Kontagious Kids

Kontagious Kids: Keeping Children and Day Care Staff Healthy

H1N1 “Swine” Flu

H1N1 “Swine” Flu
Person-to-person, not pig-to-human
Pandemic
Type of influenza A virus
Similar to flu virus that infects pigs
Spread same way as seasonal flu; coughing, sneezing, fomites

Transmission
Similar to seasonal flu; coughing, sneezing, touching contaminated surface
Spreads easily between people
Recommended to stay home from work/school if infected to avoid spread
Face masks of limited value; do not block viral agents

Symptoms
Similar to other flus
Chills/fever
Coughing
Headaches
Muscle/joint pain
Sore throat
Fatigue
Runny nose

High Risk Groups
People older than 65
Children younger than 5
Pregnant women
Folks with underlying medical conditions;
Asthma
Diabetes
Obesity
Heart disease
Decreased immune response

Vaccination Recommendations
Pregnant women
Household contacts and caregivers for children < 6 months of age
Healthcare and emergency medical services personnel

6 months to 18 years
Close contact; schools, daycare
5-11 years has highest infection rate
19 through 24 years
Live, work, study in close proximity
Mobile population
25 through 64 who have health conditions associated with a higher risk of complications
As mentioned previously

Those over 65?
Carry some antibody protection
Similar to flu circulating in the 20’s through 50’s
Have lower infection rates

Prevention
Difficult to contain
WHO states that containment is not a feasible option
Focus on decreasing the effects of the virus
No recommendations on closing borders or restricting travel
Stay home when sick; reschedule travel plans if possible

Prevention
Cover nose/mouth when you cough/sneeze
Wash hands afterwards
Avoid touching eyes, nose, mouth
Avoid close contact with sick individuals
CDC recommends staying home 24 hours after fever subsides

H1N1 and Children
Keep them home when sick, especially when symptomatic
Keep them away from other children
Call family physician first; don’t run to the ER
Kids can catch H1N1 in the ER

H1N1 in Children
Emergency attention should be considered:
Breathing difficulties
Bluish or gray skin color
Decreased fluid intake
Irritability
Lethargy

Treatment
OTC remedies;
Fluid intake
Soup to relieve congestion
Pain relief

Treatment
Antiviral medications
Tamiflu
Relenza
Use for folks in high-risk groups
Healthy people don’t need it

Common Cold & Flu

Respiratory Syncytial Virus (RSV)

RSV
Major cause of lower respiratory tract infections during infancy & childhood
No vaccine available
Treatment is oxygen
Usually produces mild symptoms
Virus is ubiquitous; avoidance of infection is not possible

RSV Treatment
Oxygen is the only thing that works in severe cases
Often indistinguishable from the common cold

RSV Prevention
Just like the common cold, wash your hands often

Strep Throat
Most common bacterial cause of sore throat
Common in children 5-15
Can lead to Rheumatic Fever; treat with antibiotics (penicillin or amoxicillin)
Scarlet Fever – allergy to Strep toxin

Strep Throat
2-5 day incubation
Rapid onset
Resolves in about a week, with or without antibiotics

Signs/Symptoms
Fever >101
White draining patches on the throat
Swollen, tender lymph glands in the neck
Headache
Stomach pain
Loss of appetite
Nausea

Diagnosis
Culture of throat
Rapid tests; not always accurate
Culture any negative rapid tests

Prevention
Contagious until antibiotics kick in (24-48 hours)
Stay home for at least a day after antibiotics have been started
Change your toothbrush; reinfection
Wash hands often
Clean utensils
Re-occurring strep? Possible carrier?

MRSA
Staphylococcus Aureus bacteria
Resistance to beta-lactam antibiotics
Open wounds, invasive devices
Weakened immune systems; children and the elderly

MRSA
Colonizes the anterior nares
Carried asymptomatically by healthy folks
Treated with sulfa-drugs or clindamycin
Vancomycin
VRSA; rare

What is MRSA
Strain of Staphylococcus Aureus
Resistant to beta-lactam antibiotics
Penicillins and cephalosporins
Last line of defense is Vancomycin

MRSA Fast Facts
In the USA, 95 million people carry S. Aureus
2.5 million thought to carry MRSA
Increased outbreaks in locker rooms and gymnasiums

Signs/Symptoms
Skin and soft tissue infections
Red bumps, resemble pimples or boils
Open into painful pus-filled boils
Can become systemic , toxic shock and necrotizing pneumonia & fasciitis

Treatment
Sulfa drugs have some effectiveness
Vancomycin is the last drug of choice
Linezolid is a newer drug with good effectiveness too

