If you have already chosen your favorite brand of hand sanitizer, cough into your sleeve, and greet people not with a hand shake but with a fist bump, then you are painfully aware that it's flu season.
Simply mention the letters, H1N1 and the talk moves to the fear of a wide-spread pandemic on a global scale. The H1N1 flu virus affects many populations, but one of the most vulnerable groups is the very young, which is why children under age five are a target for prevention. Many of those young Iowans spend their parents' work days at child care centers where prevention is critical.
Sally Clausen, Iowa Department of Public Health: "Child care businesses really have a very critical job. In Iowa we have one of the highest percentages in the nation where the parents are working, and parents are working often more than one job, the child might be spending nine hours of day in child care."
Shining Stars Child Development Center has two sites; both are located in Pleasant Hill, just east of Des Moines. The centers have a combined staff of nearly 100 employees, and serve 400 children daily.
Dianna Marquardt, Shining Stars Development Center: "When you have a large number of children that you serve and you have children that are obviously in one area that are sharing items or a child that would come in that may not be feeling well or showing signs or symptoms, it makes you very vulnerable. If you have to make sure that you put a lot of procedures and policies in place to keep those children safe and healthy."
Dianna Marquardt, owns and operates Shining Star's two centers. She says, preventing the spread of H1N1 and other infectious diseases is challenging, given that it requires the full commitment of even the very youngest.
Dianna Marquardt, Shining Stars Development Center: "If you follow the correct guidelines for hand washing and cleanliness and sanitizing and cleaning the items that these children use everyday it takes up a huge part of the day. We have additional staff here that go through and help to maintain the cleanliness standards and to make sure we're taking toys to be sanitized and cleaned properly."
"The other thing that we use here, we have a commercial high temperature dishwasher. We're very fortunate we can send those items that are sent into a dirty toy tub and they are cleaned at least three times daily."
These prevention practices are part of the center's long-standing efforts to prevent the spread of all infectious diseases.
Dianna Marquardt, Shining Stars Development Center: "For us in a child care center you have other things like a rotavirus, a normal influenza that has been around for several years. Children that maybe come down with strep throat, ear infections, all of those things are what we would try and prevent with our cleaning methods. We're just going through and re-training to make sure that we're not skipping any of those steps to make sure we can try and avoid the H1N1 as much as possible."
That training can come in the form of a state-wide public health nurse network.
Sally Clausen, Iowa Department of Public Health: "Child care business can call and invite a child care nurse consultant to come to their business and to work with them."
Dianna Marquardt, Shining Stars: "Visiting nurse services provide some key elements for us, but you really have to rely upon making sure that you're finding out the current information. We go to Center for Disease Control, to that website quite often."
Shining Star’s procedures and policies include standard illness criteria that define when children are most at risk of infecting others, and therefore not allowed to attend the child care. Although it's a necessary preventative measure, it may create hardships for parents.
Dianna Marquardt, Shining Stars Development Center: "That's the thing they've really urged in these like Department of Public Health and the CDC website is for workplaces to understand when you talk about H1N1 that there maybe time periods when children are excluded from a center and in-home provider because of an illness criteria and they really need to follow those standards to try and keep the other children in the program healthy and safe as well."