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Chickenpox (Varicella)

Chickenpox (also known as varicella) is an acute viral illness. It is a common childhood infection that may be prevented by vaccination. It is highly contagious, but rarely serious for most children.

Cause: Varicella-zoster virus, a member of the herpes virus family.

Symptoms: Mild fever and generalized skin rash that begins on the chest, back, underarms, neck, and face. It starts out as red bumps. Within several hours, the bumps turn into small blisters, and then scabs after a few days. The sores commonly occur in batches with different stages (bumps, blisters, and sores) present at the same time. Chickenpox can be severe in newborns and those with weakened immune systems. Most people have had chickenpox by the time they are adults. However, when it does occur in adults, it may be more severe.

Spread: From person to person by direct contact with (touching) the blister fluid or secretions from the nose or mouth of a person with chickenpox. Occasionally, when a person with chickenpox coughs or sneezes tiny droplets with chickenpox virus into the air and another person breathes them in (airborne spread).

Incubation: From 10 to 21 days, usually 14 to 16 days, after being exposed until symptoms develop.

Contagious period: From 1 to 2 days before the rash begins until blisters have become scabs (generally within 5 days after the appearance of the first blisters in an otherwise healthy child).

Exclusion: Until all the blisters have dried into scabs and no new blisters or sores have started within the last 24 hours; usually by day 6 after the rash began. Chickenpox is still a common disease. It takes 10-14 days after receiving vaccine to develop immunity, vaccine failure occasionally occurs, and the incubation period is 10-21 days. Therefore, exclude children who: appear to have chickenpox regardless of whether or not they have received varicella vaccine, or develop blisters within 10–21 days after vaccination. Exposed children without symptoms do not need to stay home unless chickenpox develops.

Diagnosis: Based on typical symptoms and the characteristic rash.

Treatment: Call your healthcare provider. Do not give aspirin or other salicylate containing medications to any child or adolescent under 18 years of age. There is a risk of developing Reye's syndrome (a serious condition which can cause death) when children or adolescents take aspirin for viral illnesses such as chickenpox or influenza.

Prevention/Control: All children should be routinely vaccinated at 12-18 months of age with one dose of varicella vaccine. Unvaccinated children 12 months-12 years of age, who do not have a reliable history of chickenpox, should receive one dose of chickenpox varicella vaccine. Susceptible persons 13 years of age and older should receive two doses of vaccine, at least 4 weeks apart. If you think that your child has chickenpox, call your healthcare provider. Please do not go to the healthcare provider's office without calling first. They will want to keep your child separate from others to prevent further spread. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth or blister fluid. Thorough hand washing is the best way to prevent the spread of infectious diseases.

Preventative Treatment: Susceptible persons (have not had chickenpox or varicella vaccine in the past) who have been exposed to someone with chickenpox should call their healthcare provider immediately. Getting varicella vaccine within 3 days, and possibly up to 5 days, of exposure may prevent disease in these people. When a pregnant woman or a person with a weakened immune system who has not had chickenpox or vaccine is exposed, they should contact a healthcare provider immediately for possible treatment.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and child care consultants.

CONJUNCTIVITIS (PINKEYE)

Conjunctivitis, commonly known as pinkeye, is redness and soreness (inflammation) of the membrane (conjunctiva) that covers the eye and lines the inner surface of the eyelid. Pinkeye is a common infection in young children.

Cause: Bacteria, viruses, allergies, eye injuries, or chemicals.

Symptoms: May include redness, itching, pain, and discharge depending on the cause. Bacterial conjunctivitis can sometimes be distinguished from other forms of conjunctivitis by a more purulent (pus) discharge.

Spread: Direct contact with the secretions from the eyes, nose, or mouth of infected persons.

Incubation: It takes about 1 to 12 days after exposure for symptoms to begin (depending on the cause).

Contagious Period: Until the active infection passes.

