Infectious Diseases For Pregnant Educators Working In Childcare

Educators and other staff who are pregnant need to be aware of how some infections can affect their unborn child. If a staff member is pregnant, it is even more important than usual for the education and care service to make sure that all staff are following good infection control practices. The following article provides information on infectious diseases that could affect pregnant women and the preventative measures Educators should take and risk management during pregnancy.

Cytomegalovirus (CMV)

CMV infections can cause serious birth defects. The highest risk to the unborn child is during the first half of the pregnancy. CMV infection occurs in 1% or less of pregnancies and, of these cases, less than 10% of infants are likely to have a severe illness. CMV can spread through infected urine and saliva. Women of childbearing age working with young children should pay particular attention to good hand hygiene after contact with body secretions, especially after changing nappies or assisting in toilet care.

Responsibilities Of Educators and Other Staff

• Ensure that staff wear disposable gloves for activities involving contact with urine, such as changing nappies.
• Make sure staff and children practise effective hand hygiene, especially after handling articles contaminated with urine or saliva, and after changing nappies.
• Where practicable, relocate pregnant women to work with older children to reduce their contact with urine and saliva.
• Inform staff who are pregnant or considering pregnancy about CMV risks and how to protect against infection.
• Ensure that appropriate cleaning practices are being followed in the education and care service.

Hand, Foot and Mouth Disease

Hand, foot and mouth disease is rare in adults. It is not a serious illness; infection with the virus that causes it often produces mild symptoms or no symptoms at all. The risk associated with this disease during pregnancy is low; however, in extremely rare cases, it can cause miscarriage. If the mother becomes infected shortly before giving birth, she can pass the infection on to the baby. Most infants born with hand, foot and mouth disease have mild symptoms, but complications in very rare cases can affect the infant’s organs. Pregnant women should consider strategies to reduce their risk of infection, including regularly performing effective hand hygiene.

Responsibilities of Educators and Other Staff

• Advise the parent to keep the child home until they are feeling well and all blisters have dried.
• Make sure staff and children practise cough and sneeze etiquette and hand hygiene.
• Ensure that appropriate cleaning practices are being followed in the education and care service

Human parvovirus B19

Infection with human parvovirus B19 generally causes a mild illness. However, if a pregnant woman is infected, the virus may be transmitted to her unborn baby.
In less than 5% of these cases, the virus may cause severe anaemia (low red blood cell count) in the baby, resulting in miscarriage. The risk of miscarriage is highest if the mother is infected during the first half of pregnancy. Infants who survive if the mother is infected do not have birth defects. Pregnant women should consider strategies to reduce their risk of infection, including regularly performing effective hand hygiene.

Responsibilities Of Educators and Other Staff

• Advise the parent to keep the child at home until they are feeling well.
• Make sure staff and children practise cough and sneeze etiquette and hand hygiene.
• Ensure that appropriate cleaning practices are being followed in the education and care service.

Listeriosis

Listeriosis is caused by bacteria (Listeria monocytogenes) and can be spread through foods such as soft cheeses and pre-cooked meat products (e.g. pâté and deli meats), along with many other types of food. It can cause a range of symptoms; if a pregnant woman is infected, it can cause miscarriage, stillbirth or premature birth. Infants born to infected mothers can also suffer a range of complications. Pregnant women can reduce their risk of exposure to Listeria by avoiding raw or partially cooked foods, and ensuring that raw fruit and vegetables have been washed in clean water.

Responsibilities Of Educators and Other Staff

• Advise the parent to keep the child home until they are feeling well.
• If an educator or other staff member is ill, they should stay at home until they are feeling well.
• Make sure staff and children practise effective hand hygiene, especially after handling food.
• Inform staff who are pregnant or considering pregnancy about listeriosis risks and how to protect against infection.
• Ensure that appropriate cleaning practices are being followed in the education and care service.

Rubella (German measles)

Rubella is a vaccine-preventable disease that usually causes mild illness in children. However, if expectant mothers are infected during the first 20 weeks of pregnancy, their infants may have severe birth defects. This risk is highest in early pregnancy. If non-immune mothers catch rubella in the first 10 weeks of pregnancy, their baby will have up to a 90% chance of having rubella-associated problems. Defects are rare if the mother is infected with rubella after the first 20 weeks of pregnancy. Anyone who works with children should be immunised against rubella, or be certain that they are immune to rubella by having a blood test.

