1. Paediatric Infection Control
Jodie Burr
Infection Control Coordinator
Women’s and Children’s Hospital

2. IC Issues specific to children
Communicable diseases affect a higher % of children than adults
Developmental immunity (increased susceptibility) - acquire – spread

3. IC Issues specific to children
Child care staff are at a greater risk for exposure to communicable diseases - immune status
Type and amount of physical contact (eg feeding, diapering)

4. IC Issues specific to children
May lack the mental / physical ability to adhere to IC principles
lack of hygiene
unable to understand / comply with IC principles

5. IC Issues specific to children
More likely to have contact with contaminated environmental surfaces and objects

6. IC Issues specific to children
Parents and siblings
may have the same infectious agent
education about transmission and IC principles

7. Spread of Infection Sources of infections
The host’s own (endogenous) flora
The hand’s of child care workers
Inanimate objects (fomites)
After being exposed to an infectious agent:
Some people already have immunity and therefore don’t develop an infection
Some people become asymptomatic carriers
Other people develop clinical disease (ie infection)

8. Spread of Infection The Susceptible Host Varies with age
Underlying medical conditions
Nutritional status
Drug therapy
Trauma
Surgical procedures
Invasive or indwelling devices
Therapeutic and diagnostic procedures

9. Spread of Infection 3 main routes of transmission Contact
Direct / Indirect
Most frequent means of transmission
Droplet
Generated during coughing, sneezing, talking
Airborne
Generated by coughing, sneezing, OR by, OR by air currents

10. Standard Precautions Apply to:
Blood
Non-intact skin
Mucus membranes
All body fluids (including sweat)
Regardless of whether there is visible blood or body fluids

11. Standard Precautions Hand Washing
The single most effective method in the prevention of disease transmission is to wash your hands well

12. Hand Washing How to wash your hands
Use soap and running water
Rub hands together (count to 10)
Wash all over, including:
Backs of hands
Wrists
Fingers, nails and thumbs
Rinse hands well (count to 10)
Dry hands thoroughly

13. Areas most frequently missed

14. When to wash hands When you arrive at the centre Before handling food
Before eating
After changing nappies
\after going to the toilet
After cleaning up, coming onto contact with faeces or vomit or other body fluids
After wiping noses (either your own or a childs)

15. Specific childcare issues
Nappy change area:
Have a specific area for nappy changing
Clean nappy change area after each nappy change
Wear gloves
Wash hands afterwards
Linen
Use hot water and detergent
Wear gloves if linen soiled
Ensure clean linen is stored away from soiled linen

16. Specific childcare issues
Toys
All shared toys should be able to be washed
Sandpits
Keep well maintained and clean
Ensure good drainage, rake often , cover
Dispose of any soiling (blood, faeces, etc)
Blood / body fluid spills
Wear gloves
Detergent & water +/- bleach
Dispose of soiled articles or place in waterproof bag for parents to take home

17. Food Ensure that tables and area are clean
Wash your own and the children’s hands
Do not share food, plates, eating utensils
Serve food rather than use a communal dish
Use a separate spoon for each baby fed

18. Handling food Wash hands Keep raw food separate from cooked foods
Use different utensils for raw and cooked foods
Keep food hot or cold (do not keep food warm for a period of time)
Reheat food and bottles only once
Throw out left overs

19. Be aware of symptoms suggesting infection
Infectious diseases
Be aware of symptoms suggesting infection
Severe, persistent, prolonged coughing
Conjunctivitis
Unusual spots or rashes
Crusty or discharging skin lesions
Frequent scratching
Unusually coloured / smelly faeces or urine
Sore throat / difficulty in swallowing
Vomiting. Headache, stiff neck
Loss of appetite
Diarrhoea

20. Infectious diseases
Have a written policy regarding what to do if a child is unwell, may include:
Notify director and parents
Separate ill child
Take the child’s temperature
Encourage parents to inform staff if a family member is ill

24. Infectious diseases and staff
Most infectious diseases can be prevented by good hand washing
Ensure immunization status is up to date
Pregnant staff should be aware that some diseases may have an impact on their pregnancy
Infected child care workers may be excluded from working

25. Meningococcal Disease
Bacterial infection caused by Neisseria meningitidis
Transmitted by contact or droplet
Non infectious after 24 hours of appropriate antibiotic therapy
Significant contacts traced and may be given prophylaxis

26. Meningococcal Disease

27. Measles
Complications more common and severe in chronically ill and very young children
Transmitted by droplet and contact with respiratory secretions
Infectious for 4 days before and after rash
Vaccination available
Notifiable disease

28. Measles

29. Rubella In early pregnancy risk of teratogenic damage to fetus
Infectious for 7 days before and days after onset of rash
Infants with congenital rubella may shed virus for several months or years
Transmitted by droplet route
Vaccination available
Notifiable disease

30. Rubella

31. Varicella Zoster Virus Chicken Pox
Highly contagious
Most cases in children, over 90% of adult population is immune
Transmitted by droplet and contact
Infectious 2 days prior and days after rash
Now a notifiable disease
Vaccination now available

32. Varicella or Chicken-pox

33. Parvovirus B19 Usually a mild rash disease
Also called Fifth Disease or “Slapped - Cheek”
Infectious prior to the rash
Transmitted by droplet route

34. Parvovirus B19

35. Hand, foot and mouth disease
Incubation period:
3 – 5 days
Infectious period
Whilst fluid in blisters
Transmission:
Contact with blister fluid / faeces
Control:
Exclude until blisters have dried
Good hand washing

36. Hand, foot and mouth disease