Illness and Infectious Diseases Procedure

In this procedure, words in italic text are defined terms which have the specific meanings set out in Gowrie Victoria Policies and Procedures – Definitions and Abbreviations.

Purpose

This procedure sets out steps to be taken to control the spread of infectious diseases at Gowrie Victoria’s services.

The procedure includes:

• children’s immunisation requirements
• routine measures to reduce the risk of an occurrence of an infectious disease (National Regulations r88(1))
• measures to be followed if there is an occurrence of an infectious disease including:
• exclusion of children as required
• special disinfection processes
• reporting as required under the National Law and National Regulations (National Regulations r88(2)), and the Public Health and Wellbeing Act 2008 (Vic) and Public Health and Wellbeing Regulations (2009)
• steps to be followed if a child falls ill at the service (National Regulations r85(b))

Scope

This procedure applies to all staff members, volunteers, students on placement and contractors/labour hire employees of Gowrie Victoria.

Procedure statement

Planning for control of infectious diseases

The early years manager must ensure that:

• a routine cleaning plan is developed for the service, which includes regular cleaning of rooms, toilet and bathrooms, food preparation areas, furniture, equipment and toys in accordance with recommendations (see ‘Staying Healthy Preventing Infectious diseases in Early Childhood Education and Care Services’ NHMRC June 2013)
• a routine laundry plan is developed for the service, which includes regular laundering of all towels, bedding and other washable items at the service (see ‘Staying Healthy Preventing Infectious Diseases in Early Childhood Education and Care Services’ NHMRC June 2013)
• an effective disinfecting plan is developed for the service ready for implementation following an occurrence of an infectious disease, which includes disinfecting all surfaces in children’s and staff rooms, toilet and bathrooms and food preparation areas, and all furniture, equipment and toys
• immunisation records are maintained and organised so that at any time:
• children who have just received a vaccine can be identified
• children who are not vaccinated against a particular infectious disease can be identified
• systems and work practices are in place to ensure that the early years manager is informed as soon as possible about:
• a child becoming sick at the service, and the symptoms which the child displays
• a child being absent because they are unwell, and the child’s symptoms as reported by the family
• there are procedures in place for staff to follow to notify the service that they will be absent from work due to illness or having the symptoms of an infectious disease
• systems and work practices are in place to make the required reports of an infectious disease to:
• the child’s family
• DHHS (schedule 7 of the Public Health and Wellbeing Regulations 2009)
• systems and work practices are in place to monitor cases of gastroenteritis and to report any outbreak to the local council health department

Resources

The early years manager must ensure that:

• there is sufficient cleaning equipment and consumables to carry out all routine and special cleaning operations
• there is sufficient bedding and towels to allow for frequent laundry without interruption to the routines in children’s rooms

Information to be available for families

The early years manager must ensure that:

• Gowrie Victoria’s policies and procedures for dealing with infectious diseases are readily accessible to staff members and volunteers, and are available for inspection at each service (National Regulations r168(2)(c), r171)
• Families have access to any accident, injury, trauma or illness record for their child or children (National Regulations r181(b))
• the current DHHS poster ‘Minimum Period of Exclusion from Primary Schools and Children’s Services Centres for Infectious Diseases Cases and Contacts’ is displayed in the entrance area and in the staff room at the service
• information about the National Immunisation Program Schedule is displayed in the entrance area and in the staff room at the service

Information required from families

Families must ensure that:

• if a child has been given any medication, including paracetamol or Ibuprofen before coming to the service, details are given to the child’s educator on arrival at the service
• if a child becomes sick at the service and is taken home, or if a child is absent because they are unwell, the family keeps the service fully informed about the child’s symptoms, diagnosis, treatment and recovery
• if the family is not keeping the service full informed, the family is called to get information about the sick child

Protecting staff member’s health

The early years manager must:

• encourage staff members to be vaccinated against:
• pertussis (whooping cough)
• measles-mumps-rubella (MMR), if staff members are born after 1965 and do not have evidence of two dose of MMR or do not have antibodies against rubella
• varicella (chickenpox), if staff members have not previously had varicella (which can be determined by a blood test)
• hepatitis A and B
• ensure that the health of staff members who are pregnant is not placed at unnecessary risk by any infectious disease

Staff members who are pregnant are strongly encouraged to advise the CP manager.

