7.5.1.1: Conjunctivitis (Pinkeye)

Conjunctivitis (pinkeye), defined as redness and swelling of the covering of the white part of the eye (1), may result from a number of causes. Bacteria, viruses, allergies, chemical reactions, and immunological conditions may manifest as redness and discharge from one or both eyes. Management of pinkeye should involve frequent hand hygiene to prevent the spread (1). Children and staff with conjunctivitis (pinkeye) should not be excluded from child care unless:

1. They are unable to participate in activities;
2. Care for other children would be compromised because of the care required by the child with conjunctivitis;
3. The person with conjunctivitis meets any of the following exclusion criteria outlined in Standard 3.6.1.1; or                  
4. A health care professional or health department recommends exclusion of the person with conjunctivitis.

Children and staff in close contact with a person with conjunctivitis should be observed for symptoms and referred for evaluation, if necessary. If two or more children in a group care setting develop conjunctivitis in the same period, seek advice from the program’s child care health consultant or public health authority about how to prevent further spread (1). Children who have severe prolonged symptoms should be evaluated by their primary care provider (1)

RATIONALE

Hand contact with eye, nose, and oral secretions is the most common way that organisms causing conjunctivitis are spread from person to person. Careful hand hygiene and sanitizing of surfaces and objects exposed to infectious secretions are the best ways to prevent spread.
Conjunctivitis may be caused by both infectious and non-infectious conditions. The length of time that a person is considered contagious due to a bacterial or viral conjunctivitis depends on the organism. Antibiotic eye drops and oral medications may decrease the time that a person is considered to be contagious from a bacterial conjunctivitis. For viral conjunctivitis, the contagious period continues while the signs and symptoms are present (1). 

COMMENTS

Occasionally, conjunctivitis might occur in several children at the same time or within a few days of each other. Some children with conjunctivitis may have other symptoms including fever, nasal congestion, respiratory, and gastrointestinal tract symptoms.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.6.1.1 Inclusion/Exclusion/Dismissal of Ill Children

REFERENCES

1. Aronson, S. S., T. R. Shope, eds. 2017. Managing infectious diseases in child care and schools: A quick reference guide, 4^th Edition. Elk Grove Village, IL: American Academy of Pediatrics.

NOTES

Content in the STANDARD was modified on 3/31/17.