Exclusion: Conjunctivitis with pus and/or fever or eye pain: until the child has been evaluated by the healthcare provider and until 24 hours after antibiotic treatment begins, or until the healthcare provider has cleared the child for readmission. Conjunctivitis without pus (clear, watery discharge without fever, eye pain, or eyelid redness): no exclusion necessary.

Diagnosis: Call your healthcare provider if your child has conjunctivitis with pus and/or fever, eye pain, eyelid redness, or if you have any questions.

Treatment: Antibiotic treatment (eye ointment or drops) may be prescribed.

Prevention/Control: Wash hands thoroughly with soap and warm running water after contact with eye drainage. Thorough hand washing is the best way to prevent the spread of infectious diseases. Keep the child's eyes wiped free of discharge. Avoid touching the eye drainage. Dispose of used tissues. Do not share any articles, such as towels and washcloths. Clean and disinfect mouthed toys at least daily and when soiled. Try to prevent sharing of toys when conjunctivitis is present.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Fifth Disease

Fifth disease (also called parvovirus B19 infection) is a mild, common illness caused by a virus. Rash is the most common symptom. Immunity increases with age; 50-80% of adults are immune (have had the disease in the past and cannot get it again). Outbreaks of fifth disease frequently occur in childcare settings.

Cause: Human parvovirus B19.

Symptoms: Rash; possibly a low-grade fever or sore throat. The characteristic rash causes an intense redness of the cheeks (a "slapped cheek" appearance) in children. The rash often begins on the cheeks and is later found on the arms, upper body, buttocks, and legs; it has a very fine, lacy, pink appearance. In general, the rash on the face will fade within 4 days. The rash on the rest of the body initially fades within 3-7 days. However, the rash may come and go for days or even weeks, when the person is exposed to sunlight or heat. Adults, especially women, may have pain, redness, and swelling of the joints. Joint pain and swelling may last 1-3 months. Most people who get fifth disease do not become very ill. However, children with sickle cell anemia, chronic anemia, or a weakened immune system may become seriously ill and require medical care when infected with parvovirus B19.

Spread: When a person with fifth disease coughs or sneezes tiny droplets with parvovirus B19 into the air and another person breathes them in. People can also get infected from touching these secretions and then touching their mouth, eyes, or nose.

Incubation: 4 to 21 days, usually 4 to 14 days, from the time of infection until symptoms begin.

Contagious Period: Most contagious before the beginning of the rash and unlikely to be contagious after the rash begins.

Exclusion: None, if other rash-causing illnesses are ruled out by a healthcare provider, since persons with fifth disease are no longer infectious once the rash begins.

Diagnosis: Lab (blood) tests are available to determine whether you are immune (have had the disease in the past and cannot get it again) or currently are infected with parvovirus B19.

Treatment: None.

Prevention/Control: Wash hands thoroughly with soap and warm running water after touching secretions from the nose or mouth. Thorough hand washing is the best way to prevent the spread of infectious diseases. Dispose of used tissues. Pregnant women or children with weakened immune systems, sickle cell anemia, or other blood disorders should call their healthcare provider if they have been exposed. If you do not know whether you are immune (have had fifth disease in the past and cannot get it again), call your healthcare provider for advice and whether a blood test is needed.

Information for Pregnant Women: Usually there are no serious problems for a pregnant woman or her baby because of an exposure to fifth disease. About 50% of women have already had fifth disease (are immune), so they and their babies are not at risk. Even if a woman is susceptible and gets infected with parvovirus B19, she usually experiences only mild illness. Likewise, her unborn baby usually does not have any problems caused by parvovirus B19 infection. Sometimes, parvovirus B19 infection will cause the unborn baby to have severe anemia and the woman may have a miscarriage. This occurs in less than 5% of all pregnant women who are infected with parvovirus B19 and happens more commonly during the first half of pregnancy. There is no evidence that parvovirus B19 infection causes birth defects.

