The never-ending case of scabies... I want to terminate care -- what would you do?

[SevenwatersDaughter]

Good evening everyone! I hope you are all having a great day.

I've been looking after a little boy, we'll call him Gary, for several weeks now. He just turned two.

When he first came to my day care he was covered in what looked like scratches -- they were scabs that would bleed and he would itch. His mom told me it was eczema and that we just needed to put cream on him. But I told her she should get it checked out by the doctor. She did, and he said that Gary had scabies. So she kept him out of day care and treated him. The next day I sought the advice of my own doctor who told me that I shouldn't accept him back into the day care until the mom brings a note that says not only he has been treated but everyone else in the family too (her children bathe and sleep together).

I told her this, and that was about three weeks ago. She keeps taking him back to the doctor to try to get the note and they keep saying that he still has the scabies. I have no clue why they are hanging on so long -- I've read horror stories on the internet though of scabies lasting months or even years or just never going away.

I'm six months pregnant and do NOT want to subject myself, or my family, to this! Especially the chemical treatment needed to get rid of them. So, I've kept his spot open but haven't allowed him back until he has a note. His mom says Gary has seen the doctor five times now and still the scabies aren't gone. I'm getting sick of holding the spot and losing out money -- she said she'd pay full price but I just don't know if I trust her to keep her house clean enough or to do what needs to be done to rid her son of the scabies -- also they can come back.

Would it be totally an overreaction for me to terminate care? I have had a lot of interest in my day care, and I only have two full-time spots in addition to my daughter, so we're a small group.

I just get the heebie jeebies and don't understand why he can't get over his scabies, with MULTIPLE doctors saying that it IS scabies.

What would you do?

[Suzie_Homemaker]

I would either accept her offer to pay for the place and work with her to resolve issue to my standard before allowing child into place or I would terminate.

She been to dr 5 times and still he has, would be wrong diagnosis if same doctor. You sure it different doctors? Who say this? Mom? Can you get permission to speak with the doctor?

To me, if something not makes sense, it not normally true.

Maybe Mom not really understanding what is needed to get rid of these properly.
Maybe family re-infect each other.
Maybe Mom not treating everyone at same time.
Maybe something off with Gary's system for the treatment not be working properly.

I Mom is stating she is doing all she can, then it not enough to reassure you and that fine. Just say that you sorry she has this to deal with but you can't hold the place any longer.

[SevenwatersDaughter]

Can anyone else please weigh in? Thanks!

[5 Little Monkeys]

Is she not paying for his spot now?

[MsBell]

I have never had this issue (thank GOD! Makes me itchy just thinking about it) If I were in your shoes, I would terminate. You have given lots of time to seek a remedy, and you really need to think of your own.

[kindertime]

One of the resources that I used to determine exclusion periods is here: http://www.hennepin.us/residents/hea...-diseases#Sec7

At the bottom of the page under Infectious Diseases in Childcare Settings and Schools Manual, you will find the Parent fact sheet and a technical fact sheet for scabies and all kinds of other childhood illnesses.

This particular site says to exclude until 24 hrs after treatment begins. Do you know what they have been using to treat it? Are they thinking the mites are still there because dck is still itchy? Or have they done more skin scrapings and seen them?

[bright sparks]

If the child has been treated multiple times then it is one of two things. Either the parents are not treating it properly or it is not scabies. I doubt the child has seen multiple doctors as you can't just see multiple drs. Only in a practice of multiple drs may a dr call on a colleague to confirm but I find it highly unlikely that a dr would ask for a second opinion on something so common as scabies. Is this parent paying for the spot right now? Do you have in your contract that regardless of attendance if you are available to provide care they have to pay for the days? If not then terminate. I understand trying to be accommodating and compassionate to certain situations as these but it does not serve you well as a business to take a financial loss over an extended period of time. If you are charging for the spot then on their heads be it. Scabies are brutal as I have had them a few times years back when I worked in hospitals but as kindertime said, once treated I was allowed to go back to work within 24 hours regardless of itching.

[MsBell]

Great Link Kindertime! Thanks!

[kindertime]

Great Link Kindertime! Thanks!

I hope it can help. I think, off the top of my head that's from Minnesota, the other resource I use is from Australia:
http://www.nhmrc.gov.au/_files_nhmrc...d_130701_0.pdf

If there is anyone who has a similar source from... Canada.... that would be great. I know the Que gov't has one, it's a huge book for this exact purpose, but...it's only available in French. So no use to me.