Infections at School & Daycare

Dr. Parang Mehta, MD.

In any large group of children, one or more are likely to have an infectious disease.  Schools, playgroups, and daycare centres are places where large numbers of children stay for several hours each day with each other.  It is well known that children who go to daycare centres have more infections than those who stay at home.  School entry is also known to be a period when children have several infections.

Infections do spread where many children spend time together, but some precautions can reduce the risk

Among the infections spread in school, the most common are respiratory infections, diarrhea, and infestations like scabies and head lice.  While not all of these are serious or life threatening, they are a great deal of trouble.  Some, if not all, of these illnesses can be avoided by taking some preventive measures.

Why are these infections common?

In kinder, gentler days, children who were sick would be allowed to stay at home for a few days.  These days, most parents are terrified of the backlog of work that builds up.  Besides, even if the child stays at home, there is no one to look after her.  Acutely sick children going to school and daycare centres is an unfortunate reality of our times.

Apart from being bad for the sick child, this is a hazard for the other children.  Children are naturally more susceptible to diseases than adults, and spending several hours in a room with a sick person is very likely to result in the acquisition of the infection.

Sick children often do not understand the need for safe practices like sneezing into a handkerchief, or washing their hands after wiping a running nose.  Disease causing germs are thus carried on their hands, or disseminated into the air.  Not all the staff of a school or day care center are well informed about infection reducing practices.  They may not wash their hands after changing a diaper, or before preparing and serving food.  Small children often do not wash hands well after visiting the toilet.  All these are responsible for the high rate of infection spread in classrooms and day care centres.

Another important factor is overcrowding.  Combined with poor ventilation and sunlight, this can increase the risk of spread of infections many times.  

How are infections spread?

Large respiratory droplets: A sick child's coughing produces these large drops of secretions, which contain germs.  Being heavy, they settle on nearby surfaces, including hands, napkins, toys, etc.  Several viral and bacterial infections are spread in this way.  Among them are respiratory syncytial virus, adenoviruses, Neisseria meningitidis, Hemophilus influenzae, and Streptococci pneumoniae.

Small respiratory droplets: These are produced similarly, but being light, they float in the air for a long time with their deadly cargo of disease producing germs.  They can be breathed in by children in the class, leading to disease.  Measles, chicken pox, whooping cough, and tuberculosis are spread thus.

Enteric spread: This means spread by the sick child's feces.  The child who doesn't wash hands well, or the staff member who changes diapers for small children, can carry germs on their hands.  Typhoid fever, jaundice, and diarrhoea are spread thus.

Direct contact: Some diseases like scabies, head lice, fungal skin infections, bacterial skin infections, and conjunctivitis (pink eye) are spread by direct contact with an infected person.  

Biting: This is quite rare, but dangerous.  Hepatitis B has been known to be transmitted by bites.  Also possible are hepatitis C and AIDS.  Bites can also cause infections at the site of the bite.

 

Preventing infections in the classroom

Last Revision: May 20, 2020