For more information, you or your healthcare provider may call Hennepin County Community HealthDepartment at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Head Lice

Head lice infestations are a common problem for children in childcare settings. Anyone can get head lice. There are two other kinds of lice that infest people, but they do not live on the head. Check your child(ren) for head lice. If you find lice or eggs, use the information provided below or consult a lice removal expert.

Cause: Pediculus humanus capitis, a louse. Head lice are very small (less than 1/8" long, about this size [--]), brownish-colored insects that live on human heads and lay their eggs (nits) close to the scalp. The eggs are tiny (about the size of the eye of a small needle) and gray or white in color. Adult lice move fast and don’t like light.

Symptoms: Itching of the head and neck. Look for: crawling lice in the hair, usually few in number; eggs (nits) glued to the hair, often found behind the ears and at the back of the neck; and scratch marks on the head or back of the neck at the hairline.

Spread: Lice are spread by head-to-head contact and by sharing personal items such as combs, brushes, barrettes, hats, scarves, jackets, blankets, sheets, pillow cases, stuffed animals, play activity clothes and hats.Lice do not jump or fly; they crawl and can fall off the head. Head lice do not live longer than 48 hours off the head. They only lay their eggs while on the head. Nits which are more than ½" from the scalp are dead or empty and will not hatch. The eggs do not hatch if they fall off the head. Lice do not spread to or from pets.

Incubation: It takes 7 to 10 days from when the eggs are laid until they hatch.

Contagious Period: Until treated with a lice treatment product.

Exclusion: Until first treatment is completed and no live lice are seen. (Nits are not considered live lice.)

Treatment: Call your healthcare provider or pharmacist for advice. Recommended treatment includes using either a prescription or over-the-counter medicated (lice killing) product. Use products that contain permethrin, a synthetic insecticide or a pyrethrin-based shampoo. Follow the product directions carefully (especially the amount of product to use, length of time on the hair, and whether to use on dry or damp hair). Directions will vary, depending on the product used. With certain products a second treatment is recommended between 7 to 10 days later to kill any lice that may have hatched after the first treatment. Allow 24 hours for products to kill lice. Many alternatives to OTC or prescription head lice control products have been suggested. Although there is little scientific evidence to support these treatments, people often use alternative treatments when the usual treatments haven’t worked, or when there is concern about the toxicity of using head lice control products repeatedly. Some of the treatments being used include mayonnaise, oils (vegetable, olive, mineral, etc.), and petroleum jelly (Vaseline). When applied to the hair, these materials may suffocate and/or make it hard for the lice to move but do nothing to kill the nits. Some of these products are very difficult to remove from the hair. Lice treatment products are not 100% effective in killing lice, especially nits. Removing the nits (nitpicking) is an essential part of the treatment for controlling the spread of head lice. The nits are glued onto the hair shaft as they are laid, and require effort to remove. To remove the nits use a metal nit comb, cat flea comb, or your fingernails to slide eggs off the hair shafts, or use scissors to cut the hair shafts that have nits glued to them. Continue checking the head and combing hair daily for 2 weeks. If all nits within ½" of the scalp are not removed, some may hatch and the child will be infested again. Remember: it takes at least 2 weeks to get rid of lice. Check all household members for head lice. Treat only household members with head lice, and treat all at the same time.

Prevention/Control: Do not share combs, brushes, other hair grooming items and other hair accessories (barrettes, etc.), towels, bedding, clothing, hats, and headgear, suchas personal headphones and sports helmets. Hang coats, jackets, and caps in individual lockers or on assigned coat hooks. If this is not possible put the clothing in separate plastic bags. Bedding, when not in use for nap time, can be stored in individual plastic bags or storage boxes. Check your child's head frequently throughout the year. If one person in a household, childcare, school, etc., has head lice, others should be checked too. Clean all combs, brushes, other hair grooming items and accessories (barrettes, etc.) by doing one of the following: soaking in the lice treatment product for 10 minutes, cleaning with hot soapy water, or boiling for 5 minutes. Vacuum carpets, upholstered furniture, mattresses, and seats in the car(s)thoroughly. Insecticide sprays are NOT recommended because this will expose household members to unnecessary pesticides. Wash clothing worn in the last 3 days (e.g., jackets, hats, scarves, pajamas),bedding, and towels in hot (1300 F or higher) water and dry in a hot dryer for at least 20 minutes before using again. Clothing or backpacks that cannot be washed or dried, linens, and stuffed toys can be dry cleaned or sealed in plastic bags for 2 weeks.

