REPORTING REQUIREMENTS
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REPORTING REQUIREMENTS

REPORTING REQUIREMENTS

When you know that a child has a specific disease, you may need to take control measures so that the disease does not spread to others. Some diseases or conditions must be reported to the local health department. Child care providers should contact their local health department to find out what diseases they need to report. You may want to inform parents of these requirements in "parent information" packages.

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When you are required to report certain diseases to the health department, you should do so promptly, even if the sick child is under the care of his or her own physician. The physician, who is also required to report the occurrence of these diseases to local health authorities, may not do so, or the physician may not know that the child is attending child care. The health department needs to know a child is in child care in order to determine appropriate preventive measures. These might include watching the other children in the child care home or center for signs of illness and giving them preventive treatment, if necessary. Suspected child abuse or neglect must also be reported. The agency to which you report abuse and neglect varies by locality. The agency may be the police department, the department of family and child services, child protective services, or others. Check with the local authorities in your area to identify the appropriate reporting agency. You also should inform parents of this reporting requirement.

The table on the next few pages summarizes actions that CDC recommends that you take if you know a child in your care has been diagnosed with one of the diseases that commonly occur in a child care setting. The table also tells you when to allow the sick child to return to the child care setting after being excluded.

EXCLUSION/READMISSION DUE TO ILLNESS

Disease If a Child in Your Care Has Been Diagnosed With This Disease
You Should		 When to Allow
Child to Return
Bacterial Meningitis
  • Exclude the child from child care. (In most cases, the child will be hospitalized.)
  • Immediately contact your Health Department to report the case of meningitis.
    They will contact the child's physician and make recommendations about what to do to prevent the spread of infection..
    • Ask whether you need to contact the parents of the other children in your facility. The Health Department may recommend antibiotics for children and adults in the facility.
  • If so, in cooperation with the Health Department, contact the parents of the children in your facility and tell them:
    • that their child may have been exposed to meningitis.
    • that their child should see a physician IMMEDIATELY if fever, headache, rashes, spots, unusual behavior, or any other symptom that concerns them develops.
    • to follow any preventive measures the Health Department recommends.
  • Carefully follow group separation and good hygiene procedures. (See chapter on Protective Practices.)
    		• When the Health Department tells you it is safe.
    Chickenpox
  • Temporarily exclude the sick child from the child care setting.
  • Notify parents, especially those whose child is
    • taking steroid medications.
    • being treated with cancer or leukemia drugs.
    • is immunosuppressed.
    (Chickenpox can be extremely dangerous to these children.)
  • You may contact your Health Department to find out what other preventive measures to take.
  • Carefully follow group separation, handwashing, and cleaning procedures. (See chapter on Protective Practices.)
    		• 6 days after the rash begins or when blisters have scabbed over.
    Diarrheal Disease
  • Temporarily exclude the sick child from the child care setting.
  • Carefully follow group separation, handwashing, and cleaning procedures. (See chapter on Protective Practices.)
  • If you know the diarrhea is caused by bacteria or a parasite such as shigella, campylobacter, E. coli, Cryptosporidium, salmonella, or giardia, ask the Health Department
    • whether other ill and well children and adults should be tested.
    • when to allow the sick child to return to child care.
    		• When the child no longer has diarrhea. However, some of these diseases require negative stool cultures; allow the child to return when the Health Depart-ment tells you it is safe.
    Diphtheria
  • Temporarily exclude the sick child from the child care setting.
  • Immediately contact the Health Department to ask what additional preventive measures should be taken.
  • Observe all children and adults for sore throats for 7 days.
  • Anyone developing a sore throat should see a physician.
  • Advise parents that their child should see a physician if
    • the child develops a sore throat.
    • the child is incompletely immunized against diphtheria.
  • Carefully follow group separation and good hygiene procedures. (See chapter on “Protective Practices.”)
    		• When the Health Department tells you it is safe.
    Epiglottitis
  • A child diagnosed with this disease will probably be hospitalized. Contact your Health Department and ask what preventive measures to take.
      — The Health Department may tell you to contact all parents and tell them
    1. that their children may have been exposed to a serious contagious disease,
    2. that their children should immediately see a physician if they develop fever, headache, symptoms of infection, or behavior that seems unusual and
    3. about any additional preventive measures the Health Department has recommended.
  • Carefully follow group separation and good hygiene procedures.
    IMPORTANT: H-flu is not the same germ as "flu" or influenza. H-flu can cause SERIOUS ILLNESS in young children. If a case of H-flu occurs in your facility, TAKE ALL ACTIONS ABOVE.
    		• Not due to H-flu:
    When treating physician tells you it is safe.

