear like cough, runny nose or rash it means they have lost the battle and are considered sick.

Mistake was accepting the child with the rash. When the child showed up with the rash - first the parent had the nerve but she should have been sent to the clinic at that point to get the rash evaluated and pronounced safe - with results in writing. The doctor would likely have diagnosed the disease. If the doctor had said yes from the MMR then well you have your answer although that means the child has a mild form of the measles and I have heard from some that if they do get the rash they are contagious but not sure.

I would rething closing the daycare. You already have one child out with the disease and now your son makes the second. Chances are by tomorrow there will be more. I would stay open and give parents the option of keeping their child at home at no charge or bringing them as regular since they have already been exposed. The mom who started it doesn't have a choice she can't bring her child - I would do that out of spite and anger. Also if your son is old enough to be in school he is old enough to understand that he needs to play separate from the other children for a couple days.

In most areas you are supposed to contact your local health association to report an outbreak of a disease in your daycare and they would give the information about whether to close or not and what to do such as what and how to sanitize as well as how long to be closed.

The down side to closing is that all it does is expose other people to the disease since the other kids in care are now exposed and in the period of contagiousness if they have gotten it. Which means there is no point in a parent having back up care since no one wants the child. Yes the parent should take the time off but not everyone can do it without putting in for a personal day and you don't do that overnight. It has to be approved if you even have personal days at all.

BTW, OP......I don't allow any child to attend until 48 hours has passed since they were vaccinated. I do this for a number of reasons. One being that it is the riskiest time for adverse reaction. I just mention this as you mention it was passed off as a reaction to his MMR vaccine. That could not happen here because I wouldn't have allowed him into care for 48hrs so I would KNOW it wasn't from the vax.

To be completely honest I would not renew the problematic mother's contract.
He blatant lack of respect for you and your business is just insulting.
If a parent ever told me they could not come and get their sick child I would call the next emergency contact on the list and they would be sent home. Period.
Now you say she has the nerve to give you attitude ?
You did NOT over react so please don't doubt yourself.
a parent who is only nice to you when things are going well is not acceptable.
In my daycare I do not accept children with a fever.
A noisy,active environment is no placed for an ill child.

Oh man!! That's so frusterating Alphaghetti, I am sorry to hear that your kids are now sick.
In my contract I use the Province of Alberta's definition of a fever which I found on the web site for Alberta Health Services (maybe the province you are in has a similar definition). Anyways AHS defines a fever as over 98.6 F. taken under the arm, over 99.5 F. taken orally, and over 100.4 F. taken rectally. I used this wording in my contract. I also don't allow kids to come to care after the have had shots except my policy is 24 hours. I think if this mother has the nerve to give you attitude then perhaps its time to think of termination...she is being just plain rude. I hope your kids feel better soon.

Quote:

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Originally Posted by playfelt

In most areas you are supposed to contact your local health association to report an outbreak of a disease in your daycare and they would give the information about whether to close or not and what to do such as what and how to sanitize as well as how long to be closed.

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I told the RN at Telehealth that I do home daycare, and she said that although it was up to me, the responsible thing to do would be to close until my son's temperature returns to normal. I have already done deep cleaning in order to avoid further spread as well. She said it was not necessary to contact public health.

Unfortunately, re the personal days etc, I am not responsible for backup care, nor is it my fault that this is all happening. Whether the kids are already exposed or not, my son is sick, and my first priority will always be to him, not my job.

I DEFINITELY made a mistake re the rash. I won't make it again. I am going to amend my health policy immediately regarding vaccinations, and have the parents sign. I do have an illness policy in place - problem is, I was too soft in enforcing it.

The reaction time to the MMR is 2-3 weeks after the vaccine is given.

My daughter's severe MMR reaction happened less than 48 hours after her immunization. I guess it varies. I will be doing more research, as I am thinking that since you have read this, a vaccination policy might be a moot point. Thanks.

I have a question about communicable illness- I think my two yr old daughter may have pink eye. If she goes to the clinic and they diagnose it would you close your daycare or give parents the option to come? The problem with giving them the option would be that if their child gets it, they won't be aloud to come back until cleared up and I'm worried it will seem unfair to parents.

As the parent of 4 kids who all played together and two of the girls shared a room since toddlerhood I have had many contagious things go through the house and only one or two of the four get it. The same has happened with the daycare. If you aren't closed today while you "think" she has pink eye then not much point in closing tomorrow since by then she has put the germs around if she is going to and she will be on meds by tomorrow with having had at least 2 doses. Things go through groups of kids and it is just a normal fact of life. The closing and sending kids home is more for the appearance of doing something than it actually helping since we all know today and yesterday is when the infection was spreading.

We had hand foot and mouth come through here in the summer. Actually it's not on the list for communicable disease when I checked with licensing. We had 2 in care with it, out of 5. They had all been exposed for first couple days (I thought my dd was having a reaction to a wasp sting) it wasn't until we went to hospital a couple days later to find out it was HFAM. Anyways, no other child got it and most parents opted to remain in care. I did do a clean but still had friends come to my home and the kids left with HFAM. This was weeks later! It's so highly contagious. My dd also lost all her finger and toe nails because of it, which is rare. Not a fun one! Good luck :)

Lost her nails? Oh my!! I have opted to stay closed until my son's fever has broken. I think it's good for him to have momma to himself anyway, and if I worked outside the home, I'd likely be staying home with him.

I think my closing is now a moot point. I don't think I would have any kids show up today...I received word this am that all but ONE of my daycare children now have it...sigh.

As playfelt mentioned, the challenge with saying "NO FEVERS" is that a fever can be caused by so many things. Teething, or fighting off an illness, especially.
Personally, I think with most kids you can see the difference between a fever that's working, and a fever that's not (ie: at that point the child is sick). I had one of those just yesterday, unfortunately. I didn't call mom because we were only an hour or so away from home time. But he's not here today.
I think you can say "a fever IN COMBINATION with (name other symptoms) will not be acceptable at daycare"?

Apparently nail and hair growth can stop as a immune system defense. Luckily they are growing back.