Upper Respiratory Infection (Common Cold)—Child Care and Schools

What is an upper respiratory infection?

The term upper respiratory infection usually refers to a viral infection of the upper respiratory tract (ie, nose, throat, ears, and eyes). Upper respiratory infections are common among infants in child care and occur frequently but tend to decrease as children mature. In the first 2 years of life, children have about 8 to 10 colds per year. Older children and adults have an average of 4 upper respiratory infections per year.

What are the signs or symptoms?

• Cough

• Sore or scratchy throat or tonsillitis

• Runny nose

• Sneezing

• Watery eyes

• Headache

• Fever

• Earache

• The presence of green or yellow discharge from the nose is common. Darker or greener nasal discharge does not mean the child is more ill or contagious or has a greater need for antibiotics.

What are the incubation and contagious periods?

• Incubation period: 2 to 14 days.

• Contagious period: Usually a few days before signs or symptoms appear and while signs and symptoms are present.

How is it spread?

• Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs, sneezes, or sings. These droplets can land on or be rubbed into the eyes, nose, or mouth. The droplets do not stay in the air; they usually travel no more than 3 feet and fall onto the ground.

• Contact with respiratory secretions or contaminated objects from children who carry these viruses.

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.

• 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.

• Ventilate the facility with fresh outdoor air when possible, and maintain temperature and humidity conditions as described in Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs Standard 5.2.1.2 (https://nrckids.org/CFOC).

  • ? Winter months: 68 ?F to 75 ?F (20.0 ?C?23.9 ?C) with 30% to 50% relative humidity.

  • ? Summer months: 74 ?F to 82 ?F (23.3 ?C?27.8 ?C) with 30% to 50% relative humidity.

  • ? Air quality: Have a contractor assess and recommend what should be done to have the air quality in the facility meet the current American Society of Heating, Refrigerating and Air-Conditioning Engineers standards (www.ashrae.org) or US Environmental Protection Agency standards for air quality in schools (www.epa.gov/iaq-schools). See Heating, Ventilation, and Air-Conditioning in Chapter 2 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition for more details.

What are the roles of the educator and the family?

Exclusion of children with signs or symptoms has no benefit in reducing the spread of common respiratory infections. Viruses that cause upper respiratory infections are often spread by children who do not have signs or symptoms (ie, before they get sick or after they recover) or who never develop symptoms.

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 (see Conditions Requiring Temporary Exclusion in Chapter 4 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition).

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