CDC Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009–2010 Influenza Season

CDC Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009–2010 Influenza Season
November 3, 2009, 3:36 PM ET

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This document provides guidance to help decrease the spread of influenza (flu) among children in early childhood programs and among early childhood providers during the 2009–2010 flu season. The guidance expands upon earlier guidance documents by providing a menu of tools that health officials, Head Start, and other early childhood and child care providers can choose from based on conditions in their area. It recommends actions to take now, during the 2009–2010 flu season, suggests strategies to consider if CDC determines that the flu is becoming more severe, and provides a checklist for decision-making at the local level. Explanations for the recommended strategies and suggestions on how to use them are included in the Technical Report. Based on the severity of 2009 H1N1 flu-related illness thus far, this guidance recommends that children and early childhood providers with flu-like illness remain home until 24 hours after resolution of fever without the use of fever-reducing medications. For the purpose of this document, “early childhood programs” will refer to center-based and home-based child care programs, Head Start programs, and other early childhood programs providing care for children in group settings. The guidance applies to all early childhood programs, even if they provide services for older children.

Children less than 5 years of age are at increased risk of complications from influenza (flu); the risk is greater among children less than 2 years old. Importantly, infants less than 6 months of age represent a particularly vulnerable group because they are too young to receive the seasonal or 2009 H1N1 influenza vaccine; as a result, individuals responsible for caring for these children constitute a high-priority group for early vaccination. Influenza vaccination is the primary means of preventing flu. Additionally, infection control measures are recommended to reduce the spread of flu. However, early childhood settings present unique challenges for infection control due to the highly vulnerable population, close interpersonal contact, shared toys and other objects, and limited ability of young children to understand or practice good respiratory etiquette and hand hygiene. Thus, parents, early childhood providers, and public health officials should be aware that, even under the best of circumstances, transmission of infectious diseases such as flu cannot be completely prevented in early childhood or other settings. No policy can keep everyone who is potentially infectious out of these settings.

The purpose of this document is to provide updated guidance for reducing the spread of influenza in early childhood settings. We provide recommendations assuming that severity of illness is similar to what was seen during the spring and summer of 2009 through the 2009–2010 flu season, as well as recommendations that could be added if the severity of illness worsens. However, influenza is unpredictable, and CDC will provide periodic updates of these assessments and may recommend additional strategies if they are needed. Also, because conditions may vary from community to community, early childhood providers should also look to their state and local health officials for information and guidance specific to their location.

Preparing for the Flu: A Communication Toolkit for Child Care and Early Childhood Programs

Recommendations for early childhood programs for the 2009–2010 influenza season
Early childhood providers should examine and revise, as necessary, their current crisis or pandemic plans and procedures; develop contingency plans to cover key positions when staff are absent from work; update contact information for families and staff; and share their plans with families, staff, and the community. Early childhood providers should review and revise, if necessary, their sick leave policies to remove barriers to staff staying home while ill or to care for an ill family member. A doctor’s note should not be required for children or staff to validate their illness or to return to the early childhood setting.

Early childhood providers should frequently remind children, their families, and staff about the importance of staying home when ill; early treatment for people at higher risk for flu complications; hand hygiene; and respiratory etiquette. Educational materials (for example, posters) to enhance compliance with recommendations should be visible in the child care setting. Examples of these materials are available.

The recommendations that follow are divided into two groups: 1) recommendations to use now, during the 2009–2010 flu season, assuming that the severity of influenza in the fall and winter will be of similar severity to that seen during spring and summer 2009, and 2) recommendations to consider adding if a more severe flu season occurs

Recommended strategies to use now, for flu conditions with severity similar to spring/summer 2009 (please, see below):

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