Childhood infections: minimising the spread

Infections are very common in young children. In fact, it’s not unusual for a preschool child to have up to 10 infections per year. That’s because they are in frequent close contact with many other children, and infectious illnesses can spread easily from person-to-person. Very young children tend to put things in their mouths and frequently touch their faces, making infections even more likely.

Children also tend to get a lot of infections because their immune systems (which fight infection and disease) are not fully developed. Fortunately, most infections will not be serious.

Common childhood infections

Infections that commonly affect children are caused by a variety of germs, including bacteria, viruses, fungi, mites and parasites.

These germs can enter the body through the eyes, nose and mouth and through broken skin.

Catching infections

One of the most common ways of passing an infection to others is through sneezing and coughing. When an infected person sneezes or coughs, they spray infected droplets into the air. If you breathe in these droplets you can catch the infection. This is known as droplet transmission, and it’s one of the ways the common cold is spread.

Another common way of getting infections is through direct contact. The contact can be with an infected person or a contaminated object. Direct contact with someone who has head lice or a skin infection often results in infection. Touching a contaminated surface (such as a door handle, toy or benchtop) and then touching your eyes, nose or mouth can also lead to infection. Some germs can linger on surfaces for hours, or even days. You catch infections such as the colds and flu in this way.

Some conditions are highly contagious and can be passed from one person to another very easily. For example, people can catch measles and chickenpox just by being in a room or space that an infected person has recently been in. But remember, only people who are not immune (either through vaccination or having previously had the illness) can catch measles or chickenpox.

Stopping the spread of infections

The 3 most effective ways of stopping childhood infections spreading are vaccination, exclusion (staying at home when you are sick), and hand washing.

Getting vaccinated

Immunisation is the most effective way of protecting children against many common and serious childhood infections. Immunisation not only helps to protect your child against particular infections, but also helps to stop the spread of these diseases in the community.

So by having your children vaccinated, you are not only protecting them, but also protecting children who are too young to be vaccinated and those with medical conditions that mean they cannot be vaccinated.

There are some side effects of immunisation, but the most common side effects are very mild and only last a day or two. Serious reactions to immunisations are rare. If you have specific questions about immunisation, talk to your doctor.

Staying at home when you are sick

When your child is sick, they should stay home from school or childcare. It’s the best way for them to rest and get better. If they have a contagious illness, staying away from others will also help stop the spread of infection.

There are guidelines, published by the Australian Government and the National Health and Medical Research Council (NHMRC), recommending the length of time that children should stay home when sick with an infectious condition. Your doctor can advise you when your child can go back to school or day care.

Because some infectious illnesses can still be contagious even after you’ve recovered, children may be asked to remain at home for a certain period of time after they are feeling better. For example, if you’ve had gastroenteritis caused by norovirus, you can still shed virus for several days after you feel better and infect other people. You should remain at home and not be involved in food preparation for other people for at least 48 hours after symptoms have disappeared.

Similarly, some infections are contagious before symptoms develop. Children who have been exposed to certain infections may be asked to remain at home until it can be confirmed that they do not have the infection to reduce the possible risk of spread. This precaution is usually only necessary for unimmunised children when there is an outbreak of a vaccine-preventable illness.

Washing your hands

One simple yet important way to help prevent the spread of infection is by keeping your hands clean. Always wash your hands after blowing your nose, wiping a child’s nose, going to the toilet and changing a child’s nappy, and wash them before preparing food and eating. Children should be taught to wash their hands properly from an early age.

Washing your hands properly requires soap and running water. Regular soap is recommended (for example a bar of soap or liquid soap in a pump pack). Antibacterial soaps are not necessary. Lather the soap and rub it over every part of your hands, including the wrists, under your nails and between your fingers.

Properly drying your hands after washing them is also important because hands that are still damp can pick up many more germs than dry hands. Drying your hands can also help remove any germs that were not rinsed off during hand washing. Use a clean towel to dry your hands. The whole process of washing, rinsing and drying your hands should take just under a minute or so.

If you find that regular hand washing dries out the skin on your hands, try using cold water rather than hot, a plain (non-fragranced) soap, wetting your hands before applying soap and moisturising your hands regularly.

Alcohol-based hand rubs (hand sanitisers)

Alcohol-based hand rubs, or hand sanitisers, can be useful when you are out and about and don’t have access to soap and running water. Hand sanitisers can be purchased from supermarkets and chemists, and should be used according to the instructions on the pack. Apply the amount suggested to dry hands and rub all over the hands until they are completely dry.

Alcohol-based hand rubs are toxic when ingested and are highly flammable, so keep them out of the reach of children. Always carefully supervise children when using these products, as they can be harmful if you get some in your eyes, nose or mouth.

While hand sanitisers can reduce the number of germs on your hands, they won’t clean them if they are visibly dirty or sticky. Hand washing is best for cleaning hands.

Other ways to minimise the spread of infection

Cover your sneezes and coughs. When people cough and sneeze, they can spread tiny infected droplets a surprisingly long way. By covering your mouth and nose with a tissue you can help stop this spray of germs. Make sure you throw any used tissues in the bin and wash your hands afterwards. Children should be encouraged to do this from an early age.

Don’t use your hands to cover coughs and sneezes because germs can get on your hands, which you may then unknowingly pass on to others (for example through shaking hands or via objects that you have touched, such as door handles). If you don’t have a tissue, use the inside of your elbow.

Cover up skin cuts and abrasions with band-aids or bandages to keep them clean and reduce the risk of infection.

Clean household surfaces regularly, especially in the kitchen and bathroom. Wipe surfaces with a cloth that has been soaked in detergent and water, then rinse and dry the surface. Disinfectants may also be needed as well if the surface was contaminated (for example, if used tissues were left there) or if several members of the household are unwell.

Should I choose products that are antibacterial?

Antibacterial soaps are not needed for regular hand washing. They don’t do a better job of cleaning your hands than regular soap, and they don’t provide any additional benefit in terms of minimising the spread of infections when used day to day. Worse still is the possibility that over-use of antibacterial products may contribute to antibiotic resistance and reduce the numbers of ‘good’ bacteria that are actually good for our health.

Antibacterial or antimicrobial cleaning products are similar - they don’t offer any real benefit over regular cleaning products for use in people’s homes, and are often more expensive.

So unless your doctor has recommended using antibacterial soap or cleaning products, stick to regular soap/detergent and warm water.

References

1. National Health and Medical Research Council. Staying healthy: Preventing infectious diseases in early childhood education and care services, 5th edition. Canberra: NHMRC, 2012 (updated June 2013). https://www.nhmrc.gov.au/guidelines-publications/ch55 (accessed Apr 2018).
2. Centers for Disease Control and Prevention (CDC). Stopping the spread of germs at home, work and school. https://www.cdc.gov/flu/protect/stopgerms.htm (accessed Apr 2018).
3. Hand hygiene Australia. What is hand hygiene? http://www.hha.org.au/abouthandhygiene.aspx (accessed Apr 2018).
4. NPS Medicinewise. Hand sanitisers: hygiene in a bottle (15 Apr 2016). https://www.nps.org.au/medical-info/clinical-topics/news/hand-sanitisers-hygiene-in-a-bottle (accessed Apr 2018).
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