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What You Can Do To Stop Disease In Your Child's Day Care Center

In child care centers, diseases can spread easily because large numbers of children from different families spend hours together in one place every day. 

How diseases spread:
Many common childhood diseases are contagious. That is, they spread from one person to another. Everyone knows that some illnesses (like chicken pox) can spread from one person to another but many people don't know that diseases like diarrhea, hepatitis, and impetigo can also spread.

Contagious diseases are spread by germs. Germs are so small that you cannot see them without a microscope. Yet just a few germs on a hand or on a toy may be enough to spread a disease.
Germs spread through body secretions. Intestinal tract infections spread through stool. Respiratory tract infections spread through coughs, sneezes, and runny noses. Other diseases spread through direct contact.

People can spread germs without being sick themselves. A person with a disease is often contagious before he develops symptoms. Sometimes people, especially young children, spread disease germs to their families and caregivers without ever getting sick themselves. This means that steps to prevent diseases must be followed ALWAYS, not just when the person is obviously sick. It is inevitable: children will get sick. They will get sick whether or not they are in day care. There are steps parents and day care workers can take to keep ONE child's illness from spreading through the center to the other children, their families, and staff.

To prevent disease:
  • Exchange important information with your day care center director when you register your child for day care. Be sure to include where the child's parent(s) can be reached during the day, your family physician and hospital of choice, and a person to contact in the case of an emergency in case you can't be reached (a relative, a neighbor, or other dependable adult).
  • Provide the Center Director with any special information he or she should have about your child's medical history. For example: Has your child had any serious illnesses? Is your child taking any medication? Does your child have any allergies that you know of?
  • Every child must have a physical examination before entering child care. The Director will provide you with the health exam form (CH-205).
  • Provide the Center Director with a copy of your child's immunization record. Ask the Director to keep this record in your child's permanent folder.

Be sure your child receives all immunizations on schedule. Several diseases that used to be terrible problems for adults and children can now be prevented by immunization. This group includes measles, mumps, German measles (rubella or 3-day measles), polio, diphtheria, tetanus, whooping cough (pertussis), Haemophilus Influenza Type B (Hib) and Hepatitis B. Some people think these diseases no longer exist or are no longer problems. THIS IS NOT TRUE. Cases still occur. The reason these diseases are no longer widespread problems is that people are being IMMUNIZED. If people stopped getting these protective shots for themselves and their children, these diseases would once again become common problems.
Because young children in child care groups are likely targets for disease, ALL children in day care centers need to have ALL recommended immunizations to protect themselves, their families, the other children, and the center staff. Arrange to take your children to the doctor to receive these immunizations on schedule. Also, inform your Child Care Program when your child has received an immunization so his record can be updated. Your child cannot attend school, according to NYS Public Health Law (PHL) 2164, unless his or her immunization history is up to date, or in progress.

School Medical and Immunization Requirements for 2014-2015 (PDF)

Letters to Parents [re: Influenza Vaccine Requirement] (PDF) Other languages: [العربية] [বাংলা] [中文] [ Kreyòl ayisyen] [Français] [한국어] [Русский] [Español] [اردو] [ײִדיש]

How Parents Can Prepare Their Children for Influenza Season
Plan ahead:
Make provisions for alternate day care when your child is sick. Sooner or later all children get sick. This causes changes in plans and expectations, and makes life complicated, especially for working parents. The best way to be prepared for these unavoidable sick days is to plan ahead. Think ahead of time what your choices will be:

  • If you work during the day, find out your employer's sick leave policies.
  • If it is difficult for you to take time away from work, find an alternative caregiver. This might be a relative, a neighbor, a friend, or other dependable adult you could call when your child is too sick to be at the day care center.
When illness occurs:
  • Inform the Day Care Center if your child has been exposed to any contagious disease such as bacterial meningitis, chicken pox, diarrheal diseases (shigella, campylobacter, salmonella, giardia, E. coli), diphtheria, hepatitis A, measles, mumps, pertussis (whooping cough), pneumonia, and rubella (German measles). Certain diseases and conditions are reportable to the Health Department. If your child has been exposed to or has any of these illnesses, it must be reported by the health care provider and/or child care provider.
  • Keep your child at home if he or she develops any symptoms of contagious diseases. You may also want to consult a physician.
If your child develops any of the following symptoms:
  • Diarrhea (diarrheal diseases spread very easily among young children. If parents keep children with diarrhea at home, all children will get diarrhea less often).
  • Severe coughing (to the point where the child gets red or blue in the face and/or makes a high pitched croupy or whooping sound after he coughs).
  • Difficult or rapid breathing (this is especially important in an infant under 6 months old).
  • Yellowish skin or eyes (these may be signs of hepatitis).
  • Pinkeye (tears, redness of eyelid lining, irritation followed by swelling and discharge of pus).
  • Unusual spots or rashes
  • Sore throat or trouble swallowing
  • Infected skin patches (crusty, bright yellow, dry, or gummy areas of skin)
  • Unusually dark, tea colored urine
  • Grey or white stool
  • Headache or stiff neck
  • Vomiting
  • Unusual behavior (less active or cranky, cries more than usual, in general discomfort)
  • Loss of appetite
  • Severe itching of body or scalp or scratching of scalp
  • Fever (101 degrees or above)
Keep your child home until:
  • The symptoms disappear
  • Your physician decides he can return to the center without danger to himself or to the other children and staff

Keep your child at home if he or she is diagnosed as having any of the following contagious diseases. Some of the diseases on this list are common, others are rare among children who stay in day care or at home. The uncommon infections are included in this list so that information will be available should a case occur in your child's center.

DiseaseIs reported to the Health DepartmentWhen the Child Can Safely Return to the Center

Bacterial Meningitis or Viral Meningitis 

When the Health Department indicates it is safe.

Chicken Pox


One week after the rash begins, or when all chicken pox are scabbed over.



When he or she no longer has diarrhea.

Campylobacter, Cryptosporidiosis, E. coli 0157:H7, Giardia, Salmonella, Shigella

When your physician or the Health Department says it is safe.


When your physician tells you it is safe.

Hepatitis A

One week after the illness begins.



24-48 hours after symptoms resolve.


5 days after the rash appears.


After the swelling subsides (or 5 days after the swelling begins).

Pertussis (whooping cough)

4 week after intense coughing begins, or 5 days after antibiotic treatment begins.



When your physician tells you it is safe.