Kids share everything, including germs. When there’s something going around at daycare, the temptation to kids home can be too much. Daycare providers often choose to send mildly ill children home so they don’t spread it to others, but their extra efforts may be useless.

“By the time (children) start showing symptoms, the cat’s already out of the bag,” study author Dr. Andrew Hashikawa of the Medical College of Wisconsin told Health Day. By then, chances are the bug has already spread.

The survey included responses of 305 directors of metro daycare facilities in Milwaukee, Wisconsin. Surveyors from the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA) briefly described five different illnesses—a cold, conjunctivitis (pink eye), stomachache, fever, and a scalp infection—to directors of childcare facilities to test their knowledge of excluding sick children from daycare.

Based on AAP/APHA guidelines, none of these situations should result in exclusion from daycare, but directors would send as many as 4 out of 5 children home. Although the state has promoted exclusion guidelines to childcare facilities since the nineties, only 38 percent of these directors were aware of the AAP/APHA’s exclusion guidelines.

“If the directors of child care facilities and centers are well-educated and understand the recommended guidelines, then it’s fairly clear which children should stay and which should go home,” Hashikawa said. “This study highlights the need for ongoing training.”

Read the original story on Health Day, or check out AAP/APHA’s book of guidelines on managing ill children in a daycare or school setting.

The more you know about the real cause of ringworm, the better you can prevent it. You may think that ringworm is caused by a worm. Makes sense, “worm” is a part the disease’s name. Actually, ringworm has nothing to do with worms. Instead, ringworm is a skin infection caused by a fungus. The name comes from the red ring that can appear on an infected person's skin. A ringworm infection can occur on the scalp, body, groin, feet, and nails. When it occurs on the feet, it is called athlete’s foot and when it occurs in the groin it is called jock itch.

Ringworm infections on all parts of the body are caused by a group of fungi called dermatophytes, which includes several different species. Dermatophytes live among the outer portion of the skin or on hair where they feed on the keratinized cells found in the upper layers of the epidermis. Any of these parasitic species may colonize skin that is warm and moist and they tend to grow best in places like locker rooms and swimming pools.

Ringworm is highly communicable and can spread in several ways. It can be passed from person to person via direct, skin-to-skin contact with an infected person and can also spread when you share things like clothing or towels. Ringworm can be passed to people by infected animals including dogs, cats, rabbits, goats, and horses. The fungi can also be spread by contact with object or surfaces that were touched by an infected person or animal or, in rare cases, by contact with infected soil. If one part of your body is infected with the fungus that causes ringworm, it may spread from there to other body parts.

Sometimes ringworm causes a skin pattern in the shape of a ring, but not always. It is often just a red, itchy rash. Most ringworm of the skin can be treated at home with over-the-counter creams. If ringworm is not treated, the skin could blister, and the cracks could become infected with bacteria. If this happens, your doctor will need to prescribe antibiotics.

To help prevent ringworm, the National Institutes of Health recommends the following tips:

• Keep your skin and feet clean and dry.
• Shampoo regularly, especially after haircuts.
• Do not share clothing, towels, hairbrushes, combs, headgear, or other personal care items. These items should be thoroughly cleaned and dried after use.
• Wear sandals or shoes at gyms, locker rooms, and pools.
• Avoid touching pets with bald spots.

Do you have a question about ringworm? Join Healia's health social networking site and talk with other members of the Skin Disease Community. Or you can Ask the Experts at Healia Health Communities.


_{Photo: CDC/Dr. Lucille K. Georg, Public Health Image Library}

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