Use this FREE interactive online activity to learn about preventing and managing infectious diseases. Four experts who are pediatricians and members of the PA Chapter of the American Academy of Pediatrics (PA AAP) collaborated with the national AAP to prepare the module.

Users must create a log in to enter the AAP online e-learning system called Pedialink. Thereafter, Pedialink will recognize your log-in to use modules. The AAP does not charge anything at check-out for FREE modules. The AAP issues a certificate awarding 3 hours of credit for successful completion of the module. For the log in and this online learning activity, go to the Healthy Child Care America, Healthy Futures website. 

DPW Facility Licensing Representatives and STARS Specialists will recognize the AAP certificate of credit. To have ECELS record the credit in your PA Keys PD history, attach a scan of the certificate to an e-mail, fax, or send a copy of the AAP certificate to ECELS. Follow the instructions in the “Important Reminders” box on the self-learning module pages of the ECELS website to order a self-learning module review by ECELS. ECELS requires a $10 administrative fee to process your request. (ECERS-ITERS: Personal Care Routines, Parents and Staff. K7-C2-84. 6/2017


State regulations require documentation that the child has received vaccines and screening tests according to the recommendations of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Any document (including an electronic printout from the child's medical record) that provides this information is acceptable. The Office of Child Development and Early Learning (OCDEL) offers a form that allows health care providers to say whether the child is up to date, the CD 51. This Child Health Report form was last revised in 2008. It does not require the dates and results of the recommended screening tests. It has a check box to indicate "yes" or "no" that the child has received all the recommended screenings. The only screening information it requests is the results of any abnormal vision, hearing or lead screening. These are important, but not all the screenings that assess whether a child is healthy and ready to learn. 

Families, staff members and health professionals can help control infectious diseases among children and adults involved in group care settings. Each has a role. The three roles described in these fact sheets overlap. Families, staff members and health professionals benefit from ongoing coordination and collaboration with one another. Sharing these fact sheets may help those whose role is defined in them identify ways to contribute to reducing illness.

See the online (most recently updated) version of Caring for Our Children, 3rd edition for the national stanards related to cleaning, sanitizing and disinfecting surfaces in child care settings. Details about how to select a sanitizer and disinfectant are in Appendix J. The table that lists Routine Schedule for Cleaning, Sanitizing and Disinfecting is in Appendix K . Updated 12/2013


Head lice are little insects that live and lay their eggs close to the scalp. They bite and then feed on blood they draw. They glue their eggs (nits) to the hair. The eggs must be within ¼ of an inch of the scalp to hatch. Small pieces of dandruff are often mistaken for lice eggs. Dandruff slides off hair easily. The tightly-glued eggs are very hard to remove. Combing to remove the lice and nits is tedious. Lice spread easily in group care settings, mostly by head-to-head contact.


Every fall, programs for children in groups face possible outbreaks of flu. Flu can be life-threatening. ECELS recommends that all early education and child care programs actively use measures to prevent this disease.

The best way to stop the spread of seasonal flu is to get flu vaccine as soon as it is available. Whether you get the shot or the nasal spray depends on your age, health condition and preference. The 2013 vaccines have either 3 or 4 strains of influenza virus material. If it is available, get the one with 4 strains. Both of the vaccines prepare your body to resist influenza.

Too many people believe myths about flu vaccine and about influenza. The vaccine does not give you influenza. It stimulates the immune system to recognize influenza viruses. While you might get a sore spot on your arm or feel a bit under the weather for a day or so, getting infected with disease-producing influenza is much worse. Influenza disease can make healthy people sick enough to miss months of work or school or worse. Sadly, each year thousands die from influenza. Flu vaccine could have prevented many of these severe illnesses and deaths.

Child care facilities should start promoting influenza vaccination in September and continue until everyone has received the vaccine or spring comes. With very few exceptions, everyone over 6 months of age should get annual flu vaccine.

In the fall, reinforce the value of practicing good hand hygiene and using an elbow or shoulder to catch a sneeze or cough. Flu viruses spread easily in group care settings. Adults and children in group care take the virus home and spread it in the community. Consider the risk that people who do not get flu vaccine pose to others while respecting their right to make individual decisions.

Act now for the 2013-14 influenza season.

