Pneumonia—Child Care and Schools

What is pneumonia?

• Pneumonia is an inflammation of the lungs primarily caused by a viral or, less commonly, bacterial infection. Infection of the lungs often is secondary to an infection that starts in the nose and throat area (ie, the upper portion of the respiratory tract) and then spreads to the lungs (ie, the lower portion of the respiratory tract).

• Pneumonia is most common during the fall, winter, and early spring, when children spend more time indoors in close contact with others.

• Although most pneumonias are caused by viruses, pediatric health professionals cannot always tell the difference between viral and bacterial pneumonia at the time of diagnosis.

What are the signs or symptoms?

• Cough

• Fast, difficult breathing

• Fever

• Muscle aches

• Loss of appetite

• Lethargy

What are the incubation and contagious periods?

• Incubation period: Pneumonia is a condition caused by a variety of types of germs; therefore, incubation periods will vary depending on the germ causing the pneumonia.

• Contagious period: Depends on the germ causing the pneumonia.

How is it spread?

Pneumonia does not spread. The germ that causes pneumonia can spread if the person is still infectious at the time the pneumonia develops. Most of the germs that cause pneumonia spread by direct or close contact with mouth and nose secretions and touching contaminated objects.

How do you control it?

• Use good hand-hygiene technique at all the times listed in Chapter 2 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition

• Reduce crowding by ensuring space and ventilation meet the requirements in national standards.

• Prevent contact with respiratory secretions. Teach children and educators to cough or sneeze into a disposable tissue or their inner elbow/upper sleeve and to avoid covering the nose or mouth with bare hands. After coughing or sneezing, practice hand hygiene to prevent the spread of respiratory droplets. Ensure that anyone who contacts mucus or debris on their skin or surfaces washes their hands and any other contaminated skin immediately. Change or cover clothing soiled with mucus. Dispose of facial tissues that contain nasal secretions after each use.

• Clean or sanitize surfaces that are touched by hands frequently, such as toys, tables, and doorknobs, according to the Routine Schedule for Cleaning, Sanitizing, and Disinfecting in Chapter 8 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition.

What are the roles of the educator and the family?

• Immunizations against Haemophilus influenzae type b, Streptococcus pneumoniae (pneumococcus), and pertussis prevent some of the bacterial infections that cause pneumonia. Influenza vaccine helps prevent pneumonia that sometimes occurs as a complication of influenza infection.

• Ensure all immunizations are up to date, including annual influenza immunization for all people older than 6 months. See the most recent immunization schedule at www.cdc.gov/vaccines.

Exclude from educational setting?

No, unless

• 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 for the germ causing the pneumonia (see Conditions Requiring Temporary Exclusion in Chapter 4 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition and the appropriate Quick Reference Sheets).

Readmit to educational setting?

Yes, when all the following criteria are met:

When exclusion criteria are resolved, 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