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Preventing Infections Handwashing. This is very, very important. Staff must be educated about this. Hands must be washed after changing diapers, and before serving or preparing food. Keeping sick children away. Children with an illness should not be allowed in the class while infectious to others. The problem is, many diseases like chicken pox and whooping cough are infective before they are diagnosed. Vaccination. Available against many diseases now. Washing of toys frequently. Antibiotics.For infections like meningococci, which can be very dangerous. All children who have been in touch with an infected child should be treated for infection.

Infections at School
and Daycare

Your child spends several hours each day in a classroom with 20-70 other children. At any time, one or more will be probably be sick, and other children in the classroom are at risk. What can schools do to lessen these risks?

In kinder, gentler days, children who were sick would be allowed to stay at home for a few days. These days, most parents are terrified of the backlog of work that builds up, and send even acutely sick children to school. Apart from being bad for the sick child, such acts are a hazard for the other children.

Are infections really common in schools? Yes, suggest careful sudies carried out at several places. Children who attend school and daycare facilities have a higher incidence of diarrhea, respiratory infections, and other diseases.

Why infections are common

In India, especially in the cities, it is common practice for children two years old to start going to schools or "playgroups". This age is very susceptible to infections. Mothers pass on protective antibodies to their babies through the umblical cord, which last till 6-12 months of age. After this, children are easy prey to any infection that comes along, till they can manufacture their own antibodies.

Since infections are common at this age, the probability of a sick child being present in a classroom is high. Children have no idea of idea of safe practices like sneezing into a handkerchief, or washing their hands after wiping a running nose. Disease causing germs are thus carried on their hands, or disseminated into the air.

The staff of a school (or even a day care center) are usually ill informed about infection reducing practices. They may not wash their hands after changing a diaper, or before preparing and serving food. Small children often do not wash hands well after visiting the toilet.

The main problem in many schools is overcrowding. Combined with poor ventilation and sunlight, this can increase the risk of any infection many times.

How are infections spread?

• Large respiratory droplets. A sick child's coughing produces these large drops of secretions, which contain germs. Being heavy, they settle on nearby surfaces, including hands, napkins, toys, etc. Several viral and bacterial infections are spread in this way. Among them are respiratory syncytial virus, adenoviruses, Neisseria meningitidis, Hemophilus influenzae, and Streptococci pneumoniae.
• Small respiratory droplets. These are produced similarly, but being light, they float in the air for a long time with their deadly cargo of disease producing germs. They can be breathed in by children in the class, leading to disease. Measles, chicken pox, whooping cough, and tuberculosis are spread thus.
• Enteric spread. This means spread by the sick child's feces. The child who doesn't wash hands well, or the staff member who changes diapers for small children, can carry germs on their hands. Typhoid fever, jaundice, and diarrhoea are spread thus.
• Direct contact. Some diseases like scabies, head lice, fungal skin infections, bacterial skin infections, and conjunctivitis (pink eye) are spread by direct contact with an infected person.
• Biting. This is quite rare, but dangerous. Hepatitis B has been known to be transmitted by bites. Also possible are hepatitis C and AIDS. Bites can also cause infections at the site of the bite.

Last revision: July 15, 2007

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