Communicable Illnesses?

[Sandbox Sally]

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?

[Bugaboo]

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!

[sunnydays]

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.

[mom-in-alberta]

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.

[Skysue]

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?

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

[Sandbox Sally]

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.

[Sandbox Sally]

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.

[sunnydays]

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.

[playfelt]

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.

[Judy Trickett]

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.