By F. Spike. Northwest College of Art.
Equipment Changing surface - The changing surface should be separate from other activities discount precose 25mg line. Check with your childcare health consultant or school nurse to determine which handwashing procedures are appropriate for different age groups of children order 50mg precose otc. Diapers High-absorbency disposable diapers are preferred because cloth diapers do not contain stool and urine as well and require more handling (the more handling effective precose 50mg, the greater chances for spread of germs). Cloth diaper considerations The outer covering and inner lining must both be changed with each diaper change. Disposable gloves Non-latex gloves without powder should be considered because of possible allergy to latex in staff and children. Disposable wipes A sufficient number of pre-moistened wipes should be dispensed before starting the diapering procedure to prevent contamination of the wipes and/or the container. Parents/guardians or healthcare providers must provide written, signed directions for their use. Plastic bags Disposable plastic bags must be used to line waste containers and to send soiled clothing or cloth diapers home. Waste containers and diaper pails A tightly covered container, preferably with a foot-operated lid, is recommended. Potty chair or commodes (not recommended) Flush toilets are recommended rather than commodes or potty chairs. However, if potty chairs or commodes are used, frames should be smooth and easy to clean. Wipe the area to distribute the sanitizer evenly using single-service, disposable paper towels. If you have questions about cleaning and sanitizing procedures, ask your childcare health consultant or school nurse for specific instructions. July 2011 44 July 2011 45 Please Post Changing Pull-ups/Toilet Learning Procedure *Note: This procedure is recommended for wet pull-ups only. Thoroughly with soap and warm running water for 15-20 seconds using posted procedure. Place pull-up directly into plastic bag, tie and place in a plastic lined waste container. Thoroughly with soap and warm running water for 15-20 seconds using posted procedure. Thoroughly with soap and warm running water for 15-20 seconds using posted procedure. Acknowledge Toilet Learning Praise child for all attempts/successes in toilet learning process. Toileting results and any concerns to parents (rash, unusual color, odor, frequency, or consistency of stool). Handwashing Wash hands thoroughly with soap and warm running water after using the toilet, changing diapers, and before preparing or eating food. Thorough handwashing is the best way to prevent the spread of communicable diseases. Food and beverage storage, handling, preparation, and cooking guidelines Storage guidelines/rationale - Store all potentially hazardous foods (eggs, milk or milk products, meat, poultry, fish, etc. Childcare centers/schools that receive hot food entrees must hold potentially hazardous foods at 135° F or above and check food temperature with a clean, calibrated food thermometer before serving. Bacteria may grow or produce toxins if food is kept at temperatures that are not hot or cold enough. This will help to prevent the meat and poultry juices from dripping onto other foods. Never refer to medicine as “candy” as this may encourage children to eat more medicine than they should. For example, cleansers may look like powdered sugar and pine cleaners may look like apple juice. Preferably, one sink should be dedicated for food preparation and one for handwashing. This area has equipment, surfaces, and utensils that are durable, easily cleaned, and safe for food preparation. This helps remove pesticides or trace amounts of soil and stool, which might contain bacteria or viruses that may be on the produce. Cross contamination occurs when a contaminated product or its juices contacts other products and contaminates them. High concentration of sanitizer can leave high residuals on the food contact surface, which can contaminate food, make people ill, and damage surfaces or equipment. Staff knowledgeable about safe food handling practices can prevent foodborne illnesses. Use a food thermometer to achieve an internal temperature of 155° F for 15 seconds. Large quantities of hamburger may “look” cooked, but may contain “pockets” of partially cooked meat. Monitoring temperatures can ensure that all potentially hazardous foods have not been in the “danger zone” (41° - 135° F) too long, which allows for bacterial growth. The container or platter could contain harmful bacteria that could contaminate the cooked food. These items may be the source of foodborne illnesses caused by pathogens such as Campylobacter, Salmonella, E. Cooking projects in the childcare and school settings should be treated as a science project. Children could contaminate food and make other children/staff ill if they handle food during these types of projects. Monitor the children’s handwashing and supervise children so they do not eat the food. Children and parents may not understand food safety principles as well as staff at licensed food establishments. Licensed commercial kitchens are more controlled environments for preparation than private homes. If you choose to have an animal in the childcare or school setting, follow the listed guidelines to decrease the risk of spreading disease. Check with your local health department or childcare licensing agency before bringing any pets to your childcare setting or school because there may be state and/or local regulations that must be followed. General considerations Inform parents/guardians of the benefits and potential risks associated with animals in the classroom. Types of pets allowed in childcare and school settings include: guinea pigs birds (must be free of Chlamydophila psittaci) gerbils fish domestic-bred rats domestic-bred mice rabbits hamsters dogs cats Animals not recommended in school settings and childcare settings include: - ferrets - reptiles (e.
