Disaster and Emergency Preparedness in Child Care

1. Child Care Basics SeriesModule 3:Emergency Preparedness,Communicable Disease Control, andImmunizations inChild Care Settings

2. Disaster and Emergency Preparedness in Child Care

3. Planning Things we can’t plan for… Tornadoes Earthquakes Fires Intruders/Lockdown Hazardous spills Accidents/death Things we plan for… • Parties • Holidays • Vacations • First day of school/daycare • Moving • Family Reunions

4. JOPLIN MISSOURI 2011 Tornado Damage – 13 child care facilities were completely destroyed Photo credit: Kathy Harris

5. WHAT CAN OUR FACILITY DO TO PREPARE??? WRITE AN EMERGENCY PLAN

6. Purpose of an Emergency Plan To assist in protecting the health and safety of the children in its care should disaster or emergency, be in natural or deliberate, affect the facility, operation or its community The safety of the child and staff is the primary goal

7. Types of Emergency Response Evacuation Evacuate a location to go to another location either nearby or far away to remain safe (fire, flood, chemical exposure, bomb threat) Shelter in Place / Lock Down Staying inside a designated area, or a safe room, within your facility to secure children, staff, and visitors in a protected area (tornado, earthquake, severe storm)

8. Emergency Planning Considerations Post local emergency numbers by every phone in the building and in every room where staff/children may need them All staff should load emergency numbers into their cell phone Have emergency contact information for every child in every classroom and accessible in case of an emergency

9. Emergency Planning Considerations • Assign specific staff to be responsible for primary emergency functions: • One staff is responsible for the following • Communication with teachers in each class/head count • Contacting parents • Classrooms have adequate staff/item to keep children calm • Contact local officials/communicate with emergency officials

10. Emergency Supplies Emergency supplies should be stored in one location that is easily accessible. Supplies should be easily transportable t o another location. Supplies should be checked/updated every 6 months. Supplies: • Contact lists (children and staff) • Weather radio • First aid kit/Medications • Flashlight/batteries • Diapers/wipes • Food/Water • Clothing /toys/equipment for Children

11. Staff / Parent Education An emergency plan doesn’t work if staff are not aware of and trained on it. DRILLS are critical, just as you practice CPR and other vital skills practice for emergencies can save lives. KNOW THE PLAN – PRACTICE THE PLAN

12. Next Steps For more information on Emergency Preparedness in Child Care watch the Ready in 3 video (25 minutes)

13. Your Preparedness Plan If you don’t have a personal and family preparedness plan you will be less likely to be able to help the children in your care during an emergency. Take the time to write a plan for your family. http://health.mo.gov/emergencies/ readyin3/

14. COMMUNICABLE Disease in child care Prepared by MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR LOCAL PUBLIC HEALTH CHILD CARE HEALTH CONSULTATION PROGRAM

15. INTRODUCTION TO COMMUNICABLE DISEASE PREVENTION • YOUNG CHILDREN AND THE ADULTS WHO CARE FOR THEM ARE OFTEN AFFECTED BY COMMUNICABLE DISEASES • GOOD INFORMATION AND PRACTICES CAN HELP KEEP CHILDREN IN CHILD CARE HEALTHY • THE SAME PRACTICES CAN HELP YOU AS A CARE GIVER STAY HEALTHY

16. Illness in child care--why are children at risk? • Children’s immunity is not fully developed • Children in out-of-home care often are sick more frequently and for longer (exposed to bugs they aren’t exposed to at home) • Larger numbers of children are in close contact for longer periods of time • Their activities increase opportunity for disease transmission • They are not reliable hand-washers

17. Illness in child care—why are children at risk? DISCUSSION: Talk with the person next to you for a few minutes. Come up with 3-4 examples of behaviors or activities you have seen children do, that increase the sharing of germs.

18. COMMUNICABLE DISEASES—WHAT ARE THEY? Spread from one person to another by germs that are microscopic Only a few germs on a hand, sink or toy can cause disease

19. HOW DO GERMS SPREAD? RESPIRATORY TRANSMISSION Coughing Sneezing Runny noses

20. RESPIRATORY TRANSMISSION Examples: • Common cold • Influenza • Many vaccine-preventable diseases (measles, mumps, chickenpox, pertussis) • Tuberculosis • Strep throat When a germ passes from the lungs, throat, or nose of one person to another person The most common infections in child care Children in child care average 10-12 colds a year

21. How do germs spread— from the intestinal tract Intestinal tract (germs are swallowed) Called “fecal-oral transmission” Germs pass in stool Hands are contaminated with stool Surfaces are contaminated Food is contaminated Happens when contaminated hands touch objects such as food, utensils, or toys that someone else puts into their mouth. Hands can be contaminated during toileting, or by touching objects contaminated by stool.

22. Examples of fecal-oral diseases Shigella Giardia Salmonella E. coli O157:H7 Hepatitis A

23. How do germs spread—through secretions Contact with infected secretions (urine, saliva, blood ) Can occur when secretions or other body fluid such as blood from an infected person enters open skin or mucous membranes, like a child’s mouth, nose or eye.

