Recommended Strategies Under Conditions Similar to Spring 2009

  • Get vaccinated against the flu
    The best way to protect against the flu — seasonal or 2009 H1N1 — is to get vaccinated. A vaccine will be available this year, as it is each year, to protect against seasonal influenza. Vaccine to protect against the 2009 H1N1 flu virus is currently in production, and initial doses are expected to become available later in the fall.
  • Stay home when sick
    Children and caregivers with flu-like illness should remain at home and away from others until at least 24 hours after they are free of fever (100° F ) or signs of a fever, without the use of fever-reducing medications. Epidemiologic data collected during spring 2009 found that most people with 2009 H1N1 flu who were not hospitalized had a fever that lasted 2 to 4 days; this would result in an exclusion period of 3 to 5 days after onset of symptoms in most cases. CDC recommends this exclusion period whether or not antiviral medications are used. Early childhood programs, parents, or state and local health officials may elect to require longer periods of exclusion.
  • Conduct daily health checks
    Early childhood providers conducting daily health checks should observe all children and staff and talk with each child's parent or guardian and each child. He or she should look for changes in the child's behavior, a report of illness or recent visit to a healthcare provider, and any signs or symptoms of illness. During the day, staff also should identify children and other staff who may be ill. Ill children and staff should be further screened by taking their temperature and inquiring about symptoms.
  • Separate ill children and staff
    Children and staff who develop symptoms of flu-like illness while at the early childhood program should promptly be separated from others until they can be sent home. While this may be challenging for some home-based providers, they should provide a space where the child can be comfortable and supervised at all times. Staff members who develop illness while at work should wear a surgical mask when near other persons when possible and if they can tolerate it. Early childhood providers who care for persons with known, probable, or suspected influenza or flu-like illness should use appropriate personal protective equipment.
  • Encourage good prevention techniques of both people who are well and those who have flu symptoms.
    Wash hands frequently with soap and water when possible; keep hands away from your nose, mouth, and eyes; and cover noses and mouths with a tissue when coughing or sneezing (or a shirt sleeve or elbow if no tissue is available). For children with emerging self-care skills, parents and caregivers should closely monitor their respiratory etiquette and hand hygiene and remind children not to share cups or eating utensils.
  • Perform routine environmental cleaning.
    Areas and items that are visibly soiled should be cleaned immediately, and all areas should be regularly cleaned — with a particular focus on items that are more likely to have frequent contact with the hands, mouths, and bodily fluids of young children (for example, toys and play areas). The CDC does not believe any additional disinfection of environmental surfaces beyond routine cleaning is required.
  • Encourage early treatment for children and staff most vulnerable to complications from the flu.
    Staff among the priority groups for receiving vaccination when it first comes out and parents of children under age 5 who become ill with flu-like illness should call their healthcare provider as soon as possible to determine if they need antiviral treatment. Early treatment (within 48 hours of the onset of illness) with antiviral medications can decrease the risk of severe illness from influenza.
  • Consider selective child care facility closures.
    If flu transmission is high, some communities or early childhood programs may consider temporary closures with the goal of decreasing the spread of flu among children less than 5 years of age. The decision to selectively close should be made locally in partnership with public health officials and should balance the risks of keeping the children in early childhood programs with the social and economic disruption that can result from closing these programs.