H1N1 Flu (Swine Flu): Information for Child Care Providers

CDC has identified cases of swine-origin influenza A (H1N1) virus infection in people from several states including California, Kansas, Texas, New York and other states (see updates at www.cdc.gov/swineflu). CDC is working with local and state health agencies to investigate these cases. It has been determined that this virus is spreading from human to human.
8 U  l( Y2 F7 `5 v- J& T% nMexico has reported increased levels of respiratory disease including reports of severe pneumonia cases and deaths.  The swine-origin influenza viruses identified by CDC from cases in Mexico are similar to viruses from patients in the United States.  As of April 29, 2009, of 91 patients identified thus far in the US, most have recovered, but five have been hospitalized and one patient, a child, has died.   However, the CDC is concerned about these cases in the United States and the World Health Organization are concerned about continued spread of this new virus.  Right now, there is no vaccine for this new virus and the current seasonal influenza is thought to be unlikely to provide protection against this new strain.
/ j3 L3 r. `! x5 A; n& h8 F$ bChild care providers in community based child care programs in all settings including both center-based and family child care programs should:

• Review their plans for responding to a pandemic.  Make sure that they are up to date and that parents know what they are.
• Remind parents and enforce policies for having ill children stay at home during their illness.  Children with symptoms of an influenza-like illness should not come to school.  Symptom of  influenza include fever, cough, sore throat, body aches, headache, chills, fatigue, and, in some cases diarrhea.  The child's health care provider will determine whether influenza testing is needed and when the child can return to child care.  In most areas, children with other, mild respiratory illnesses including allergies may  be allowed to attend child care as long they are able to participate comfortably and their care does not result in a greater need for care than the staff can provide without compromising the health and safety of the other children (Caring for Our Children- Standard 3.065).

• Remind workers not to come to work while if they have an influenza like illness.  They should consult their health care provider to determine whether influenza testing is needed.

• Health departments in areas where cases of persons affected with this new virus have been identified may recommend more rigid exclusion policies so providers will need to stay informed on what is happening in their communities.

• Child with influenza may be infectious for up to 10 days after illness onset with influenza while adults are thought to likely infectious for 5-7 days.  Public health investigators are working to more precisely learn the length of infectiousness.   If a child has been confirmed to have swine-origin influenza, then seek the advice of the child’s health provider and the health department about when the child can return to the child care program
• Be familiar with local/state plans for child care in the event of a mild or severe pandemic. This information may be available from state or local health authorities, child care licensing agencies or resource and referral agencies.  If these plans do not include specific approaches to communicate with and handle situations in child care, do what you can to advocate for updating the plans.Develop and implement a system to track illness and absence due to illness among children and staff if one is not already in place. The system should be simple and easy to maintain but should record the number of persons with various illnesses (e.g. respiratory, diarrhea, rash) by day or at least by week.  (see Caring for Our Children Standards 3.001 and 3.002 for information on how to do this  (http://nrckids.org/CFOC/PDFVersion/Chapter%203.pdf
  
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  - page 2) Review and implement CDC Guidelines and Recommendations for Preventing the Spread of Influenza (the Flu) in Child Care Settings: Guidance for Administrators, Care Providers, and Other Staff, (http://www.cdc.gov/flu/professionals/infectioncontrol/childcaresettings.htm)
• Make sure staff are familiar with the above guidelines and that they are being followed in your program.  Remind child care staff to clean/disinfect frequently touched surfaces within the facility.
• Provide information to parents on steps that they could take to prevent flu.  (See attached fact sheet that could be distributed to each parent or posted on a door to the facilities with providers calling attention to the posted fact sheet).Monitor the postings on the CDC web site about this virus (www.cdc.gov/swineflu) and information from state or local health departments to see if child care facilities should begin preparing for possible closure or changes in operation.
• Work with parents to consult the child’s health provider if you have questions about a child with a respiratory illness or if you suspect a child might have influenza.  Contact your child care health consultant or local public health department if you need help to make decisions promptly that affect the children as a group

Child care and preschool programs can help protect the health of their staff and the children and families they serve by calling attention to the every day preventive actions that parents can initiate to protect their children. (Please consider posting or distributing the attached message in your child care facility).
; x* ^: r# e( E9 H6 ~; h$ oMore information on preventing the spread of influenza can be found at: http://www.pandemicflu.gov/plan/school/preschool.html

                               
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. For generic information on disaster preparedness, see NACCRRA’s web site http://www.naccrra.org/for_parents/coping/disaster.php

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Additional generic planning information for child care programs and schools, including examples of state and local plans, can be found on the Department of Education's website at: http://www.ed.gov/admins/lead/safety/emergencyplan/pandemic/index.html

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Note:  Conditions and situations are rapidly changing and these recommendations may change over time.