These include standard precautions such as wearing gloves generic precose 50mg mastercard, gowns and masks where appropriate generic precose 25mg without a prescription, and taking necessary care during collection of the specimens themselves precose 50mg with visa. Storage and transport After collection, the two key aims of storage and transport are to keep the specimens viable and to minimise contamination. For transportation outside of the laboratory environment, an overnight courier or faster means should be employed, using chiller pads and insulated containers to keep the specimens cool. These instructions could include (for faecal specimens): collect the faecal sample in the pottle supplied wash hands place pottle in the supplied biohazard bag place bag in a cool area out of direct sunlight while awaiting collection. Background Organism typing refers to a variety of processes that describe detailed characteristics of microorganisms of the same species, thereby allowing further subdivision into different organism types or subtypes. Organisms that are indistinguishable by typing are said to have epidemiological relatedness, and are therefore more likely to have come from a recent common ancestor and common source. This information can be used to link human cases to assist in the identification, description and investigation of outbreaks. In addition, human cases can be linked to environmental samples to determine potential sources of infection (e. Advantages of organism typing Enhanced sensitivity for detecting dispersed outbreaks likely to have emerged from a common source. Subtyping has contributed directly to the identification of the sources of many 57, 58 salmonellosis outbreaks. Epidemiological investigation should not be delayed until typing results become available. However, in the analysis of samples from a large multicentre outbreak where the strain type is very common, results from molecular typing are required to narrow the case definition and exclude non-related cases. For example, the genotyping system currently used for Giardia lamblia divides the organism into only two types, limiting its value for outbreak investigation. Be advised by the appropriate reference laboratory on the practicality and applicability of typing methods. Examples of the typing methods used are given in Table 10; these are grouped into two main categories, phenotypic and genotypic. Interpretation of laboratory results Laboratory test results are generally used to support a diagnosis or hypothesis, not to make it. Testing may not be 100% accurate because methods have to balance sensitivity and specificity. In other words, increasing the ability of a test to recognise specimens which are truly positive (making it more sensitive) also increases the chance of ascribing a positive result to negative samples which have similar characteristics to the agent of interest (making it less specific), and vice versa. Therefore, a positive result from a person or item without epidemiological association does not prove the person or item was a source or vehicle of infection. On the other hand, a positive result from an epidemiologically implicated person or item strongly suggests that person or item was most likely a source or vehicle of infection. Possible reasons, apart from the pathogen truly not existing in the specimen source, include: intermittent or non-uniform inoculation of the pathogen in the specimen, for example, due to intermittent faecal shedding of pathogens specimen size is too small competitive microorganisms outgrew pathogen (if culture) item / source not tested for pathogen diminished, injured or inactivated pathogen due to inappropriate processing, handling or storage for human faecal specimens, elimination of the pathogen may have already occurred inappropriate or inadequate laboratory methods agent is not a pathogen, for example, it could be a toxin agent is an emerging pathogen not detectable by currently available laboratory methods. If an organism or type of organism different to the ‘outbreak strain’ is found, this may still provide evidence for a contamination or infective process and should be investigated further. Tables 11 to 15 provide summary lists of specimens and tests available in a laboratory investigation under certain common outbreak