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They should send the feverish kids home immediately, especially if they knew there was an outbreak. There was a note on our daycare last week of a confirmed case...so we took E out of daycare for a few days and he still got it.

The problem is that there can be a lag time between getting sick and showing symptoms, and you are contagious the entire time!

I don't have a ton of experience with this. Xander's had HFM before (and so have I ), but I don't know what the protocol is at my daycare. He didn't have a fever (which would require him to stay home for at least 24 hours) and didn't seem bothered by his HFM at all. At the time, I didn't even know he had it. I didn't realize he had it until after I had it, and by then he was mostly recovering from it! For us, HFM just made his eczema flare up, so it wasn't obvious that that's what it was. I don't know if any of the other kids in his class had it or not (though I assume one of them must've given it to Xander).

I have though seen them post a sign on the door warning about HFM when other kids have had it. I'm not sure if they make them stay home or not. I think by the time you develop some of the symptoms, you've already been contagious for a few days, so it's kind of too late...

@Mrs. Jump Rope: According to the CDC: "People with HFMD are most contagious during the first week of their illness. However, they may be contagious for weeks after symptoms go away."

http://www.cdc.gov/features/handfootmouthdisease/

Gosh, don't send! Georgia got it from somewhere - we have no idea where, she doesn't go to daycare and none of her friends had it - we can only think contact in a playgym or something. She had it SO badly, and was sick for weeks - and passed it on to two other adults (my dad, my SIL) during her sick period. Awful virus, man. AWFUL. She also peeled for weeks after, and about 7 weeks later, lost two fingernails!

@Mrs. Jump Rope: I'm not sure when being contagious ends, but you're contagious before you even develop the blisters!

@Mrs. Jump Rope: Our ped told us the fluid in the blisters WAS contagious. Our daycare requires that you can't return if you have any visible blisters.

@Mrs. Jump Rope: our doc said only contagious during the fever stage.

Our daycare requires a note from the doctor to come back.

There was an outbreak of HFM in our daycare class, and the kids without fevers continued to attend - even ones where it was obvious they had it because you could see blisters on their hands. LO's teachers and the director said they thought LO had it too (very, very mild case) and told me LO didn't need to stay home unless she had a fever. We didn't even end up taking her to the doctor because there isn't really anything they can do anyway, and because she was fine (no fever, acting like herself, etc).

Just chiming on to say that I currently have this!!!! Its HORRIFFIC - I actually described the tongue pain as being almost as bad as childbirth - and apparently kids get it worse than adults. If I were you I'd keep your child off so your whole family doesn't get it. I can't believe someone would knowingly send their child in with this - its agonising.

I would address it with the director. But we have had to address a number of items with our director over the past two years.

I would absolutely say something. We had to talk to our daycare owner when DD got HFM at 6 months. We KNOW she got it from daycare because she was at the time not around any other kids. Yet we were the first to report it at the daycare so some little germ bug was being sent to daycare with obvious symptoms like a fever. It made me so mad because while LO had a mild case DH got it really bad (like it hurt to wear socks) and was down and out for a while. We both had to take time off to keep DD home for a week. My blood boils when I think about other parents being so careless. Sharing a daycare setting means you need to do to he right thing to protect all kids so you can feel good that others are doing the same so your kid is protected as well. Nobody wants to take PTO to care for a sick kid, but it's part of being a parent. Apparently some people need a reminder and I think it's more than fair to address that with your director.

My ped said the same about it really being contagious during the fever. Once blisters appear it shouldn't be. Our daycare policy is you can send back when the blisters are crusted over.

LO got it but not so bad. Thankfully it was a Wednesday so we kept her home the rest of the week through the weekend. DH got it after her and he was miserable!! He got sores in his mouth and throat. The stress on his immune system then caused shingles.

I think it's really irresponsible of your preschool to allow kids with confirmed case of HFM back if they are still contagious
. We're not allowed back until 24hr fever free! To be honest it sounds like your preschool needs a sick policy revamp! We have to be 24hr free of diarrhea, fever etc before the kids are allowed back.

I would have no hesitation calling the director and saying something. Even without a NB at Home!

FWIW, you can catch HFM more than once. Granted, if it's the same strain probably your kid will just get another "viral" fever instead of the full blown HFM. But if it mutates enough through the various kids, they could all catch it again. HFM is bad. It starts out as coxsackie and then could become HFM. coxsackie isn't that bad. It's just another viral rash and fevers. Sometimes not even a fever. The fevers come before the rash, so you're infectious when you have the fever. I think that's why parents send their kids to school because they think it's just a mild fever that they can manage with motrin/tylenol. Then a few days later the rash comes. By then, the other kids have already been exposed.

My LO has had HFM four times now, and our pediatrician has told us to keep him home for a week every time. It's definitely very conservative, and it sucks for us schedule-wise, but we have gone along with it because it's such a horrible virus and I can't stand the thought of passing it on to another child. But day care has always said he's welcome back as soon as he's 24 hours fever free, as long as there are no open sores.

It amazes me the range of recommendations that I've seen in this thread. It might be worth looking at the CDC's recommendations and comments on the virus and using some of it in your email to the director.

Certainly sounds like they need to firm up their policies at the school.

I would try addressing it as while Chloe has been fortunate, I'm concerned about the school policy for handling things like HFM. Can you tell me what the guidelines are that you are adhering to when a student is ill with this virus? You might throw in some of your observations and how they seem conflicting with CDC advice.

Do they post contagious illnesses on the classroom doors so that you know when Chloe has been exposed?

@Mrs. Jump Rope: That's shocking! We get notices for all major illnesses - They are generic and say "A student in our program has contracted XYZ. Here are things to look for in your child. here are ways you can help prevent the spread, etc.

@Mrs. Jump Rope: That might be a place to start, is to request that they post all contagious illnesses. I believe the notice that is printed at our school is from the CDC. It gets taped to the classroom door of the infected child. I know last week as I walked the hall there were postings for head lice, HFM and pink eye (conjunctivitis) on various doors. It at least provides the other parents with an awareness of what their child has been exposed to so they can be on the look out for symptoms.

Things like ear infections are not posted as they aren't contagious. Over the past two years we've also seen strep throat, croup, and Influenza A & B posted.

Also, when we had HFM in our house last summer, no one else in our daughter's class had it before or after her. So either someone was a carrier with no symptoms or she got it from somewhere like the grocery store or a restaurant.