7.5.3.1: Human Papillomaviruses (HPV) (Warts)

Children and staff with warts should not be excluded from child care.

Human papillomaviruses (HPV) cause a number of skin and mucous membrane infections; the most common infection is the skin wart. These dome shaped, sometimes conical lesions generally appear on fingers, hands, feet, and face. HPV that causes these lesions are spread via person to person contact. However they are not very contagious. Warts do not require covering with an occlusive dressing. Hand hygiene should be regularly practiced to reduce opportunities for transmission of HPV (1,2).

RATIONALE

The length of time that an individual with a skin wart is considered contagious varies. However the presence of a wart likely represents an opportunity for transmission. The time from contact to the appearance of a wart may vary from months to years. In addition to hand hygiene after contact with warts, sharing of clothing and towels should be avoided. People with warts should be discouraged from touching and scratching warts.

COMMENTS

The HPV that causes skin warts differs from the HPV that causes genital warts and cervical cancer. Treatments of skin warts including liquid nitrogen and topical antiviral agents may result in earlier clearance of warts; however, warts may reappear, requiring additional treatments. Over time, most warts disappear without treatment. The appearance of skin warts is a common occurrence; immunocompromised people may have more lesions that may be present for an extended duration. The HPV vaccine does not prevent or treat skin warts.

For more information, consult the current edition of the Red Book from the American Academy of Pediatrics (AAP).

TYPE OF FACILITY

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

REFERENCES

1. American Academy of Pediatrics. Human Papillomaviruses (HPV) In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st Edition. Itasca, IL:  American Academy of Pediatrics; 2018: 582-590
2. 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.