Nathalie Thibault's bachelor's degree in Microbiology and master's degree in Immunology make her a germ and immune system specialist. Since the birth of her two daughters, she has been particularly interested in the infections which affect children who attend daycare. She is a teacher, speaker, and author. The specialized documents and courses she conceives help those involved in early childhood outsmart germs. She writes for a magazine called La Culbute and the mamanpourlavie.com website.

Infect-Aid Column

Note: This column may be photocopied. It must be contagious... Of course, remember to mention the source of contamination.

Flu pandemic: surveillance

Fall is here and the increased number of flu cases is being announced everywhere due to the pandemic. Several articles are published at all hours of the day and it is impressive to see how quickly information is distributed throughout the Internet. What about your daycare? Do you have any cases? If I asked you, today, would you be able to tell me the number of probable cases you will have? Most would not know what to say. Every time a daycare is faced with an infectious problem and requests our services, we ask how many children are affected. Is this number increasing or decreasing? Which group is affected? Etc. I am sure you can imagine that the responses are quite evasive.

To be an efficient flu virus enemy, surveillance is necessary. How can we succeed without microscopes and tests? We must observe and jot down our results. Several daycares (too few) already do this! Some are able to tell us exactly how many cases of gastroenteritis they recorded this year, how many cases of fever, how many days of exclusion, how many cases of pediculosis, etc. Excellent, they can therefore, from one year to the next, determine their "infectious" score.

Why is it that we keep records of all incidents in daycares, but not infectious incidents? Throughout this exceptional period, when germs are luring us into a particular battle, it is appropriate to evaluate children's state of health daily. Why? We must make decisions based on facts as opposed to fear, rumors, impressions, and panic. Panic is highly inefficient when it comes to germs. It reduces the strength of our immune system. Normally, a weekly chart is sufficient but when gastroenteritis strikes or during the pandemic, daily surveillance is required.

I suggest you do like the rare daycares mentioned above and keep records of the daily infectious situation of your daycare. Several options exist: a simple sheet of paper, a homemade chart, a calendar, or one of the models we have prepared for you. It's simple. Each caregiver uses the sheet of paper to record the state of health of each child upon his arrival as well as any information the parent may have provided. Around 8:30-9:00 a.m., this sheet is sent to the daycare directors for control. The directors will decide at this time of any actions which must be taken depending on the information collected. You may think this is exaggerated and too much work. Of course, but as I often say during courses related to the pandemic, an exceptional situation requires exceptional measures...

Why is surveillance and counting the number of cases necessary since public health officials are no longer doing it?

First of all, it is more difficult to watch less than 100 children (for most daycares) than six million Quebecers! Early detection of infected children also makes room for the use of preventive measures (hygiene and disinfection) and offers us the chance to isolate sick children who are contagious (exclusion). Keep in mind that children can be extremely affected by the flu! The faster we act, the better are our chances of limiting the damage! We use this exercise for gastroenteritis epidemics and the results are impressive.

Why wait for half of the children in your daycare to be sick before asking questions and taking action? Information is the key to success when it comes to germs. Infections prevention is a science which requires action.

Nathalie Thibault 

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