How to Remove Nits: In a well lit room or under a bright lamp (using a magnifying glass may help you see the nits), Divide the hair into 4 sections and divide each section into 1-inch strands. Use a metal nit comb or a cat flea comb or your fingernails to slide eggs off the hair shafts, or use scissors to cut hair shafts that have nits glued to them. Comb each hair strand individually with a nit comb starting from the scalp. Remove all nits.

Remember: it can take at least 2 weeks to get rid of lice.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Impetigo

Impetigo is a contagious skin infection often occurring on the nose, arms, legs, or around the mouth. This infection is common in young children.

Cause: Streptococcus and/or Staphylococcus bacteria. Methicillin-resistant Staphylococcusaureus has also been identified as a cause.

Symptoms: Typically begins at a break in the skin (e.g., insect bite, cut, etc.). Sores form on the skin and produce a thick golden-yellow discharge that dries, crusts, and sticks to the skin. Rarely, problems such as kidney disease or cellulitis (skin infection) may develop if children do not receive proper treatment.

Spread: From person to person through touching the fluid from the sores. Rarely, through touching contaminated objects.

Incubation: It usually takes 1 to 10 days from the time a person is exposed until symptoms begin.

Contagious Period: Until sores are healed or the person has been treated with antibiotics for 24 hours.

Exclusion: Until treated with antibiotics for 24 hours and sores are drying or improving.

Diagnosis: Call your healthcare provider if you think your child has impetigo.

Treatment: Impetigo can be treated with topical antibiotics (applied directly to the skin) when only a few sores are present. When there are more than a few sores, your health care provider may prescribe oral (by mouth) or injectable (shot into the muscle) antibiotics.

Prevention/Control: Wash hands thoroughly with soap and warm running water after contact with sores. Thorough hand washing is the best way to prevent the spread of infectious diseases. Wear gloves if applying ointment to sores or use cotton-tipped swabs. Cover sores as a barrier to prevent spread, whenever possible. Discourage children from scratching infected areas. Do not share towels, washcloths, or clothing. Clean and disinfect toys at least daily and when soiled.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Influenza

Influenza (also known as flu) is a very common upper respiratory disease. Influenza is not what is commonly referred to as “the stomach flu,” which is a term used by some to describe illnesses causing vomiting or diarrhea. Every year, millions of people in the United States get influenza.

Cause: Influenza virus. The two main types of influenza viruses are type A and type B. Within each type there are many related strains or subtypes, which can change every year. This is the reason a person can get influenza more than once and why a person should get vaccinated every year. Influenza A and B most often cause very large numbers of respiratory illness (epidemics). Epidemics usually occur between November–April.

Symptoms: Starts quickly with fever, body aches, headache, cough, runny nose, sore throat, chills. Illness lasts at least three days. Children may develop ear infections, pneumonia, or croup as a result of influenza infection. People with chronic health problems or weakened immune systems may develop pneumonia or bronchitis.

Spread: When a person with influenza coughs or sneezes tiny droplets with influenza virus into the air, and another person breathes them in. Spread can also occur by touching the secretions from the nose and mouth of an infected person or by touching hands, tissues, or other items soiled with these secretions.

Incubation: It takes from 1 to 4 days, usually 2 days, from the time of infection until symptoms begin.

