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Q&A with Dr. Nitin Verma

Consultant Paediatrician and Allergist at King’s College Hospital London, Jumeirah Medical Centre, Dubai

1. What tips or steps can mothers take to help reduce the chances of their toddlers catching a virus at nursery?

Toddlers are genuinely inquisitive by nature. Exploring their environment (be it at home or the nursery) is second nature to them. The common precautions to be taken to prevent infections or their spread, are essentially similar in homes and nurseries.

Most viruses are spread by close contact with an infected person. Toddlers can also become infected by touching objects or surfaces that have the virus on them and then touching their mouth, nose, or eyes with unwashed hands. Handwashing is critical to preventing the spread of germs, as about 80 percent of infectious diseases are spread by touch. Teachers, carers and parents should try and wash hands (theirs and toddler’s) often with soap and water, specifically before eating and after going to the toilet. Toys and other objects handled by toddlers, like doorknobs, tap handles and remote controls, should be kept clean and disinfected. If your sick toddler is suffering from vomiting and diarrhoea, take extra care to disinfect the toilet, floor, and sink in the bathroom. Use facial tissues to wipe off runny nose/nasal secretions and then bin it.

The single best way to protect against the seasonal flu and its potential severe complications is for children to get a seasonal influenza vaccine each year. Flu vaccination is recommended for all children aged 6 months and older.

2. What are the three or five most common viruses or sickness that toddlers tend to catch or spread at nurseries? (Please elaborate- add number of days each virus takes to subside)

The common viruses prevalent at this time of the year are, as follows:

  • Flu (influenza)
  • Common cold and other respiratory viruses (causing breathing difficulties/cough)
  • Hand, foot and mouth virus
  • Diarrhoea and vomiting causing viruses

All viruses tend to take about 5-7 days to clear. Symptoms tend to peak in the first 24 – 48 hours and then slowly wean away. This is the reason why viral illnesses are more troublesome to manage in day 2-3 of the illness.

3. When is it safe for a toddler to return to nursery after a virus or cold?

If toddlers have a runny nose and a bit of cough, they don’t necessarily need to stay at home, but if they have fever, then a general recommendation would be to stay home for at least 24 hours after the fever is gone.

Toddlers who have diarrhoea and vomiting should be kept away from the nursery for at least 48 hours after the last bout of diarrhoea or vomiting.

4. Do you advise mothers to keep their sick toddler at home instead of attending nursery? Explain.

The question to ask yourself would be, does my toddler have a condition that could be passed on to other children or nursery staff? A child with a minor cough or cold may attend nursery. If your child has a raised temperature, they shouldn’t attend nursery. They can return 24 hours after they start to feel better.

Skin rashes can be the first sign of many infectious illnesses, such as chickenpox and measles. Children with these conditions shouldn’t attend nursery. Get the rash checked up by your Paediatrician or Family Medicine Consultant, who will act as your family’s health champion.

Children with diarrhoea and/or vomiting should definitely be kept home until 48 hours after their symptoms have gone. This is because children are most infectious from when their symptoms start until 2 days after they’ve passed.

5. What should teachers do from their side to ensure the health of toddlers attending the nursery is not compromised?

For the staff in nurseries, it is vital to be able to recognise when a child is unwell, in order to be able to prevent the spread of infection amongst other children in the nursery. If any child has fever, sudden onset rash, diarrhoea or vomiting, the staff should keep the child safe and away from other children if possible, and ask the parent to come and collect their child. All the staff should ideally know and understand these infection control precautions required to control the outbreak of infections and how to apply them.

Nurseries should buy toys and equipment that can be easily cleaned. Toys should be stored in a clean container. It is also important that staff don’t let children take toys into toilet areas.