scenarios. Common event or dispersed outbreak of foodborne or waterborne illness In a common event or dispersed outbreak of foodborne or waterborne illness, the role of laboratory investigation is to: confirm the diagnosis help identify the source establish links between cases using phenotypic or genotypic testing (particularly dispersed outbreaks). Institutional outbreak In an institutional outbreak, the role of laboratory investigation is to: confirm the diagnosis help identify the source. Environmental outbreak In an environmental outbreak, the role of laboratory investigation is to: confirm the diagnosis establish environmental contamination and its source. If chlorinated, use bottle containing sodium thiosulphate Enteric bacteria Water 1 L in a sterile container for each pathogen being investigated. Community-wide, person-to-person outbreaks In community-wide, person-to-person outbreaks, the role of laboratory investigation is to: confirm the diagnosis establish links among the cases. Outbreak control measures These guidelines present a brief, somewhat generic, summary of outbreak control measures. It is beyond the scope of this document to provide detailed information about control measures for specific diseases and situations. These relate to the duties of Medical Officers of Health, Health Protection Officers and Food Act Officers. This list should not be considered as a substitute for the text of the actual statutes and regulations. General considerations Although definitive measures usually require knowledge of the source and reasons for the outbreak, control activities should be considered at all stages of the investigation. Initial control measures will be based on knowledge of the pathogen, and probable sources and modes of transmission. The sources of an outbreak can usually be considered as a continuum from ‘upstream’ determinants to ‘downstream’ factors. For example, an outbreak of meningococcal disease in a community could be simultaneously due to social and economic conditions predisposing people to over-crowding and poor housing, a lack of availability of accessible primary health care services for early diagnosis, and to close physical contact with an individual carrying nasopharyngeal Neisseria meningitidis. Points of potential outbreak control can also occur at several places on this continuum. In general, however, upstream determinants can only be addressed over a long time scale and with substantial political and community support. For this reason, most outbreak control measures focus on the immediate sources of the outbreak, but it is important to bear in mind that the causes of outbreaks occur in a much broader context. To use the example of an outbreak of meningococcal disease, immediate outbreak control measures will involve tracing and administering prophylaxis to close contacts of the index case, but it is important to remember that improved living conditions and improved access to affordable and appropriate health services (along with development of an effective vaccine) could have greater impact on meningococcal disease outbreaks in the long term. Control measures may be considered under three areas aimed at: the outbreak source contaminated vehicles of infection transmission susceptible humans. The choice of control measure within these three areas is dictated by factors such as whether the outbreak source is known, whether a suspected vehicle has been identified and whether a vaccine or prophylactic treatment is available for susceptible humans. Outbreaks associated with food, water or environmental sources Closure of premises or site of outbreak (e. Outbreaks associated with animal contact Removal from contact, treatment, isolation, immunisation or destruction of animal reservoirs (e. Outbreaks associated with contaminated food or water Removal or recall of contaminated product (e. Outbreaks associated with vectors Application of insecticides, setting traps, eliminating breeding habitats, improving management of solid waste (e. Outbreaks associated with food, water or environmental sources Education to change behaviour associated with food preparation or hygiene (e. Communication during outbreak investigation A coordinated approach to communication is an essential part of outbreak investigation activities.
