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little girl washing her hands

Little Kids, Lotta Germs

May 2016

Watch little kids and you’ll notice they touch everything: their nose, their eyes, their toys, other kids’ toys, each other …

Now consider that many haven’t learned to wash their hands, have less developed immune systems than adults, and may not have received all of their vaccinations.

All these factors create the perfect storm for an infectious disease outbreak.

Indeed, most kids in a childcare or school setting will contract eight to 10 colds per year and one to two cases of diarrhea.

Infants, toddlers and preschool-aged children are particularly susceptible to contagious diseases because they have not been exposed to many infections, have little or no immunity to infections, and have not received any or all of their vaccinations.


But parents, teachers, and childcare staff can take steps to reduce the likelihood of infectious disease outbreaks.

One step: discourage kids from covering their mouths with their hands when they sneeze or cough.

This may seem counterintuitive, but coughing or sneezing into the hands will leave germs on the hands that can spread by touching people and objects. Most often, germs are spread by the hands, not through the air.

Instead, encourage kids to cough or sneeze into a tissue or onto their sleeve (and immediately throw used tissues in a wastebasket). Afterward, make sure that kids wash their hands with soap and warm water or an alcohol-based hand cleaner.

Childcare provider reads a boy a book
Barb Stoll consults with childcare providers and school staff about infectious disease
diaper changing



Another tool for parents, teachers, and childcare staff is Hennepin County Public Health’s Infectious Diseases in Childcare Settings and School Manual.

Now in its thirtieth year and sixth edition, the manual provides disease prevention and control guidelines that are consistent with national standards set by the American Public Health Association, American Academy of Pediatrics, and the Minnesota Department of Public Health.

It contains 47 infectious disease fact sheets for parents and guardians.

It also has 54 technical fact sheets for childcare providers and school health staff. Technical fact pages indicate when immediate action is necessary. For example, infectious diseases like pertussis (whooping cough) and measles must be reported to the state or local health department.

The manual also contains Cover Your Cough posters and handwashing materials.

“The manual is accurate, easily accessible, and contains health department supported information,” says Barb Stoll, a public health nurse. “It’s a great resource for anyone.”

Stoll owns Health Consultants for Child Care, Inc. The company consults with childcare providers on state licensing requirements, health, safety, and nutrition. Infectious disease prevention is their specialty, and Stoll has relied on the manual for years.

An example? Recently kids at a childcare facility in Hennepin County developed molluscum contagiosum. The skin infection is characterized by bumps on the face, body, arms, and legs. It’s spread by skin-to-skin contact with an infected person or by sharing personal items or equipment.

Stoll was called in to consult with staff. The facility has a pool, and she surmised that the infection was being spread in the locker room.

Eliminating swimming from the curriculum was not an option, so Stoll made recommendations to decrease the risk of transmission. She advised staff to make sure that kids weren’t sharing towels, washcloths, or kickboards. She told staff and parents to keep kids’ bumps covered by clothing or watertight bandages.

And she directed everyone to the molluscum contagiosum fact sheets in the Infectious Diseases in Childcare Settings and School Manual.

After taking these steps, the outbreak subsided.

Ultimately, preventing and controlling infectious diseases does more than save costs and keep kids out of the clinic or hospital. “My motto is that a healthy and safe school or childcare facility enhances learning and play,” says Stoll.

Access the Infectious Diseases in Childcare Settings and School Manual online at:

By: Lori Imsdahl

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