1. Communicable Disease Control in Child Care facilities. Professor Paul Van Buynder Public Health Staff Specialist Gold Coast

2. Overview  Why are we here  What is required  Staff vaccination policies and monitoring  Child vaccination policies and monitoring  Disease Recognition  “Staying healthy in child care”  Response plan  Exclusions for affected children and unvaccinated  Staff exclusions

3. Η πρόληψη είναι καλύτερη από τη θεραπεία Hippocrates 468BC

4. Overview  Why are we here  Child care is a virus production and transmission factory

6.  childhood flu childhood flu

7. Impact of Influenza  300,000 GP consultations per year  18,000 hospitalisations per year  1500 - 3000 deaths  CCW more likely to be infected  Infected people spread disease before they are ill themselves  Vaccinated staff are less likely to spread illness  Vaccinated staff protect residents

8. Impact of influenza in 2015 | Presentation Title | Presenter Name | Date | Subject | Business Use Only 8  100,569 Australians suffered in 2015 from laboratory confirmed influenza.  This is only the tip of the iceberg. Laboratory confirmed cases represent only a small proportion of the overall flu cases in the country.  In 2015 children aged less than 15 years accounted for one third of all influenza notifications.  Children under 10 represented 25% of all notifications in 2015. (Age- specific incidence varies from year to year)  9% of hospitalised children with laboratory confirmed influenza were admitted directly to ICU in 2015.  In Queensland in 2015 children aged less than 20 years accounted for 40% of all influenza notifications and 20% of admissions

12. Post mortem respiratory virus surveillance. 2006-2015* Influenza Deaths by Age Group (Perth, WA) Surveillance based on Perth city in Western Australia … 12 deaths in 10 years.. Equates to around 10 – 15 deaths a year in Australia

13. Summary | Presentation Title | Presenter Name | Date | Subject | Business Use Only 13 Influenza hospitalisations in children are substantial especially in non-H3N2 years Influenza and its complications kill more children each year in the developed world than all other vaccine preventable diseases combined …

14. Summary | Presentation Title | Presenter Name | Date | Subject | Business Use Only 14 Influenza and its complications kill more children each year in the developed world than all other vaccine preventable diseases combined … By around an order of magnitude

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17. Pertussis on the Gold Coast 2016

18. Overview  What is required  Staff vaccination policies and monitoring  Child vaccination policies and monitoring

19. CCW Vaccine  Must put children first  Must do no harm  Must protect those who cant protect themselves  Vaccinating staff reduces all cause mortality and hospitalisations

20. Staff Immunisation assistance  What is required  Protection against respiratory diseases  Critical  Measles booster  Pertussis booster  Highly desirable  Influenza vaccine

21. Staff Immunisation assistance  Child care centres should fund the following  Measles booster  Free for all adults if required..any clinic  Pertussis Booster  Cost price at Public Health and some clinics listed on sheet ($25-26)  Influenza  $12 at Public Health and some clinics and some pharmacies

22. No Jab No Play  What is required  A local vaccination policy  Not accepting legal now  Some still do (?liability)  Some encourage  If accept  Exclusions during outbreaks  Interventions  Dr Paul does not believe unvaccinated children should be in child care

23. Requirements at time of Outbreaks  Child care centres should have available  A Register of staff vaccination status  A register of attendee vaccination status  paul.vanbuynder@health.qld.gov.au paul.vanbuynder@health.qld.gov.au  0414278031