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

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Presentation on theme: "Paediatric Infection Control Jodie Burr Infection Control Coordinator Women’s and Children’s Hospital."— Presentation transcript:

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

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

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

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

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

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

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

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

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

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

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

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

14 Areas most frequently missed

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

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

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

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

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

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

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

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

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

27 Meningococcal Disease

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

29 Measles

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

31 Rubella

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

33 Varicella or Chicken-pox

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

35 Parvovirus B19

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

37 Hand, foot and mouth disease


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