Measures to reduce the risk of an occurrence of an infectious disease

The early years manager must ensure that:

• the service’s routine cleaning plan is implemented and monitored for compliance
• the service’s routine laundry plan is implemented and monitored for compliance
• rooms at the service are not overheated
• sick children are excluded from the service in accordance with this procedure

Early years leaders and educators should:

• encourage families to accompany their child to the bathroom to wash their child’s hands on arrival at and departure from the service
• ensure that all hygiene requirements in the Nappy Changing and Toileting Procedure, the Nutrition and Food Safety Procedure, and the Injury and Administration of First Aid Procedure are followed

Measures to help minimise the impact of and eradicate an infectious disease

If there is an occurrence of an infectious disease at the service, the early years manager must ensure that:

• the service’s disinfecting plan is implemented and continued, with adaptions as necessary, until the service is declared disease free
• further cleaning and disinfecting work recommended by DHHS or an environmental health officer from local government is carried out and continued until the service is declared disease free
• any necessary exclusions of children or staff members are carried out
• the required notices and reports and made to families, to DHHS and the local council, and the required signs are placed at the service
• the service complies with requests for further information and assistance in diagnosing the outbreak

Exclusion of children from a service

Exclusion requirements are set out in Schedule 7 of the Public Health and Wellbeing Regulations 2019. Despite what is stated in Item 4 of Schedule 7, Gowrie Victoria will exclude all children with symptoms of gastroenteritis until they have not vomited or had a loose bowel motion for 48 hours.

Gowrie Victoria will also follow the exclusion recommendations contained in Staying healthy: Preventing infectious diseases in early childhood education and care services (NHMRC, 5^th edition 2013). If there is a conflict between the exclusion periods set out in Schedule 7 of the Public Health and Wellbeing Regulations 2009 and the periods included in table 1.1 of the NHMRC recommendations, Gowrie Victoria will apply the longer exclusion periods.

Symptoms and signs of illness

Children attending a service are often susceptible to infections due to the close contact with other children. However, our practice around indoor/outdoor programs and our infection control procedures reduce this risk considerably.

Children who have experienced any of the following symptoms in the last 24 hours, or whilst attending a service, will be deemed to be unwell and should not attend the service until all symptoms have ceased and a doctor’s clearance is provided (where required):

• breathing difficulties
• persistent coughing
• excessive discharge from the nose (generally associated with other symptoms such as a fever or coughing)
• a temperature of 38 degrees or higher
• a rash or blisters
• Extreme lethargy and / or loss of normal appetite

Exclusion of cases

The early years manager must ensure that:

• a child who is unwell is collected from the service and excluded until either:
• if the child has suffered any symptoms other than diarrhoea or vomiting, they feel well and have been clear of any symptoms for 24 hours, or
• if the child has suffered diarrhoea or vomiting, they feel well and have been clear of any symptoms for 48 hours, or
• if a diagnosis of an infectious disease is made by a registered medical practitioner, for the longer of the relevant period, if any, set out in column 3 of Schedule 7 of the Public Health and Wellbeing Regulations 2019 (Public Health and Wellbeing Regulations r111(1)(a)) or the period, if any, indicated in Staying healthy: Preventing infectious diseases in early childhood education and care services (NHMRC, 5^th edition 2013)
• If a child has been diagnosed with an infectious illness and excluded from the service, a medical clearance may be required upon return to the service. This medical clearance should state that the child is no longer infectious to others.

Exclusion of contacts

If the early years manager is informed that a child has been in contact with a person who is infected with an infectious disease, the early years manager must ensure that the child is excluded for the longer of the period, if any, set out in column 4 of Schedule 7 of the Public Health and Wellbeing Regulations 2019 (Public Health and Wellbeing Regulations r111(1)(b)) or the period, if any, indicated in table 1.1 of Staying healthy: Preventing infectious diseases in early childhood education and care services (NHMRC, 5^th edition 2013).

Exclusion of unvaccinated children

If there is an occurrence of a vaccine-preventable disease at the service for which exclusion is indicated in Schedule 7 of the Public Health and Wellbeing Regulations 2019, the early years manager must contact the families of each child who is not known to be fully immunised against that vaccine-preventable disease and ask them:

• to collect the child from the service
• exclude the child until the service is declared free of that vaccine-preventable disease

Exclusion at the direction of the DHHS Communicable Disease Prevention and Control Unit

The early years manager must ensure that if any directions are received through DHHS’s Communicable Disease Prevention and Control Unit to exclude a child or children from the service, affected families are notified and asked to comply.

