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Spore- and toxin-forming bacteria that cause diarrhea
Often associated with recent antibiotic use
Usually the illness is mild and causes
Non-bloody diarrhea
Mild abdominal pain
Low-grade fever
Rarely, more severe illness occurs, especially in immunocompromised children, and causes
High fever
Abdominal cramps
Very ill appearance
Very bloated abdomen
Occasional blood in the stool
In children younger than 5 years (especially infants),
Incubation period: Unknown. Illness can occur 5 days to 10 weeks after antibiotic therapy.
Contagious period: Unknown because infants can harbor the bacteria and not cause illness in themselves or others.
Fecal-oral route: Contact with feces of children who are infected. This generally involves an infected child contaminating his own fingers and then touching an object that another child touches. The child who touched the contaminated surface then puts her fingers into her own mouth or another person's mouth.
Use good hand-hygiene technique at all the times listed in Chapter 2, especially after toilet use or handling soiled diapers and before anything to do with food preparation or eating. Alcohol-based sanitizers are not effective in killing
Ensure proper surface disinfection that includes cleaning and rinsing of surfaces that may have become contaminated with stool (feces) with detergent and water and application of a US Environmental Protection Agency- registered disinfectant according to the instructions on the product label.
Exclude infected staff members who handle food.
Exclusion for specific types of symptoms (see the section Exclude From Group Setting?).
A child or staff member with
There are multiple causes of bloody diarrhea. The following recommendations apply for a child or staff member with diarrhea from any cause (see
Report the condition to the staff member designated by the early education/child care program or school for decision-making and action related to care of ill children or staff members. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms and notifies the health consultant.
Ensure staff members follow the control measures listed in the section How Do You Control It?
Report outbreaks of diarrhea (more than 2 children and/or staff members in the group) to the health consultant, who may report to the local health department.
If you know a child or staff member in the program has
Follow the advice of the child's or staff member's health professional.
Report the infection to the local health department, as the health professional who makes the diagnosis may not report that the infected child is a participant in an early education/child care program or school, and this could lead to delay in controlling the spread of the disease.
Reeducate staff members to ensure strict and frequent handwashing, diapering, toileting, food handling, and cleaning and disinfection procedures.
In an outbreak, follow the direction of the local health department.
Note:
Yes, if
The local health department determines exclusion is needed to control an outbreak.
Stool is not contained in the diaper for diapered children.
Diarrhea is causing "accidents" for toilet-trained children.
Stool frequency exceeds 2 stools above normal for that child during the time the child is in the program because this may cause too much work for teachers/caregivers and make it difficult for them to maintain sanitary conditions.
There is blood or mucus in stool.
The ill child's stool is all black.
The child has a dry mouth, no tears, or no urine output in 8 hours (suggesting the child's diarrhea may be causing dehydration).
The child is unable to participate and staff members determine they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group.
The child meets other exclusion criteria (see Conditions Requiring Temporary Exclusion in Chapter 4).
Yes, when all the following criteria are met:
Once diapered children have their stool contained by the diaper (even if the stools remain loose) and when toilet- trained children do not have toileting accidents
Once stool frequency is no more than 2 stools above normal for that child during the time the child is in the program, even if the stools remain loose
When the child is able to participate and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group
Note: It is not necessary to demonstrate negative
Adapted from
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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.