24. Examples of diseases transmitted by secretions or blood • Cytomegalovirus* • Hand, foot and mouth disease* • Hepatitis B • Hepatitis C • Herpes simplex* • HIV Infection / AIDS * most common in childcare settings

25. How do germs spread—direct contact Direct contact Germs are spread by direct contact with an infected person’s skin or body fluids

26. Examples of diseases spread by direct contact Chickenpox (varicella) Impetigo Head Lice (pediculosis)-Not a disease but an infestation. Ringworm Staph infections including MRSA (methicillin-resistant staph)

27. You can’t always tell… Diseases are sneaky! Many people with a disease show symptoms (coughing, sneezing, diarrhea) BUT… People who don’t show symptoms of being sick can still spread diseases. Some diseases are transmitted before the person has symptoms—up to several days before they know they are sick… Some who are infected never have symptoms, but they can still spread the disease People can pass on a disease even without getting it themselves (e.g., from unwashed hands or a dirty tissue)

28. Disease prevention techniques: Always follow prevention procedures, not just when a person is sick. Here are the 5 most important ways to prevent disease: Good handwashingis the most important thing (for you and the children) Use sanitary methods when diapering and toileting Teach and use the best procedure for containing coughs and sneezes Follow proper food preparation and handling procedures Maintain sanitary conditions in the child care home or center

29. In addition to the “top 5” • Understand the causes of diseases and how they spread • Call for consultation when you have questions or need help • Report certain significant diseases to your local public health department • Take special measures (when recommended) to control outbreaks of disease

30. references Infection Control in the Child Care Center & Preschool, Edited by Leigh Grossman Donowitz Managing Infectious Diseases in Child Care & Schools, American Academy of Pediatrics, Editors Susan S. Aronson, MD, FAAP & Timothy R. Shope, MD, MPH, FAAP

31. Immunizations and child care Missouri Department of Health and Senior Services Child Care Health Consultation Program

32. Learning objectives • Understand the importance of immunizations • Responsibility of child care facilities • Ability to review immunization records for age appropriate compliance • Identify reliable resources for immunization education

33. Immunizations are important for everyone • To prevent disease • To protect health • To eliminate contagious diseases • To prevent further victims of preventable diseases

34. Immunization requirementsfor child care & preschool 2017-2018 DTaP Haemophlius Influenzae type B (Hib) Pneumococcal (PCV) Hepatitis B (Hep B) Polio (IPV) Measles, Mumps, Rubella (MMR) Varicella (Chicken Pox)

35. Diphteria, Tetanus & Acellular Pertussis (DTaP) Diphtheria—bacteria lives in the mouth, throat, and nose of an infected person. Spread to others by coughing and sneezing Tetanus (Lockjaw) – infection caused by a bacteria that lives in soil and in the intestines of many animals. The bacteria enters the body through cuts or wounds. Pertussis (Whooping Cough)– Highly infectious bacteria that causes severe coughing

36. Dtap immunization schedule • The recommended schedule for DTaP is 2 mo, 4 mo, 6 mo, 12-18 mo, and 4 to 6 years • Infants do not start the series until 2 months of age and may not be fully protected until they receive the 3rd and 4th dose • There should be 6 months from the 3rd dose to the 4th dose

37. Haemophilus influenza type b (hib) Most often strikes children under the age of 5 Before vaccine was developed, leading cause of bacterial meningitis infections in this age group Germs are carried in the nose and throat Easily spread, life threatening

38. Hib immunization schedule • Recommended schedule: • 2 mo, 4 mo, 6 mo, and 12-15 mo • Depending on vaccine manufacturer, ACIP recommends 3-4 doses by age 2 years • Catch up schedule requires attention (next slide)

39. Hib catch up schedule

40. Pneumococcal (pcv)

41. Hepatitis b (hep b) Illness causes severe diarrhea and vomiting, fatigue, loss of appetite, and yellowing of skin and mucous membranes (eyes) Leads to serious liver disease, including liver cancer (2nd most common cause worldwide) Newborns can be infected if mother is infected, or through contact with blood and other body fluids Completed vaccination will protect for life

42. Hep B Immunization Schedule

43. Hep B Dose spacing NOTE: DATE OF BIRTH DOSE MUST BE RECORDED. “BIRTH” IS NOT AN ACCEPTABLE ENTRY ON THE RECORD PER STATE LAW.

44. Polio (ipv) Caused by virus that lives in intestinal tract Spread by contact with feces (ex: diapering, poor sanitation) No cure for the disease Appears as a mild cold-like illness, but is potentially crippling, can lead to paralysis and death In the 1940’s nearly 35,000 people in the US contracted polio By 1979, the US was free of polio thanks to vaccination efforts Still present in many poorer countries outside the US President Franklin D. Roosevelt was paralyzed by polio

45. Polio Immunization Schedule Recommended schedule: 2 mo, 4 mo, 6-18 mo, and 4-6 years Child entering Kindergarten must have and IPV on or after their 4th birthday

46. Measled, mumps, rubella (mmr) • Measles: • Highly contagious; caused by virus; 1 in 20 will get pneumonia; 1 or 2 in 1,000 will die • high fever, rash, cough, runny nose, eye irritation • Mumps: • Also caused by virus • fever, headache, swelling of jaw and salivary glands • Rubella (German Measles): • Viral; low fever, rash on face and neck for 2 or 3 days • Causes birth defects if passed to pregnant women

47. Mmr immunization schedule Recommended schedule: 12-15 mo and 4-6 years MMR MUST be given on or after the child’s 1st birthday with booster usually on or after 4th birthday

48. Varicella(chicken pox) Produces skin rash of blister-like lesions normally seen on face and body The lesions (blisters) can develop in other parts of the body, such as lungs, esophagus Other complications can include skin infections, scarring, pneumonia, brain damage Before vaccine, about 11,000 people hospitalized and 100 deaths annually

49. Varicella (con’t) RULE CHANGE: As of July 1, 2010, parental/guardian statements no longer accepted as satisfactory evidence of disease Must have signed statement from MD or DO with month and year of disease on file at facility

50. Varicella immunization schedule Recommended: given at 12-15 months and at 4-6 years MUST be given on or after child’s 1st birthday, booster USUALLY given on or after 4th birthday