CDC已经从包括加利福尼亚州、堪萨斯州、德克萨斯州、纽约州和其他各州的人群中确诊了由猪来源感染的A型流感病例（更新请看www.cdc.gov/swineflu）。CDC正在与当地和各州的卫生保健所合作，共同调查这些病例。已经证实这种病毒可以进行人际传播。
: m/ k/ C1 E3 [7 V0 b    墨西哥已经报道了更高级别的呼吸系统疾病，包括重度肺炎和死亡病例。CDC从墨西哥病例中确定的猪源性流感病毒和美国病例所患的病毒相类似。截止至2009年4月29日美国确诊的91位病人，大多数都已康复，但是其中5例进行了入院治疗，一例患者，一名儿童死亡。但是，CDC和WHO很担心这些病例和这种新病毒的继续传播。现在针对这种新病毒还没有有效的疫苗，而且当前的季节性流感也不认为会对这种新菌株提供保护作用。基于社区的儿童保育项目，包括基于中心的项目和家庭儿童保育项目，中的儿童保育服务提供者应该：
    检查应对大流行的计划。确保它们实时更新，同时确保父母都知道它们是什么。
  w4 j5 _! I  i/ y" @7 F    提醒父母和加强各种政策使处于生病期间的儿童呆在家中。有流感样症状的儿童不应来学校上学。流感症状包括发热、咳嗽、喉咙痛、躯体疼痛、头痛、寒战、疲劳，在有些病例中还会有腹泻症状。儿童的健康保健提供者会决定是否需要进行流感检验和此儿童何时可以返回儿童保育中心。在大多数情况下，患有其他较轻的呼吸系统疾病如过敏等疾病的儿童可以出席儿童保育中心的活动，只要他们能够舒适地参与同时在不损害其他儿童健康和安全的前提下，他们的受照顾程度不能超出员工能够提供的范围（照顾我们的孩子——标准3.065）。
    提醒员工如果出现流感样症状的疾病，则不要来上班。他们应当咨询他们的健康保健提供者以决定是否需要进行流感检验。
2 U; |( s5 Y' }' ~% G. W    被确诊为感染了这种新病毒的病例所在地区的卫生部门会建议采取更加严格的排除政策，以便提供者时刻知道其社区都发生了什么。
! p' w% _% e7 T) \& z$ n: {3 y' |    患有流感的儿童在发病起10日内有传染性，而成年人被认为在5到7内有传染性。公共卫生研究者正在研究更精确的传染期长短。如果一个儿童被证实感染了猪流感，那么请寻求其健康保健提供者和卫生部门的建议，决定此儿童何时可以返回儿童保育程序中。
2 D: C4 c. L1 D# `, Y/ i* U    熟悉在较轻或严重的大流行情况下，当地与各州为儿童保育所制定的计划。这些计划的信息可以从当地或各州的卫生当局、儿童保育执照颁发处和资源与分配代理处获得。如果这些计划中不包括如何交流与处理儿童保育中的情况，尽你所能去支持这些计划的更新。如果没有的话，请制定和实施一套系统以便追踪生病和因生病而缺席的儿童和员工。此套系统应当可以被简单地维持，但是也应当每日或至少每周对患有各种疾病（例如呼吸系统疾病、腹泻、出疹等）的人员进行记录（关于如何进行记录的相关信息，请参见照顾我们的孩子——标准3.001和3.002）(http://nrckids.org/CFOC/PDFVersion/Chapter%203.pdf - page 2)请检查和实施CDC制定的在幼托环境下如何防治流感流行的指导方针和建议：对管理人员、服务提供人员和其他员工的指导。(http://www.cdc.gov/flu/professio ... ildcaresettings.htm)
     确保员工熟悉以上的指导方针，并在项目中得以实施。提醒在儿童保育员工对房间内的接触表面进行经常的清洁和消毒。
5 T6 x2 T- ?" `6 ]+ m# b+ o4 z4 e   向家长们提供可以预防流感的相关步骤的信息 (请查看附加的可以分发到每位家长或张贴在门上的资料 with providers calling attention to the posted fact sheet) 。请留意CDC网站上关于此病毒的宣传和当地或各州卫生部门提供的信息以便决定幼托机构是否要开始为可能的关闭措施和运营改变做准备。
如果你对某个患有呼吸系统疾病的儿童存有疑问或怀疑某个儿童可能患有流感，请与家长合作共同咨询儿童的健康保健提供者。如果你在对儿童群体做出适当决定的过程中需要帮助的话，请联系你的儿童保育健康顾问或当地公共卫生部门。
    儿童保育和学前项目可以通过对每日预防措施引起注意，而起到保护其员工、儿童和他们所服务家庭的健康的目的。（请考虑在你的儿童保育机构张贴海报或分发附加信息的方式）。
更多关于防治流感流行的信息可以在以下地址找到：
3 O. {. j. A% ahttp://www.pandemicflu.gov/plan/school/preschool.html
关于灾难防备的一般信息，请看NACCRRA的网站：
" Z& r* G& a. C8 c" N$ a5 Ahttp://www.naccrra.org/for_parents/coping/disaster.php
" R0 ?, `9 R! i8 r) M3 p额外的关于儿童保育项目和学校的一般规划，包括当地和各州规划的例子，可以在教育部网站上找到：
% r) Y, |% ]5 bhttp://www.ed.gov/admins/lead/sa ... pandemic/index.html
" S3 N- I9 ~. h, @% v& E  w" |备忘：情况在紧急地发生变化，因此这些建议可能随着时间而发生改变。

有半句话没翻 呵呵 :lol
望各位大侠指正 感谢！