Notices, reports and records

Notices and reports to families

In addition to any notices to families concerning the exclusion of children from the service, the early years manager must ensure that:

• the family of a child who becomes sick at the service is notified as soon as practicable(National Regulations r86)
• if there is an occurrence of an infectious disease at the service, the family or an authorised emergency contact of each child at the service is notified as soon as practicable (National Regulations r88(2))
• regular updates are sent to families to keep them informed about the occurrence of the infectious disease and measures being taken to contain and eradicate it
• if for a particular infectious disease there have been no occurrences for the period of time specified in column 2 of Schedule 7 of the Public Health and Wellbeing Regulations 2009, all families are notified that the service is free of that disease

Reports to DHHS’s Communicable Disease Prevention and Control Unit

The early years manager must ensure that:

• if they know or suspect that a child enrolled at the service or any staff member has measles, meningococcal infection, mumps, pertussis (whooping cough) or poliomyelitis, that information is given to DHHS’s Communicable Disease Prevention and Control Unit immediately
• if the service has two new and otherwise unexplained cases of diarrhoea and/or vomiting affecting children or staff members within 48 hours the outbreak is reported to the local council health officer within 24 hours (A Guide for The Management and Control of Gastroenteritis Outbreaks in Children’s Centres, DHHS, Pt 2.1)
• any further reports or information relating to the occurrence of an infectious disease requested by either DHHS’s Communicable Disease Prevention and Control Unit or an environmental health officer from a local authority are provided in a timely fashion

Reports to DET

If a child becomes so sick at the service that the sickness is a serious incident, the early years manager must ensure that a serious incident report is sent to the DET within 24 hours (National Law s174(2)(4), National Regulations r176(2)).

Incident, injury, trauma and illness records

Following a child becoming sick at the service, the early years manager must ensure that a record of the illness is include in the child’s incident, injury, trauma and illness record as soon as practicable but no later than 24 hours after the illness starts (National Regulations r87(3,4)).

A schedule summarising the requirements for notices and reports is included in Appendix A.

Notices to be displayed at the service

The early years manager must ensure that:

• signs warning of the occurrence of an infectious disease are placed in the main entrance to the service (National Regulations r173(2)(g)(i)) (preferably on the entrance doors so as to be visible from both sides) and remain in place until the service is declared free of that disease
• information on the particular infectious disease which is affecting the service is displayed in the main entrance to the service
• additional hand-washing posters are displayed at locations around the service

Actions if a child falls sick at the service

Actions by early years leaders and educators

If a child falls sick at the service their early years leader or an educator must (National Regulations r85(b)):

• isolate the child from other children
• make the child is comfortable
• notify the responsible person that the child is sick
• actively monitor the child’s symptoms and well-being, and make a written record of observations
• continue supervising the child to ensure that the child follows all personal hygiene routines

Dealing with a fever

An early years leader or educator looking after a child who is unwell should be aware that:

• a temperature of up to 38ᵒC is normal in a child
• fevers are common in children
• if the child seems well and happy, there is no need to treat the fever
• a fever is a symptom of an illness, and care should be taken to look for other symptoms displayed by the child which might be more relevant to their condition

If the temperature of a baby of less than three months age rises above 38ᵒC they should be seen by a registered medical practitioner.

A child who is unhappy should be treated by providing clear fluids and removing excess clothing. Paracetamol, Ibuprofen and aspirin can only be given with a medical practitioner’s certificate.

Febrile convulsions

Information from RCH Melbourne Kids Health Info

A febrile convulsion is a fit or seizure caused by a sudden change in a child’s body temperature, and is usually associated with a fever and a sudden rise in temperature. Febrile convulsions most commonly happen between the ages of six months and six years.

During an episode of febrile convulsions a child will usually lose consciousness, their muscles may stiffen or jerk, and they may go red or blue in the face. Convulsions may last for several minutes. When the movements stop, the child will normally regain consciousness, but usually remain sleepy or irritated afterwards.

If a child has febrile convulsions, place the child on a soft surface, lying on their side or back. If possible, make a note of symptoms and time how long the convulsion lasts. Do not restrain the child or put anything it their mouth.

Call an ambulance immediately if:

• the child was very unwell before the convulsions, or
• it is the child’s first known incidence of convulsions, or
• if the convulsions last for more than five minutes, or
• the child does not wake up with the convulsions stop, or
• the child looks sick when the convulsions stop

If none of these factors apply, call the child’s family and ask for the child to be taken to their medical practitioner.

Actions by the responsible person

The responsible person must:

• assess the child’s symptoms and decide whether to:
• call emergency services because the child needs immediate medical assistance
• call the child’s family or another person authorised in the child’s enrolment records to collect the child from the service
• let the child remain at the service
• if necessary, ask the child’s family to take the child to their registered medical practitioner for diagnosis and/or treatment
• report the illness to the child’s family in accordance with this procedure
• record the child’s illness in their accident, injury, trauma or illness record, and any administration of medication in the child’s medication record
• if necessary, exclude the child from the service in accordance with this procedure
• find out the child’s diagnosis from the family

Authorisation

Approved by the Executive Manager, Early Learning

Name	Nicole Pilsworth
Signature
Date	8 April 2021

Appendices

Appendix A: Notices and reports required for illness and infectious diseases

References

Appendix A: Notices and reports required for illness and infectious diseases