Contagious Period: Most contagious during the 24 hours before the illness begins (very young children may be contagious longer than 24 hours before onset). Adults are generally contagious 5 days after onset of illness, and children can still shed the virus in secretions from the nose for 7 days after the illness begins.

Exclusion: Until fever is gone and the child is well enough to participate in routine activities.

Diagnosis: Call your healthcare provider if your child has a high fever and/or persistent cough. Viral cultures may be taken.TREATMENT:Call your healthcare provider. Medications (antiviral) will shorten the course of illness if given within 36-48 hours after the symptoms begin. DO NOT GIVE ASPIRIN or SALICYLATE CONTAINING MEDICATIONS TO ANY CHILD OR ADOLESCENT UNDER 18 YEARS OF AGE. There is a risk of developing Reye syndrome (a serious condition which can cause death) when children or adolescents take aspirin for viral illnesses such as chickenpox or influenza.

Prevention/Control: Influenza vaccine is encouraged for children 5 years of age or younger, especially infants 6 months to 23 months of age. Persons caring for this group should also be vaccinated. Anyone who wants to be protected against influenza should get an annual influenza vaccination. The vaccine is usually given in the late fall or can be given any time during the influenza season.

January 2003 Copyright 200310

Is it a cold or an allergy?

It isn’t easy to tell the difference between cold and allergy. This chart from the American Academy of Pediatrics can help.

Here are some websites with helpful tips in dealing with allergies or colds:

KidsHealth

Kids Health Teen Information

Molluscum Contagiosum

Molluscum contagiosum is a skin infection that mainly affects children and young adults. It may last longer and cover more of the body in people with eczema (skin disease) or those with have a weakened immune system.

Cause: A poxvirus.

Symptoms: Small, pale, shiny, domed-shaped areas on the skin (lesions), often with a characteristic dimple on the top. The lesions may be flesh-colored, white, translucent, or yellow. In children, the lesions occur on the face, body, arms, or legs. In adults, the lesions occur in the genital area or lower abdomen. People with eczema or who have a weakened immune system may have more intense and widespread lesions.

Spread: From direct skin-to-skin contact with an infected person. It is less likely to be spread by contact with contaminated objects such as sharing clothes, towels, wash cloths, gym equipment, wrestling mats, or swimming pools. Humans are the only known source of the virus. May be acquired during sexual contact.

Incubation: It takes 2 weeks to 6 months, usually 2 to 7 weeks, from when a person is exposed until symptoms develop.

Contagious Period: Unknown; probably while lesions are present. Contagiousness is generally low.

Exclusion: Children with visible lesions should not participate in close contact activities such as wrestling or swimming.

Diagnosis: See your healthcare provider.

Treatment: Discuss treatment options with your healthcare provider.

Prevention/Control: Avoid swimming pools and contact sports until the infection has cleared. Do not share towels and washcloths.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Mononucleosis (Infectious)

Infectious mononucleosis is a very mild illness in infants and young children. However, it can occur at any age.

Cause: Herpes viruses, typically, Epstein-Barr virus (EBV); about 5%-7% of cases are caused by cytomegalovirus (CMV).

Symptoms: In young children there are often no symptoms. Symptoms may include fever, sore throat, swollen glands (especially behind the neck), headache, and tiredness. Sometimes there is a rash. Young adults may have jaundice (yellowing of the skin or eyes) and an enlarged spleen. Infectious mononucleosis usually lasts from one week to several weeks.

Spread: From person to person usually through saliva. Spread can occur by kissing or sharing items contaminated with saliva (e.g., drinking cups, bottles, or toys).

Incubation: It takes about 4 to 6 weeks from the time a person is exposed until symptoms develop.

Contagious Period: From many weeks to a year or more. In some adults the virus can be present for long time periods.

Exclusion: Until the child is well enough to return to routine activities. Because children can have the virus without any symptoms, and people can be contagious for such a longtime, excluding children (or staff) who have mononucleosis will not prevent spread. If the spleen is enlarged, children should avoid contact sports for 6 weeks or until the healthcare provider has given approval for the child to continue with the sport(s).

