HEALTH
HEALTH 33
Q
IS FOR QUARANTINE by Dr Penny Fraser, MB BS BSc(HONS) MRCS(ENG)
I
nfectious diseases have always been a worrying source of illness and mortality for people. The study of the spread of such diseases and their prevention has spawned whole subspecialties of medicine such as Public Health and Epidemiology. In the 14th century as the bubonic plague swept through Europe, the government of Venice tried to limit its spread to their island by instituting maritime isolation laws. They required ships to anchor away from the city for 40 days ‘quaranti giorni’, before they could unload any passengers, livestock or cargo, during which time the ship had to fly a yellow flag. The idea was that any diseases carried would have time to be identified, treated or have run their natural course etc. Hence the concept of quarantine developed. And these concepts are directly applicable to us as parents and carers here in Switzerland. Our children catch colds, cough, lice, germs and all sorts as they go about their social, muddy, busy lives. It is an appropriate part of a normal
HEALTH: Q IS FOR QUARANTINE
childhood! What we can do is to help reduce the spread of these diseases to other children and adults by applying the principles of quarantine. Helpfully, the Swiss Cantonal Paediatricians have published some guidelines to aid medical and educational professionals know when a child can and can’t return to school after having had an infectious disease diagnosed1.
when your child can carry on and when they need to stay home. Be sure to get a firm diagnosis from a paediatrician, pharmacist or other appropriate healthcare professional before applying these guidelines to be sure your child is getting the best care they need. PAEDIATRICA Vol 16 No 5 2005 © Copyright HealthFirst 2013 1
On the following page, you’ll find a more accessible version of some of the guidelines for your use at home, in playgroups, nurseries and schools. Remember that these standards should apply to adults too as they consider returning to work…. I hope you find this chart useful as you try to appropriately balance your work, family, childcare, schooling, after school activities etc – knowing
International maritime signal quarantine flag. This means that the ship is carrying people or animals that are or may potentially be contagious.
ABOUT DR PENNY FRASER Dr Penny is a British-trained Emergency Medicine doctor, who lives in Geneva. She is also the mother of two busy little girls aged 6 and 8. Along with Dr Michelle Wright and her other colleagues at HealthFirst, she has a passion for delivering health education and First Aid training to the English-speaking community in Switzerland. HealthFirst provides a range of dynamic, interactive First Aid courses and Health and Sex Education seminars to staff members and students of Swiss International Schools, sports clubs, playgroups, businesses, NGOs and individual members of the public. Their native English speaking trainers also deliver the obligatory First Aid course for the Swiss Driver’s Licence for anyone from the age of 14. Take a look at www. healthfirst.ch for more details.
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HEALTH: Q IS FOR QUARANTINE
What do they have?
What is it usually caused by?
When can they go back to school?
How can I help stop it spreading?
What else do I need to know?
Sore throat
A virus
When they are feeling well enough
Coughing into a tissue then throwing it away. Then washing hands.
Aspirin gargles should not be given to children.
Strep throat
Streptococcus bacteria
When they are feeling well enough (at the earliest 24 hours after they have started antibiotics).
As above.
A quick in-office test can be done by the doctor to see if the sore throat is caused by a bacteria – and therefore whether they need to take antibiotics or not.
Conjunctivitis (Pink eye)
Virus or bacteria
It depends on how bad it is. If it is mild, they can go back to school. If it is quite bad then they may need to stay home to ensure adequate hand washing etc.
Lots of hand washing – including after every time the child touches their eyes or you put drops in their eyes. Avoid sharing towels, flannels and pillows too.
Always see a doctor if you think a child might have conjunctivitis – it can affect their eyesight.
Chicken pox
Virus
When the child is feeling well enough and when all their spots have burst and crusted over (usually around 5-6 days after the rash begins).
Wash any infected bedding, clothing and cuddly toys. Wipe down hard surfaces with a sterilizing solution.
It is important to tell your child’s doctor and nursery/school that they have chicken pox. Keep them away from young babies, pregnant women and people with weakened immune systems (eg those in hospital, on steroids tablets etc).
Flu (all sorts)
Various strains of virus
When they feel well enough.
Catch coughs and sneezes in a disposable tissue, throw it away straight away then wash your hands.
Keep the poorly person well hydrated and rested. Use paracetamol or ibuprofen to bring down a fever and make them feel better.
Diarrhoea and vomiting (Gastroenteritis)
Usually a virus but may be a bacteria
When the vomiting has stopped. Older children can go back to school before the diarrhoea has completed stopped if they are feeling well enough and they are able to adequately wash their hands.
Hand washing after every trip to the bathroom or contact with any diarrhoea or vomit. Washing hands before preparing or eating food, drink or babies bottles is important too.
If the diarrhoea and vomiting is caused by a norovirus (this would be identified by a doctor when there is currently an epidemic), the person should only return to school or work 48 hours after the diarrhoea and vomiting has completely stopped.
Molluscum contagiosum
Virus
Straight away.
Keep the spots covered with clothing. Avoid sharing towels, clothing and baths. Try not to let the child scratch the spots.
It is sensible to cover any open sores, including molluscum contagiosum, with a waterproof plaster before swimming to avoid spreading any infection to others and to prevent any other germs getting in.
Impetigo
Bacteria
24 hours after it has been treated with antibiotics.
Wash hands after touching the affected area – every time. And avoid sharing towels and flannels.
Be especially careful in children with eczema as the impetigo can spread rapidly.
Head lice
Insect
Straight away provided treatment has been started.
Tying long hair back is helpful, as is wet combing to detect and treat the lice early.
The lice can be treated with medicated lotions and shampoos. Ask the pharmacist for advice. Remember to treat other members of the family who have live lice detected too!
Measles
Virus
From the 4th day after the rash started but always check with your doctor first.
Catching coughs in a tissue, throwing it away and washing hands afterwards.
Measles is a serious disease that can make people very poorly, especially babies, pregnant women etc. It is preventable by a vaccine. It is a notifiable disease, which means you have to tell the doctor if you think you or your child have measles. He/she will tell the authorities so they can monitor and control any outbreak.
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AUTUMN 2013 ISIS Magazine