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Alexandria Lotstein B.S., EP (Region 2 Health Consultant)

It is that time of year again! Research suggests young children will experience 8 to 10 colds each year before the age of 2. Children are not alone in contracting illnesses: Infectious diseases are the most common health and safety risk for child care professionals.

According to the American Academy of Pediatrics (AAP), the most common reported infectious diseases in child care include respiratory, gastrointestinal and skin infections. Scabies, head lice, meningitis, cytomegalovirus, chickenpox, conjunctivitis, rubella, Giardia, tuberculosis, and hepatitis A and B are also on the list. In fact, 14% of all reported cases of hepatitis A in the United States were linked to child care facilities, mostly acquired from improper diapering and poor hand hygiene. Fortunately, incorporating certain practices into daily routines can reduce exposure to germs and illnesses.

How Illnesses Spread

Organisms such as bacteria, fungi, protozoa and viruses can exist inside our bodies. Generally, the microorganisms that reside in our bodies are harmless or beneficial – for example, some aid in digestion.

But under certain circumstances, microorganisms or pathogenic microorganisms can cause illness. Illnesses spread when a new individual is exposed to infectious particles shed by an infected person. This can occur in a myriad of ways, including direct contact with contaminated surfaces or people, or through blood, saliva, urine or infectious airborne particles.

Children in diapers easily spread illnesses of the gastrointestinal tract by contaminating surfaces with microscopic molecules produced in fecal matter.  In an early learning and care environment, floors, tables, fabric objects, toys, diapering surfaces, bathrooms and sinks can serve as a vector for pathogenic microorganism causing illness. A vector is any agent that carries and transmits infection into another living organism.


The most important measure in preventing illness is following proper hand washing procedures, according to AAP. This includes proper hand hygiene and washing hands throughout the day when recommended. Hand sanitizer or other alcohol-based hand rubs are not a substitute for handing washing in group care settings and may be harmful to children.

Proper routine cleaning, sanitizing and disinfecting can reduce the spread of germs by reducing vectors that carry pathogens. Caring for Our Children, which details national health and safety guidelines, defines cleaning as removing dirt or debris by washing with a detergent solution and rising with water; sanitizing as reducing the number of germs on inanimate surfaces to a level that public health codes determine safe; and disinfecting as inactivating most microorganisms on any inanimate object. Daily health checks are also recommended to reduce illness and the spread of germs.

Caring for Our Children standards recommend daily health checks upon the child’s arrival. They include a direct observation of the child and communicating with parents/guardians about the health of the child or any changes in behavior. Health checks function to reduce the transmission of illnesses in child care setting by recognizing children who should to excluded due to illness.

Teacher Health

Teacher and caregiver health are often overlooked when discussing reducing the spread of germs and illness. Teacher health is an important factor in fostering a healthy environment and running a successful program. Regular health check-ups with a clinician will best guide teachers to address specific health needs. The health check-ups should focus on occupational health concerns, including maintaining up-to-date immunizations for individuals who are in contact with young children recommended by the Center for Disease Control and Prevention. Do not forget about yearly flu shots, too!

If you have any questions or would like direct support in saying goodbye to germs, please reach out to your regional IdahoSTARS office and speak with your Child Care Health Consultant.

And make sure to take the ICCP annual health and safety training “Germs Are Everywhere,” which explores practices for a safe and healthy environment that reduces the spread of infectious disease and foodborne illnesses. Log into your RISE account, then click "ICCP Annual Training" on your dashboard. Or select "Go to Training," then search for the training by name.

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