Diagnosis: See your healthcare provider. Blood tests are available, but may be difficult to interpret in children less than 4 years of age.

Treatment: Call your healthcare provider.

Prevention/Control: Wash hands thoroughly with soap and warm running water after any contact with saliva or items with saliva on them. Thorough hand washing is the best way to prevent the spread of infectious diseases. Clean and disinfect mouthed toys at least daily and when soiled. 3. Do not kiss an infected child on the lips or have contact with their saliva.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants. 

Pertussis (Whooping Cough)

Reportable: Provider: This disease is reportable to the local or state health department. Parents/guardians: Inform your childcare provider if your child has this illness. Pertussis (also known as whooping cough) can be a serious illness, especially in young, unvaccinated children. Adults and older children with pertussis may be the source of infection for infants and young children.

Cause: Bordetella pertussis, a bacterium.

Symptoms: Pertussis begins with a runny nose, sneezing, possibly a low-grade fever, and mild cough. After a week or two, a persistent cough develops, which may occur in explosive bursts (paroxysmal coughing), sometimes ending in a high-pitched whoop and vomiting. A whoop may be absent in older children, adults and infants younger than 6 months. Coughing attacks occur more frequently at night. The coughing attacks usually increase during the first two weeks of illness and then remain the same for two or three more weeks before gradually decreasing. Some people, particularly infants, may develop pneumonia and ear infections. Pertussis can occur in vaccinated children, but the illness is usually milder. Older children and adults may have a less typical cough; however, it is usually persistent and may lead to vomiting or a whoop. Although the disease is less severe in adults and older children, they can unknowingly infect infants and preschoolers who are at risk for serious illness.

Spread: When a person with pertussis coughs tiny droplets with pertussis bacteria into the air and another person breathes them in.

Incubation: It takes 6 to 20 days, usually 7-10 days, from the time a person is exposed until symptoms start.

Contagious Period: Begins at the time of early cold-like symptoms, before a persistent cough and explosive bursts of coughing start. Persons remain contagious until three weeks after explosive bursts of coughing begin. Those treated with antibiotics are contagious until 5 days of treatment are completed.

Exclusion: Until 5 days after appropriate antibiotic treatment begins.

Diagnosis: To confirm a diagnosis of pertussis, laboratory tests are performed on material collected by placing a flexible swab through the nostril to the back of the nose and throat. Some lab tests (pertussis cultures) are less accurate after antibiotics are given.

Treatment: Call your healthcare provider. Antibiotics shorten the time a person with pertussis can give it to others, but may do little to lessen their symptoms. Treatment is most effective if started soon after cough begins. Antibiotics are usually not given to people who have had a cough for more than 20 days because they will no longer be helpful. Erythromycin (40 to 50 mg/kg per day orally in four divided doses, maximum 2 grams per day) for 14 days, as tolerated, is recommended for household and other close contacts, such as those in childcare, regardless of age and vaccination status. Some experts recommend the estolate preparation for children but not for adults. Clarithromycin (Biaxin) for 7 days, or azithromycin (Zithromax) for 5 days, may be effective alternatives. Bactrim or Septra for 14 days are possible alternatives, but are not recommended for use in pregnant women.

Prevention/Control: Minnesota state law requires that all children 2 months of age or older enrolled in childcare settings or schools be vaccinated against pertussis (along with tetanus and diphtheria) or have a legal exemption. Children should receive a DTaP at 2 months, 4 months, 6 months, 12 to 18 months, and a booster dose at 4-6 years of age. If your child develops the symptoms described above within 20 days after last contact with the infected child, keep your child at home and call your health care provider. Exposure to pertussis: If your child is exposed to pertussis and is not up to date on pertussis vaccinations, please call your healthcare provider or public health clinic to have your child vaccinated. Call your healthcare provider if you or your child have been exposed to pertussis because you may need to receive preventive antibiotic treatment.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Pneumonia

Pneumonia (inflammation of the lung) is a serious respiratory condition. Pneumonia can be a complication of other illnesses and can occur throughout the year. Infants and young children who experience common respiratory viruses and are exposed to secondhand tobacco smoke are at increased risk of developing bronchiolitis, bronchitis, pneumonia, and middle ear infections.