    Due to H-flu:
    When the Health Department tells you it is safe.

    Hand- Foot- and- Mouth Disease
  • Exclude if child has open, draining lesion on hand or has lesions in the mouth AND is drooling.
    		• When lesions heal or drooling ceases.
    Head Lice
  • Temporarily exclude the infested child from the child care setting.
  • Contact your Health Department or health consultant for advice about examining, treating, and readmitting exposed children and adults.
  • Check the other children for lice or nits (eggs of lice).
    		• 24 hours after treatment.
    Hepatitis A
  • Temporarily exclude the sick child from the child care setting.
  • Immediately notify your Health Department. (They may recommend immune globulin shots and possibly vaccination for children and adults and additional preventive measures.) Ask for specific recommendations on notifying parents and on exclusion policies.
  • Carefully follow group separation and good hygiene procedures.
    		• 1 week after illness begins (onset of jaundice or yellow appearance).
    Influenza In the absence of an epidemic, influenza is difficult to diagnose and usually the diagnosis comes after the end of the infectious period, so exclusion will be impractical. N/A
    Measles
  • Temporarily exclude the sick child from the child care setting.
  • Immediately notify your Health Department.
  • Identify unimmunized children and adults and make sure they get vaccinated and/or exclude them from the child care setting until 2 weeks after rash appears in the last child who had measles in the child care setting.
    		• 5 days after rash appears and Health Department says it is safe.
    Mumps
  • Temporarily exclude the sick child from the child care setting.
  • Carefully follow group separation and good hygiene practices.
  • Notify Health Department.
    		• 9 days after swelling begins.
    Pertussis (Whooping Cough)
  • Temporarily exclude the sick child from the child care setting.
  • Immediately notify your Health Department.
  • Exclude, until diagnosed by a physician, any child who develops a cough within 2 weeks of the case.
  • Carefully follow group separation and good hygiene procedures.
    		• 5 days after antibiotics are begun and Health Department says it is safe.
    Pinworms
  • Temporarily exclude the child from child care setting.
  • Notify parents.
    		• 24 hours after treatment and bathing.
    Pneumonia
  • A child diagnosed with this disease will probably be hospitalized.
    Contact your Health Department and ask what preventive measures to take.
    — The Health Department may tell you to contact all parents and tell them
    1. that their children may have been exposed to a serious contagious disease,
    2. that their children should immediately see a physician if they develop fever, headache, symptoms of infection, or behavior that seems unusual, and
    3. about any additional preventive measures the Health Department has recommended.
  • Carefully follow group separation and good hygiene procedures.
    IMPORTANT: H-flu is not the same germ as "flu" or influenza. H-flu can cause SERIOUS ILLNESS in young children. If a case of H-flu occurs in your facility, TAKE ALL ACTIONS ABOVE.
    		• Not due to H-flu:
    When treating physician tells you it is safe.

    Due to H-flu:
    When the Health Department tells you it is safe.

    Ringworm
  • Temporarily exclude the child if the lesion cannot be covered.
    		• If unable to cover lesion, after treatment begins and the lesion starts to shrink.
    Rubella (German or 3-day measles)
  • Temporarily exclude the child from the child care setting.
  • Immediately notify your Health Department.
  • Advise any pregnant women in the facility who are not known to be immune to see their physicians.
  • Carefully follow group separation and good hygiene procedures.
    		• 6 days after rash appears and Health Department says it is safe.
    Scabies
  • Temporarily exclude the child from the child care setting.
  • You may contact your Health Department for advice about identifying and treating exposed children and adults.
    		• 24 hours after treatment has begun.
    Streptococcal sore throat
    (Strep throat)
  • Temporarily exclude the child from the child care setting.
  • Contact your Health Department if 2 or more children are diagnosed with strep throat.
    		• 24 hours after antibiotics are begun.
    Active Tuberculosis
    (See Fact Sheet on Tuberculosis for information on nonactive TB infection.)
  • Immediately notify your Health Department.
  • Children with TB may usually remain in child care after treatment as long as they are receiving appropriate treatment.
    		• When Health Department says it is safe.
    Note: The term "adult" is used to refer to any adult in the facility (center or home) who may have come in contact with a sick child. This may include more that just those adults actually providing child care. In a home situation, for example, it may also include household occupants.
    Note: This information is not intended to take the place of your state's or locality's child care regulations and laws. In every case, the laws and regulations of the city, county, and state in which the child care facility is located must be carefully followed even if they differ from these recommendations.

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