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Our recent bout with swine flu (well, technically "flu-like symptoms ") made this new study catch my eye. Researchers publishing with the American Society for Microbiology found that hand sanitizers are less effective at killing the Norwalk virus than antibacterial skin cleansers.
Hat tip: Food Poison Journal
A teenager in Texas died last month from swine flu. What struck me about this particular report is that he also had an MRSA infection at the time. Last year, a report in Pediatrics magazine noted a five-fold increase in flu deaths where a child also had MRSA. Given the prevalence of MRSA in many communities, youth-serving organizations need to be as alert to the symptoms of MRSA as to flu symptoms.
The CDC has issued an updated bulletin for early childhood programs on how to respond to an outbreak of the H1N1 virus. At the head of the list is vaccinations, both ordinary flu and H1N1 (when available) for staff. Next, the CDC recommends having staff and children stay home for at least 3-5 days after exhibiting flu symptoms. The CDC also recommends frequent health checks, separating staff and children who exhibit flu symptoms, and renewed attention to environmental cleanliness and handwashing.
The most difficult recommendation to follow is likely to be having staff stay home for at least 3-5 days, or longer if the flu symptoms persist. Few schools or child care centers have extra staff sitting around, and finding substitutes on short notice for sick staff members will be a constant challenge. Groups will have to find creative solutions this flu season, whether banding together to share a pool of on-call, trained substitute teachers, or just hiring an extra staff person or two in anticipation of the inevitable illnesses over the next few months.
There are some very good new resources for dealing with swine flu. The CDC has published a new website for child care providers. The Department of Health and Human Services and the CDC have combined to create a checklist for day care centers and preschools. The American Academy of Pediatrics has a similar publication.
Although these resources are geared toward child care centers, every youth-serving organization should review them. They offer good advice and common-sense suggestions that will help you continue your program while protecting your clients.
The latest problem that day care centers, schools, and camps need to know about is swine flu. The illness is spreading, and may become our next epidemic. Like so many illnesses, children are at high risk. There is no effective vaccine, and only limited treatment options.
You can take some common-sense precautions to hep protect your clients:
* Enforce rigorous hand-washing protocols.
* If children are sneezing and coughing, anyone who comes into contact with them must wash their hands before touching anyone or anything else.
* Children who exhibit flu-like symptoms should be isolated from the general population and sent home with parents as soon as possible.
* Check with your local or state health department to learn what specific precautions authorities are recommending for your area.
* Monitor the CDC website for updated recommendations
* Watch websites related to your industry, such as the American Camping Association's summary of precautions.
You never want an article about your day care center to begin, ""Twenty-one children and one adult have contracted E. coli." You particularly don't want it to note that the outbreak was "linked to a lack of handwashing."
At least the day care has taken responsibility for sanitizing the center, and is trying to reimburse parents for out-of-pocket medical costs and expenses of having to stay home with their children. Even if it were only a PR move, it would still be the right thing to do.
A court has dismissed all criminal charges stemming from a teenager's death in a "boot camp" program. The 15-year-old died from an untreated staph infection. I missed earlier reports about this case, including this one giving some unverified details of the the child's death. If the allegations are true, it seems that someone should have at least checked his temperature. I am sympathetic to the difficulty in determining whether a child "feels bad," but fevers are hard to fake.
I have not seen any reports showing that any of the staff had the intent necessary for a criminal conviction. The civil case that remains, however, will have a lot of jury appeal.
MRSA (methicillin-resistant staphylococcus aureus) is quickly becoming a common, almost epidemic, occurrence in youth camps, schools, and day care centers. We are long past the time when caregivers could claim that it is an unusual disease that never would have occurred to anyone as a possibility. MRSA is too dangerous a disease to leave untreated. The CDC, for example, has found a fivefold increase in deaths where a child had both the flu and MRSA.
Every organization that cares for children needs to be familiar with the symptoms of MRSA, and the CDC's website about controlling its spread.
Since September 2008, the CDC has been investigating salmonella outbreaks throughout the U.S. Researchers have traced many of those cases to peanut butter distributed to food service institutions. One manufacturer, King Nut Company, has issued a voluntary recall of its peanut butter.