Cause: Many different viruses, most commonly respiratory syncytial virus (RSV) and influenza virus, and some bacteria. Most of these viruses or bacteria (germs) can cause other illnesses and not all persons exposed to the same germ will develop pneumonia. Physical and chemical irritants may also cause pneumonia.

Symptoms: Rapid breathing and pain, usually fever and cough. May have runny nose, milder cough, and fever several days before getting pneumonia.

Spread: Viruses and bacteria are spread from person to person by touching the secretions from the nose and mouth of an infected person. Spread may also occur by touching the hands, tissues, or other items soiled with nose and mouth secretions from an infected person.

Incubation: Depends upon the germ that is causing the illness.

Contagious Period: From shortly before symptoms begin and while the child feels sick.

Exclusion: Until fever is gone and the child is well enough to participate in routine activities.

Diagnosis: Call your healthcare provider if your child has a high fever or persistent sore throat or cough.

Treatment: There is no specific treatment for most respiratory viruses. Antibiotics may be prescribed if a bacterial infection is suspected or diagnosed. Call your healthcare provider if you have questions about medications or to discuss any concerns.

Prevention/Control: Wash hands thoroughly with soap and warm running water after touching the secretions from the nose or mouth. Thorough hand washing is the best way to prevent the spread of infectious diseases. Cover nose and mouth with a tissue when coughing and sneezing or cough/sneeze into sleeve. Dispose of used tissues. Clean and disinfect mouthed toys at least daily and when soiled.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

Ringworm

Ringworm is a fungal infection of the body, scalp, or hair. There have been reports of increasing numbers of cases. The infection is most common in children.

Cause: Several different fungi. (It is not a worm.)

Symptoms: Body – Ringworm appears as flat, spreading, ring-shaped areas on the skin(lesions). The edge of the lesion may be dry and scaly or moist and crusted. As the lesion spreads outward, the center often becomes clear. Scalp – Ringworm may be hard to detect in the early stages. It often begins as as mall scaly patch on the scalp and may progress to larger areas of scaling. Mild redness, swelling, itching and pustules (pus-filled bumps) may occur. Infected hairs become brittle and break off easily.

Spread: By touching the lesions of infected persons or pets (usually dogs and cats), or from sharing objects that touched the lesions of an infected person, (e.g., hats, caps, combs, brushes, towels, pillows, bedding, sofas, clothing, hair ribbons, barrettes).

Incubation: For ringworm of the body, it takes about 4 to 10 days after exposure for symptoms to appear. For ringworm of the scalp, it takes 10 to 14 days.

Contagious Period: Contagious as long as lesions are present. Contagiousness is reduced once treatment has begun.

Exclusion: Until 24 hours after treatment has been started. Children with ringworm should not participate in gym, swimming, and other activities that are likely to expose others.

Diagnosis: If you suspect ringworm in your household members, call your healthcare provider. If you suspect ringworm in your pet, contact a veterinarian.

Treatment: Call your healthcare provider to ask about treatment and other comfort measures. It is important to follow your healthcare provider’s directions exactly about the amount of time that the ointments need to be put on the lesions and the amount of time the oral medication should be taken. Body ringworm: Antifungal ointments are used on skin lesions for 4 weeks. Scalp ringworm: Medications should be taken by mouth (oral) for 4–8 weeks.

Prevention/Control: Do not share personal items such as brushes, combs, towels, bedding or pillows, clothing, hats, caps, hair ribbons, and barrettes. Wash combs and brushes in hot, soapy water. Wash bedding and clothing in hot, soapy water. Each child should have separate bedding and pillows at home and at the childcare facility. Provide separate storage space for personal items for each child or staff member.

