Paeds SAQs · preventive-and-community-paediatrics
Childcare attendance, exclusion and infection prevention — formative SAQs
Formative SAQs on exclusion principles, infection prevention and outbreak response in early childhood education and care.
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Target exams
SAQ 1 (10 marks)
A parent of a 2-year-old in full-time childcare asks for advice after the centre sent the child home with diarrhoea and vomiting. The child is now drinking well at home. [9]
- List the three principle-level reasons a child should be excluded from childcare. (3) [11] [12]
- Outline the infection-prevention measures you will recommend for the centre and the household. (4) [3] [4]
- How will you decide the return-to-care timing for gastroenteritis, and what must you avoid in any certificate? (3) [11] [12]
Model answer
1. Exclude when the child is too unwell to participate; when staff cannot provide care without compromising others; or when a pathogen-specific infectious period still applies under local guidance. [11] [12]
2. Emphasise hand hygiene after toileting/nappy change and before food; environmental cleaning of bathrooms and mouthed toys; stay home while symptomatic; avoid sharing cups/towels; staff should not work while infectious; reinforce immunisation as structural prevention. [3] [4] [1]
3. Map to the local exclusion table symptom-free interval (often framed around 24–48 hours free of diarrhoea/vomiting — quote the current local source, do not invent). Certificate should state clinical facts and the criterion used; do not claim absolute non-infectiousness, invent negative tests, or prescribe antibiotics solely for clearance. [9] [11] [12]
You have read the opening of this SAQ. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.
References8Show ledgerHide ledger
- [1]Donoghue EA Quality Early Education and Child Care From Birth to Kindergarten. Pediatrics, 2017.PMID 28771418
- [3]Black RE Handwashing to prevent diarrhea in day-care centers. American journal of epidemiology, 1981.PMID 7211827
- [4]Roberts L Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled trial. Pediatrics, 2000.PMID 10742314
- [9]Mattison CP Childcare and School Acute Gastroenteritis Outbreaks: 2009-2020. Pediatrics, 2022.PMID 36278284
- [10]Schulz C Outbreak investigation of norovirus gastroenteritis in a childcare facility in Central Queensland, Australia: a household level case series analysis. Communicable diseases intelligence (2018), 2024.PMID 39165020
- [11]Richardson M Evidence base of incubation periods, periods of infectiousness and exclusion policies for the control of communicable diseases in schools and preschools. The Pediatric infectious disease journal, 2001.PMID 11332662
- [12]Czumbel I Management and control of communicable diseases in schools and other child care settings: systematic review on the incubation period and period of infectiousness. BMC infectious diseases, 2018.PMID 29716545
- [14]Dobbins JG The risks and benefits of cytomegalovirus transmission in child day care. Pediatrics, 1994.PMID 7971042