Responsibilities Of Educators and Other Staff

• Contact your local public health unit for advice.
• Review vaccination records.Ensure that children have received one or two doses of measles–mumps–rubella (MMR) vaccine, depending on their age. The public health unit can advise if any children who have not been vaccinated will need to be excluded.
• Make sure staff and children practise cough and sneeze etiquette and hand hygiene.
• Ensure that appropriate cleaning practices are being followed in the education and care service.

Toxoplasmosis

Toxoplasmosis is a disease caused by a parasite. The disease can result in birth defects. If the mother becomes infected during pregnancy, the parasite can pass through the placenta to the developing baby. There is no risk to the baby if the mother has had the disease before pregnancy—a blood test will show if the mother is immune. If the mother is not immune, consider strategies to minimise the risk of infection, including regularly performing effective hand hygiene, washing and peeling fruit and vegetables before eating, and wearing gloves when gardening. Toxoplasmosis can be spread by mammals (especially cats) and birds; non-immune mothers should avoid contact with cats whose feeding history is unknown, and they should not clean cats’ litter trays. Educators and other staff have the same risk of contracting toxoplasmosis as other people.

Varicella (chickenpox)

Infection with varicella in the first 3 months of pregnancy may damage the unborn child. Pregnant women who are exposed to varicella at any stage of the pregnancy should seek medical advice within 48 hours. If the woman does not already have antibodies against the virus, the medical professional will give an injection of antibodies (known as varicella-zoster immunoglobulin, or VZIG). Most people have had varicella as a child and will not get it again. Anyone who works with children and has not previously been infected with varicella should be immunised, or be certain that they are immune to varicella by having a blood test Varicella is a vaccine-preventable disease; however, varicella vaccination is not recommended during pregnancy, and pregnancy should be avoided for 1 month after having a varicella vaccination.

Responsibilities of educators and other staff

• Advise the parent to keep the child home until all blisters have dried.
• If an educator or other staff member has varicella, they should stay home until all blisters have dried. Make sure staff and children always practise effective hand hygiene.
• Ensure that appropriate cleaning practices are being followed in the education and care service.
• Advise pregnant women to avoid contact with people who have varicella. Vaccination for varicella during pregnancy is not recommended, and pregnancy should be avoided for 1 month following varicella vaccination. If pregnant staff members are concerned, refer them to their doctor.

Risk Management During Pregnancy

Pregnant women could be relocated within the service to reduce their risk of exposure to diseases that can harm their unborn babies. For example, if an educator who usually works in the infant's room becomes pregnant, she could be relocated to a preschool room, where she is less likely to be exposed to cytomegalovirus through nappy changing and feeding.

Here are a few tips for staying comfortable at work.

Avoid nausea triggers – Now that you are pregnant even the smell of foods can make you run to the nearest bathroom. Even a colleague might be making lunch and your tummy will begin to have uneasy. Stay clear of anything that may trigger nausea.

Snack often – Crackers and other bland foods can be lifesavers when you feel nauseated. Keep a stash at work for easy snacking. Ginger ale or ginger tea may help, too.

Drink plenty of fluids – It's important you drink enough fluids throughout the day if not your nausea may end up getting worse. Keep a water bottle at your desk or in your work area and sip throughout the day.

Take short, frequent breaks – Getting up and moving around for a few minutes can really benefit you. Spending a few minutes with the lights off, your eyes closed and your feet up also can help you recharge, and take a catnap at work if necessary.

Keep up your fitness routine – Although exercise may be the last thing on your mind at the end of a long day, physical activity may help boost your energy level — especially if you sit at a desk all day. Take a walk after work or join a pregnancy fitness class, as long as your doctor gives you the “all clear”.

Sitting – Make sure if you spend all day sitting at work that you are comfortable and the seat has adjustable armrests, a firm seat and back cushions, and good lower back support — especially as your weight and posture change. If your chair isn't adjustable, improvise. Use a small pillow or cushion to provide extra support for your back.

Standing – Prolonged standing can cause blood to pool in your legs, which may lead to pain or dizziness. It also puts pressure on your back. If you must stand for long periods of time, put one of your feet up on a footrest, low stool or box. Switch feet every so often, and take frequent breaks. Wear comfortable shoes with good arch support. Consider wearing a support hose, too.

Bending and lifting – Proper form can spare your back, even if you're lifting something light. Bend at your knees, not your waist. Keep the load close to your body, lifting with your legs — not your back. Avoid twisting your body while lifting. Ask for help when lifting heavy objects.

Don't forget to talk to your employer about work during pregnancy once you have found out that you are pregnant to see what options are available to you. Please, if you have any concerns regarding your working environment or about pregnancy and your job, talk to your doctor.