Prevention of MRSA
Proper handwashing
Alcohol-based hand sanitizers near patient beds/care areas
Chlorhexidine solution for proper handwashing

Rotavirus

Rotavirus
Leading single cause of diarrhea among infants and young children
Transmitted via fecal-oral route
Infects cells of the small intestine
Entertoxin
Severe diarrhea
Death via dehydration

Rotavirus Epidemiology
2.7 million cases in USA annually
60,000 hospitalizations
37 deaths

Signs/Symptoms
Vomiting
Diarrhea, 4-8 days
Low-grade fever
2-day incubation once infected before signs/symptoms appear

Detection and Diagnosis
Enzyme immunoassay
Test kits, rapid sensitive and specific

Treatment
Management of symptoms
Maintain hydraytion
Water, Pedialyte, IV solutions

Prevention
Handwashing to prevent spread; not entirely effective
Vaccination
Rotarix by GlaxoSmithKline
RotaTeq by Merck
Taken orally, contain disabled live virus

Hepatitis A

Hepatitis A
Highly contagious liver infection
Contaminated food, water
Fecal/oral route
Close contact with infected persons
No treatment required
Most recover completely without any permanent liver damage; immunity thereafter

Signs/Symptoms
No signs/symptoms
Fatigue
Nausea/vomiting
Abdominal pain
Loss of appetite
Low-grade fever
Dark urine

Prevention
Contain spread
Handwashing
Vaccination
Havrix or Vaqta
Twinrix, hepatitis A & B vaccine

Salmonella

Salmonella
Causes enteritis
Self-limiting, no antibiotics required
Can cause severe illness in infants and children
Over 40,000 cases reported each year in the USA

Sources of infections
Unclean food; institutional & restaurant kitchens
Excretions from infected individuals
Polluted water
Unhygienically thawed food
Meat, poultry, eggs, milk
Tortoises and snakes

Signs/Symptoms
Nausea, diarrhea, chills, fever, abdominal cramps
8-72 hour incubation; sign/symptoms disappear in 4-7 days
Primary concern in children is dehydration, and containment

Prevention
Wash hands after handling raw eggs and meats, poultry
Separate these foods from ready-to-eat foods
Clean utensils, cutting boards and counter tops
Clean kitchen surfaces with paper towels

Escherichia Coli

E. Coli
Most strains are harmless
O157:H7 causes food poisoning
Enteropathogenic and enterotoxigenic strains are common
Gastroenteritis, UTI and neonatal meningitis

Food Sources
Ground beef
Vegetables grown in cow manure, or washed in contaminated water
Non-pasteurized fruit juices

Signs/Symptoms
Stomach cramps
Vomiting and diarrhea
Sometimes a bloody stool

Prevention
Cook ground beef thoroughly
Wash vegetables thoroughly
Wash hands after preparing these foods
Wash hands after caring for someone with E. Coli enteritis

Shigella

Shigella
Causative agent of dysentary
Fecal-oral route once again
Destruction of intestinal epithelium
Cell-to-cell spread

Signs/Symptoms
Nausea, vomiting, diarrhea, fever
Stomach cramps, flatulence
Bloody stool containing mucus and/or pus
2-4 day incubation
Self-limiting
Antibiotics in severe cases; shorten symptoms

Shigellosis
Occurs typically during summer months
Usually affects kids 2-4 years old; rarely younger than 6 months
Dehydration is a problem in children; Pedialyte
Very contagious; just need 10 cells
Good handwashing practices prevent spread

Shigellosis
Cleaning toilets
Clean diaper changing areas
Disposal of diapers
Handling foods
Isolation of kids with Shigellosis

Handwashing
Single most important procedure for preventing the spread of biological contamination
Prevents illness at home, school, work
Key prevention tools in healthcare, daycare and public facilities & schools

Handwashing – When to wash?
Hands are visibly dirty
Before eating
Before touching eyes, nose or mouth
Before and after handling/preparing food
Before dressing a wound, giving medicine
Before inserting contact lenses

Handwashing – When to wash?
After contact with blood/bodily fluids
After using the restroom
After changing diapers
After touching animals or pets
After coughing, sneezing, using a tissue
Wash more frequently when someone in the household is ill

Proper Handwashing Technique

Wash Your Hands: The Right Way When washing hands with soap and water: Wet your hands with clean running water and apply soap. Use warm water if it is available. Rub hands together to make a lather and scrub all surfaces. Continue rubbing hands for 15-20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend. Rinse hands well under running water. Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet. Always use soap and water if your hands are visibly dirty

Kontagious Kids

by danelacasse on Feb 15, 2010

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