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Streptococcal (STREP) INFECTION

Streptococcal sore throat (strep throat), a strep throat with a rash (scarlet fever), and inflammation of the skin and/or tissues under the skin around the anal area (perianal cellulitis) are common infections in young children.CAUSE:Streptococcus bacteria (Group A beta-hemolytic strep).

Symptoms: Strep throat: Starts suddenly with fever, red sore throat, and swollen glands. Headache may occur. Nausea, abdominal pain, and vomiting may be more common in children. Scarlet fever: A very fine raised rash (feels like sandpaper) is present. The rash blanches with pressure. The rash appears most often on the neck, chest, in folds of the armpit, elbow, groin, and in the inner thigh. Later on, there may be peeling of the skin on the fingertips and toes. Perianal cellulitis: The skin around the anus is painful, red, and tender. It may blister and scab over. Fever and chills may also be present. The perianal area may itch and the child may have painful bowel movements. These illnesses are usually not serious; however, rare problems such as rheumatic fever (which can damage heart valves) or kidney disease may develop if children do not receive proper antibiotic treatment.

Spread: When a person with a Group A strep infection coughs or sneezes tiny droplets with strep bacteria into the air and another person breathes them in. People can also get infected by touching objects or the hands of someone with perianal strep after the infected person touches or itches the anal area. Casual contact rarely results in spread.

Incubation: It usually takes 2 to 5 days from the time a person is exposed until symptoms start.

Contagious Period: Until 24 hours after antibiotic treatment begins.

Exclusion: Until 24 hours after antibiotic treatment begins and until the child is without fever. Children without symptoms, regardless of a positive throat culture, do not need to be excluded from childcare. Person who have strep bacteria in their throats and do not have any symptoms (carriers) appear to be at little risk of spreading infection to those who live, go to childcare or school, or work around them.

Diagnosis: Call your healthcare provider. They may confirm the identification of strep in the throat, either by throat culture or by using a rapid strep test, which can provide results the same day. For perianal cellulitis, blood cultures , or cultures of the anal area may be necessary to confirm the diagnosis.

Treatment: If the throat culture or rapid strep test is positive, your healthcare provider may give you a penicillin shot or antibiotics that are taken by mouth. Antibiotics should betaken for the prescribed amount of time. Do not stop the antibiotics early, even when the child feels better. Treatment may be dependent on how severe the infection is and will help prevent more serious illness such as rheumatic fever.

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Warts

Warts are skin growths caused by a virus. Common and flat warts are seen most often in younger children.

Cause: Human papillomavirus.

Symptoms: Common warts: are dome-shaped and have a rough appearance. They usually grow on the fingers, on the backs of the hands, and around the nails but may be more common where skin is broken (e.g., fingernails bitten or hangnails picked). Black dots in a wart are produced by broken blood vessels. Flat warts: are smaller and smoother than other warts. They tend to grow in large numbers (20 to 100) at a time and can grow anywhere. However, in children they are most common on the face. They are found in the beard area of men and on the legs of women.

Spread: Passed from person to person, sometimes indirectly from contaminated objects. The virus more easily enters the body through an area of skin that is moist, peeling, or cracked.

Incubation: It can take from several months to years for symptoms to begin.

Contagious Period: Unknown; probably as long as the wart is present.

Exclusion: None.

Diagnosis: Call your healthcare provider.

Treatment: Call your healthcare provider to discuss the appropriate treatment for the kind of wart you have.

Prevention/Control: Do not bite your nails or hangnails. Keep nails trimmed and hands dry. Perform first aid when injuries occur.

For more information, you or your healthcare provider may call Hennepin County Community Health Department at 952-351-5230, or call your local health department.

Prepared by Hennepin County Community Health Department with the support of the local and state disease prevention and control staff and childcare consultants.

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