  • Managing Infectious Diseases 
  • Dental Check-up Resources 
  • Q&A: Cold Packs, Hearing Screens 
  • Why Not to Spank 
  • Caring for a Child with Special Needs: Diabetes, Tics  
  • Websites: USDA, Kids’ Questions, 
  • ECELS-Healthy Child Care PA 
  • Praise for WellCareTracker™  
  • Safe Scooting and Biking Tips 
  • Early Intervention 
  • Training for directors, health consultants, and early education staff 
  • SIDS-Infant Death Survival Guide
  • CBK for Health and Safety Works with Keystone STARS 
  • Asthma and Allergy Awareness
  • Pottstown Early Action for Kindergarten (PEAK) Emphasizes Health & Safety
  • Sanitizing Computer Keyboards
  • How Does HIPAA Affect Child Care
  • Immunization News
  • Choking Prevention
  • Keystone STARS Financial Awards Can Pay for Child Care Health Consultation
  • New Health and Safety Professional Development Opportunities
  • Food Allergy 
  • Classroom Pets and Animal Experiences 
  • Poison Ivy, Poison Oak and Poison Sumac 
  • Choosing and Using Pest Management Professionals 
  • Tip for Oral Health in Child Care 
  • The Pennsylvania Immunization Coalition 
  • Children with Special Needs Module-Online 
  • Motion Moments - 3 Videos 
  • Sun Protection is Essential


Since 1986, conference workshops, professional journal articles, manuals, national standards, and sample forms have described the risk to an unborn child if a pregnant mother is exposed to certain infections that commonly spread in groups of young children. Employers of female early education staff of child-bearing age should educate their staff members about this risk. They should urge them to discuss with their health care providers how to reduce their risk.

Cytomegalovirus (CMV) is one of the infections that pose a risk to an unborn child. CMV is a common infection among young children, usually without symptoms. Between 30% and 70% of children less than 3 years of age in child care excrete the virus in their urine, saliva and blood at any one time. Excretion of the virus may occur intermittently for years after the first infection. Women who work in child care may or may not be immune to the strains of CMV infecting children in their care. If a woman has her first CMV infection while pregnant, or has a CMV infection with a different strain than the one she had previously, her unborn child is more likely to be infected.

In utero (congenital) CMV infection occurs in only 1% of live births. However, CMV is the most common viral infection of babies before they are born and the most common cause of sensorineural hearing loss. About 10% of the CMV-infected babies have some symptoms or signs at birth. Those who do may have devastating multi-organ damage. These include poor growth, liver damage, brain damage, hearing loss, blindness, underdeveloped brains and developmental delay. About half of infants who have some symptoms of CMV at birth develop hearing loss from damaged nerves that are needed to carry sound sensations to the brain from the ear. About 15% of those who are infected but have no symptoms of CMV infection at birth develop this type of hearing loss as they grow older. In many children, the degree of hearing loss is progressive.

Nurses who conscientiously practice recommended hand hygiene don't get CMV infections from their CMV infected patients at a higher rate than other women. Teachers/caregivers of groups of young children could similarly reduce their risk by practicing hand hygiene after every contact with urine, saliva or blood. However, achieving this level of hand hygiene is challenging in group care. Teachers/caregivers have contact with more than one drooling child at a time, and frequently touch saliva coated toys or other surfaces. They change diapers or soiled underwear for children in their group multiple times a day.
At the least, women who teach groups of young children need to know how to reduce the risk if they might become or are pregnant. When properly informed, they can consider three options: 1) be very careful about practicing hand hygiene, 2) decide to provide care for preschool or older children instead of infants and toddlers when pregnancy is possible, or 3) choose to work in settings where they have less risk of contact with body secretions of young children.

Employers should explain CMV and other common occupational health risks verbally pre-employment. The information should be in an employee handbook given to each staff member, and discussed at a staff meeting at least once a year. It is best practice to use a Staff Health Assessment form that lists the common occupational risks. The list may prompt the health care provider who completes the form to assess and discuss these risks. Many health care professionals are unaware of the tasks performed by women whose work involves close contact with groups of young children. A list of these occupational risks is in Caring for Our Children, Managing Infectious Diseases in Child Care and Schools, and in Model Child Care Health Policies. Each of these publications has a sample Staff Health Assessment Form too.

Teach early education staff members about each of their occupational risks. Then have them sign a statement acknowledging the teaching received, that they understand and know how to reduce each risk, and that with this knowledge, they accept the risks.