These infections commonly occur at sites of visible skin trauma trusted precose 25 mg, such as cuts and abrasions cheap 50mg precose mastercard, and areas of the body covered by hair (e order 50mg precose with amex. A long delay may occur between colonization with staph and the onset of infection. Activities: Children with draining sores should not participate in any activities where skin-to-skin contact is likely to occur until their sores are healed. Childcare/school personnel should notify parents/guardians when possible skin infections are detected. Wash hands thoroughly with soap and warm running water after touching secretions from the nose, tracheostomies, gastrostomies, or skin drainage of an infected or colonized person. When bacteria are antibiotic resistant it means that an antibiotic will not kill the bacteria. These infections Tell your childcare commonly occur where children have cuts and scrapes. This means that the bacteria are Childcare and School: there without causing any infection or any harm. Yes, if draining sores If your child is infected, the time it will take for symptoms are present and cannot to start will vary by type of infection. Contagious Period Activities: Avoid participating in As long as the bacteria are present. A child who has activities where skin-to- draining infections has more bacteria and is more skin contact is likely to contagious than a child who is only colonized. Wash clothes, bed sheets, and blankets in hot water with detergent and dry in a hot dryer. The bumps are usually painless, but, on rare occasions, can be itchy, red, swollen, and/or sore. It may last longer and cover more of the body in people with eczema (skin disease) or those who have a weakened immune system. It can also be spread by contact with contaminated objects such as shared clothes, towels, washcloths, gym or pool equipment, and wrestling mats. Persons with this skin disease can accidentally spread the virus to other parts of their body. Spread can occur by touching or scratching the bumps and then touching another part of the body (autoinoculation). Researchers who have investigated this idea think it is more likely that the virus is spread by sharing towels and other items around a pool or sauna than through water. After that, the bumps will begin to heal and the risk of spreading the infections will be very low. Encourage parents/guardians to cover bumps with clothing when there is a possibility that others will come in contact with the skin. Activities: Exclude any child with bumps that cannot be covered with a watertight bandage from participating in swimming or other contact sports. Wash hands thoroughly with soap and warm running water after touching the bumps or discarding bandages. Contagiosum If you think your child Symptoms has Molluscum Contagiosum: Your child may have bumps on the face, body, arms, or legs. Avoid participating in - By touching or scratching your bumps and then swimming or contact touching another part of your body. After the bumps begin to heal, the risk of spreading the infection will be very low. Contact sports or using shared equipment: Avoid sharing towels, wash cloths, uniforms, clothing, or other personal items. It may take weeks to months to regain energy; however, this will vary from person to person. Less common problems include jaundice (yellowing of the skin or eyes) and/or enlarged spleen or liver. Since this virus does not live long on surfaces and objects, you need to be exposed to fresh saliva to become infected. Because students/adults can have the virus without any symptoms and can be contagious for such a long time, exclusion will not prevent spread. Sports: Contact sports should be avoided until the student is recovered fully and the spleen is no longer palpable. Wash hands thoroughly with soap and warm running water after any contact with saliva or items contaminated with saliva. If you think your child Symptoms has Mono: Your child may have a sore throat, swollen glands, Tell your childcare headache, fever, and sometimes a rash. Childcare and School: Less common problems include jaundice (yellowing of the No, as long as the child skin or eyes) and/or enlarged spleen or liver. Sports: Children with an Spread enlarged spleen should avoid contact sports - By kissing or sharing items contaminated with saliva. Call your Healthcare Provider ♦ If anyone in your home has symptoms of mononucleosis. Your child may need bed rest, to drink plenty of water, and to avoid some physical activities. Prevention Wash hands after touching anything that could be contaminated with secretions from the nose or mouth. Mosquito-borne diseases are viral diseases that are spread by infected mosquitoes. The many viruses have the potential of causing serious disease affecting the brain and central nervous system. Removal of potential breeding sites is important in preventing the spread of mosquitoes. Birdbaths, wading pools, dog bowls, and other artificial containers of water should be emptied weekly to eliminate mosquito-breeding areas. Mosquitoes breed in water and artificial containers, especially flower pots, birdbaths, cans, children’s toys, wading pools, tire swings, old tires, or anything that will hold a small pool of water should be emptied or discarded. Rarely, swelling of the spinal cord and brain (encephalitis), inflammation of the ovaries (oophoritis) or breasts (mastitis), and deafness may occur. Other examples of how the virus can be spread is through sharing toys, beverage containers, eating utensils, and smoking materials (cigarettes), and kissing. Exclusion will last through at least 26 days after the onset of parotid gland swelling in the last person who developed mumps. A blood test specific for mumps antibody should be done as soon as possible after symptoms begin. Sometimes, healthcare providers will obtain a second blood test 2 to 3 weeks later. Encourage parents/guardians to keep their child home if they develop symptoms of mumps. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth. If you think your child Symptoms has Mumps: Your child may have swollen glands in front of and below the ear.
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