The CDC salmonella website has more information, as does the blog Minor Troubles.
UPDATE: I had an error in my post -- have I mentioned that I'm not a detail person? King Nut Company is a distributor of the peanut butter at issue. The manufacturer is Peanut Corporation of America.
At the Child Safety Blog, I found a fascinating article in the Chicago Tribune about the difficulties that diabetic students face in schools. It seems that best medical practice, which encourages students to monitor their blood sugar frequently and respond quickly to the readings, is at odds with school protocol requiring that nurses supervise those activities. Problems arise when nurses are not available, or when students need to act quickly.
In my experience, the troublesome school policies are driven by (1) rigid adherence to no-tolerance drug policies, and (2) fear of litigation if anyone other than a nurse handles medical issues. I supposes it is fitting, then, that it sometimes takes the threat of litigation to get schools to adopt common sense protocols for diabetic students.
The Internet has quite a few resource for parents and schools dealing with this issue:
From the Religion Clause blog, we learn of an appropriately narrow ruling by a judge, ordering surgery for a baby whose Amish parents had refused to allow medical treatment because of religious beliefs. Area social services had petitioned the court to remove the child from the parents' custody so that he could have surgery to repair a hole in his heart. The court found that the child was "medically neglected," but found a way to allow the surgery without removing the child from his home. Instead, the court ordered the surgery, and held that the parents could have the medical neglect case dismissed if they took the child for medical checkups after the surgery and provided medical information that the doctors need.
This is a refreshing order, addressing what needed to be addressed (the surgery) without using the blunt instrument of removing a child from his home. The surgery is going to cause enough trauma for a 20-month-old child, without causing additional distress of removing him from familiar and loving family members. The case would have been more difficult if the medical condition had been a chronic one rather than a one-shot procedure, but it is nice to see that the judge found a way to navigate the issues and reach a narrowly-tailored ruling.
Here's hoping the baby recovers quickly and that everyone is able to return to their normal lives.
The CDC says in a new report that food allergies in children rose by 18% from 1997 to 2007. It lists the most common allergies, and notes that children under 5 are more likely to have allergies than older children. (Hat tip: Child Safety Blog)
The report also says that 4 out of every 100 children has a food allergy, a fact that every organization serving food to children needs to take into account. The USDA has several helpful fact sheets with suggestions for accommodating food allergies in camps, day care centers, and schools.
Yet another expert report warns against yet another common (and educational) classroom tradition. The American Academy of Pediatrics has issued a policy statement warning against nontraditional pets in homes with children under 5. The report also warns against taking children younger than 5 to petting zoos and other public places with exotic animals. Although the report says nothing about classrooms, presumably the logic would apply to preschools and day care centers.
An AP article summarizes the reasons for the warning
Besides evidence that they can carry dangerous and sometimes potentially deadly germs, exotic pets may be more prone than cats and dogs to bite, scratch or claw — putting children younger than 5 particularly at risk, the report says. Young children are vulnerable because of developing immune systems plus they often put their hands in their mouths.
The list of pets that the AAP considers to be "nontraditional" includes turtles, hamsters, baby chicks, and hedgehogs.
Hat tip: DC Metro Area Personal Injury Law Blog
This recent story from New Jersey illustrates a growing problem for schools, day care centers, and other organizations where children gather. Methicillin-resistant staphylococcus areus (MRSA) infections are becoming more common, and more resistant to traditional antibiotic treatments. We are seeing more lawsuits involving MRSA, usually based on claims that a child contracted it because the center (a) allowed infected children or staff members to continue attending the facility, or (b) failed to adequately disinfect common areas.
Some of the lawsuits are based on misconceptions, such as a belief that anyone suffering from MRSA should be quarantined. The Centers for Disease Control has a very helpful webpage outlining what schools and other organizations can do to prevent and/or respond to MRSA. Many state and local health departments also have pages on their websites.
Because the infection is becoming so common, be sure that you are taking precautions recommended by the health departments in your area. Educate yourself about the initial symptoms, and what your licensing agency requires as far as reporting cases to health authorities and/or notifying other parents.
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