Updated: 10/01/2024
The Pennsylvania Department of Health (DOH) encourages Early Childcare and Education programs (ECE) to follow the Centers for Disease Control and Prevention (CDC) recommendation on preventing the spread of illnesses, like flu, COVID-19, and respiratory syncytial virus (RSV).
For additional information, please visit Respiratory Virus Guidance and Protecting Against COVID-19 and Other Infections in Early Care and Education Programs | Early Care and Education Portal | CDC and Diseases that Vaccines Prevent | Childhood Vaccines | CDC.
Infections are commonly spread in ECE programs by:
- Shared objects and touched surfaces (e.g., toys, door handles, tables, faucets, etc.)
- Close contact with others
Take steps to prevent infections in ECE programs:
Families should check children for signs of illness, such as runny or stuffy nose, cough, sore throat, fever, and upset stomach.
Teach families the symptoms to watch for as well as when to keep children at home. Share Pennsylvania Department of Health resources on feeling sick.
Keep each child’s belongings separate, including masks and toothbrushes.
Remind everyone to cover coughs or sneezes with a tissue or elbow, then wash their hands immediately.
Encourage staff, children, volunteers, and families to stay up to date on vaccinations.
Frequently wipe down surfaces and objects that are touched often. Clean other surfaces when they are visibly dirty. Use appropriate cleaning and disinfecting supplies and follow the directions. Follow guidelines for cleaning and disinfection when diapering and feeding. For additional information, please visit How To Clean and Disinfect Early Care and Education Settings | Water, Sanitation, and Environmentally Related Hygiene (WASH) | CDC.
Improve air quality by ensuring existing heating and air conditioning systems are providing the minimum outdoor air ventilation requirement in accordance with ventilation design codes. Bring in fresh outdoor air (open windows which can be safely opened), gather outdoors, or purify indoor air.
Provide soap and water, or an alcohol-based hand sanitizer with at least 60% alcohol. Encourage handwashing for at least 20 seconds or use hand sanitizer.
When illness rates are increasing in your ECE or community, allow masking for children 2 years or older and staff who opt for that additional measure of protection. Staff, who have returned after having a respiratory illness like flu, RSV, or COVID-19, should wear a mask for 5 days after their fever has resolved and symptoms are improving.
Encourage testing at a healthcare provider if symptomatic. Testing at home for COVID-19 is also encouraged.
ECE programs can expect children and staff to get sick:
- Choose a place to keep sick children or staff separate from others until they can go home.
- Make sure a sick child has adult supervision while waiting to be picked up.
When a child or anyone in direct contact with children gets sick, ECE programs should follow this guidance.
Exclude sick children or staff with: | Readmit children or staff when: |
|---|---|
Fever with no other symptoms. | No fever for at least 24 hours (without using fever-reducing medicine), and no new symptoms. |
Fever with productive cough. | No fever for at least 24 hours (without using fever-reducing medicine), AND symptoms are improving. Should be evaluated by a healthcare provider. |
Worsening respiratory virus symptoms (stuffy or runny nose, cough, sore throat) not caused by something else, like allergies. | Respiratory symptoms are getting better overall for at least 24 hours.
For the next five days consider masking for individuals 2 years and older, physical distancing, and monitoring symptoms. |
Fever with a new rash or behavioral changes. | No fever for at least 24 hours (without using fever-reducing medicine), and any associated rash or behavioral changes have resolved. Should be evaluated by a healthcare provider. |
Persistent vomiting. | Vomiting has resolved overnight, and the child can hold down food/liquids in the morning. |
Persistent diarrhea that causes ‘accidents’ or is more than two bowel movements above what is ‘normal’ for the person in 24 hours. | Diarrhea has improved, with no accidents and no more than two bowel movements above what is ‘normal’ for the child in 24 hours. |
Diarrhea that is bloody. | Evaluated by a healthcare provider and cleared to return. |
Sores that are draining fluid and cannot be covered. | Open sores are crusted over and receiving medical treatment. |
Consider seeing a health care provider anytime you are concerned about yourself or a child in your care.
For additional information, please visit Preventing Spread of Respiratory Viruses When You're Sick | Respiratory Illnesses | CDC
Staff caring for sick children should use protective gear:
ECEs should have protective gear available to care for sick children. The figure below outlines the basic gear needed when caring for children with respiratory or gastrointestinal illnesses.
Keeping ECE programs open:
ECE programs should use multiple prevention strategies to stay open. Any changes in normal daily operations should be coordinated with local health authorities and other impacted community partners.
ECE programs should report any unusual increase in absenteeism or illness among children or staff by calling 1-877-PA-HEALTH.
View information on respiratory outbreaks in school or ECE settings.
General guidance and information:
OCDEL Info | Department of Human Services | Commonwealth of Pennsylvania
Safe and Healthy Diaper Changing Steps In Childcare Settings (cdc.gov)
Preventing Infectious Diseases | Early Care and Education Portal | CDC
How Early Care and Education Can Help Children Keep Their Vaccinations Up-to-Date (phf.org)