H1N1 Updates from King County Health

Sep 10, 2009

Public Health - Seattle & King County would like you to know that the Centers for Disease Control has completed its H1N1 ("Swine") Flu toolkit for child care and other early childhood programs: http://www.cdc.gov/h1n1flu/childcare/toolkit/

This extensive document includes:

  • Questions and Answers
  • Fact Sheet for Early Childhood Program Providers
  • 3 Fact Sheets to Inform Parents
  • Poster for Child Care Centers to Remind Parents to Keep Sick Children at Home
  • Template Letters (or E-mails) to Send to Parents
  • Additional Communication Resources for Child Care and Early Childhood Programs


Much of the current advice is the same as our guidance in the spring and is similar to the precautions you may take every day.

One key difference is illness exclusion:
Based on current flu conditions, early childhood program staff and children with flu-like illness should stay home until at least 24 hours after they no longer have a fever (100 degrees Fahrenheit or 37.8 degrees Celsius measured by mouth *) or signs of a fever (have chills, feel very warm, have a flushed appearance, or are sweating). This should be determined without the use of fever-reducing medications (any medicine that contains ibuprofen or acetaminophen). This is a shorter time period from the previous guidance which recommended that sick early childhood program providers and children stay home 7 days after symptoms begin.

*or 101 degrees measured under the arm

Other recommendations for early childhood programs:  (Please see the website above for further information on each of these.)

    • Encourage all early childhood program staff to get vaccinated for seasonal flu and 2009 H1N1 flu in accordance with CDC recommendations.
    • Educate and encourage staff and children to cover their mouth and nose with a tissue when they cough or sneeze.
    • Remind staff and children to practice good handwashing.
    • Remind staff to stay home and parents to keep a sick child at home when they have flu-like symptoms.
    • Perform a daily health check of children and make sure that contact information for parents is up-to-date.
    • Move sick children or staff to a separate, but supervised, space until their parents can take them home.
    • Send sick staff home immediately and advise them not to return until at least 24 hours after they no longer have a fever or signs of a fever (without the use of fever-reducing medicine).
    • Routinely clean, rinse, and sanitize surfaces and items that children frequently touch with their hands, mouths, and body fluids.
    • Encourage early medical evaluation for children and staff at higher risk of complications from flu.
    • Consider temporarily closing the early childhood program if flu transmission is high in the community.


(If the flu conditions become more severe, additional steps are recommended.)

Please note that many children, staff, and families in early childhood programs are in priority groups for vaccination against 2009 H1N1 flu.  The highest priority groups include:

- pregnant women,
- people who live with or care for children younger than 6 months of age,
- health care and emergency medical services personnel with direct patient contact,
- children 6 months through 4 years of age, and
- children 5 through 18 years of age who have chronic medical conditions

The H1N1 vaccine is expected to be available beginning in mid-October.  The seasonal flu vaccine is recommended for all and is already available from some health care providers and other sources.

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