SUBJ: H1N1 INFLUENZA (SWINE FLU) GUIDANCE FOR CHILD DEVELOPMENT
CENTERS AND FAMILY CHILD CARE PROVIDERS
A. CG PANDEMIC INFLUENZA FORCE HEALTH PROTECTION POLICY, COMDTINST
M6220.12 (SERIES)
B. TECHNICAL GUIDE: PRACTICES FOR RESPIRATORY PROTECTION,
COMDTINST M6260.2 (SERIES)
C. CARING FOR OUR CHILDREN NATIONAL HEALTH AND SAFETY PERFORMANCE
STANDARDS: GUIDELINES FOR OUT-OF-HOME CHILD CARE PROGRAMS (AAP,
APHA, NRCHSCC, HRSA/MCHB)
D. CG CHILD DEVELOPMENT SERVICES MANUAL, COMDTINST M1754.15
(SERIES)
1. THIS MESSAGE PROVIDES GUIDANCE FOR RESPONDING TO THE RECENT
H1N1 OUTBREAK, FORMALLY CALLED SWINE FLU. TO MINIMIZE THE
LIKELIHOOD OF TRANSMISSION OF THE VIRUS WITHIN OUR CHILD CARE
COMMUNITIES, WE MUST FOCUS ON THE ACTIVITIES IN CG CHILD
DEVELOPMENT CENTERS AND FAMILY CHILD CARE (FCC) HOMES BY TAKING
EXTRA PRECAUTIONS.
2. CHILD DEVELOPMENT CENTER DIRECTORS AND FCC PROVIDERS ARE
ADVISED TO PROVIDE GUIDANCE TO THEIR STAFF TO BE VIGILANT
REGARDING SIGNS AND SYMPTOMS OF POTENTIAL INFLUENZA-LIKE ILLNESS
IN OUR CHILDREN. THESE INCLUDE FEVER OF 100 DEGREES FAHRENHEIT OR
GREATER, SORE THROAT, COUGH, BODY ACHES, AND FATIGUE.
3. PARTICULAR ATTENTION SHALL BE GIVEN TO THE SANITATION STANDARDS
(REF A, CHAPTER 4): SOCIAL DISTANCING, COUGH AND SNEEZE ETIQUETTE,
HAND HYGIENE, SURFACE DISINFECTION/DECONTAMINATION, AND PERSONAL
PROTECTIVE EQUIPMENT.
 A. SOCIAL DISTANCING IS DEFINED AS MAINTAINING A DISTANCE OF SIX
FEET OR GREATER FROM SOMEONE SUSPECTED OF HAVING SYMPTOMS
ASSOCIATED WITH AN INFLUENZA-LIKE ILLNESS.
 B. COUGH AND SNEEZE ETIQUETTE IS DEFINED AS COVERING THE NOSE AND
MOUTH, WHILE COUGHING OR SNEEZING, WITH TISSUE OR PREFERABLY WITH
THE BEND OF THE ELBOW.
 C. HAND HYGIENE IS DEFINED AS THE USE OF WATER, LIQUID SOAP, AND
DISPOSABLE TOWELS TO REMOVE DIRT, BACTERIA AND VIRUSES FROM THE
HANDS. IF HAND WASHING IS NOT FEASIBLE DURING CHILD CARE
OPERATIONS, HAND SANITIZER/ALCOHOL-BASED GELS SHALL BE USED.
 D. SURFACE DISINFECTION/DECONTAMINATION INCLUDES WIPING DOWN
SPACES, TOYS AND DOOR HANDLES WITH A BLEACH AND WATER SOLUTION
THAT IS PREPARED DAILY. THE ENVIRONMENTAL PROTECTION AGENCY (EPA)
HAS A LIST OF DISINFECTANT PRODUCTS THAT ARE REGISTERED AND
LABELED AS EFFECTIVE AGAINST VIRUSES. TO ACCESS THIS LIST, GO TO
THE EPA WEBSITE AT: HTTP://WWW.EPA.GOV AND SEARCH FOR "INFLUENZA
DISINFECTANTS." THEN SELECT THE ITEM ENTITLED "ANTIMICROBIAL
PRODUCTS REGISTERED FOR USE AGAINST INFLUENZA A ON HARD SURFACES."
 E. PERSONAL PROTECTIVE EQUIPMENT (PPE) INCLUDES, AT A MINIMUM,
THE DONNING OF GLOVES, SURGICAL MASK, AND THE USE OF HAND
SANITIZERS. REF B PROVIDES ADDITIONAL GUIDANCE.
4. FOR ADDITIONAL GENERAL INFORMATION AND GUIDANCE, PLEASE SEE REF
C, CHAPTER 6. REF C IS AVAILABLE AT THE FOLLOWING WEBSITE:
HTTP://NRCKIDS.ORG. THEN SELECT "CARING FOR OUR CHILDREN, SECOND
EDITION."
5. PARENTS ARE ADVISED AGAINST BRINGING ILL CHILDREN TO THE
CENTERS OR FCC HOMES. CHILDREN WHO ARE ILL SHOULD NOT BE PERMITTED
INTO THE CENTERS OR FCC HOMES. ANY CASES OF KNOWN OR SUSPECTED FLU
ILLNESSES WITHIN THE CENTERS OR FCC HOMES SHALL BE REPORTED TO THE
LOCAL CLINICS AND COGNIZANT MLC (PER REF D).
6. THE CENTERS FOR DISEASE CONTROL AND PREVENTION ARE POSTING ALL
THE LATEST INFORMATION ABOUT WHAT IS HAPPENING HERE IN THE U.S.
AND INTERNATIONALLY WITH THE H1N1 FLU OUTBREAK. YOU CAN ACCESS
THEIR WEBSITE AT WWW.CDC.GOV/SWINEFLU/PARENTS.HTM.  FROM THIS SITE
YOU CAN ALSO SIGN UP TO RECEIVE EMAIL UPDATES REGARDING H1N1
OUTBREAK. THE "GET EMAIL UPDATES" LINK IS ON THE RIGHT HAND SIDE
OF THE PAGE.
7. QUESTIONS REGARDING FCC MAY BE DIRECTED TO THE FCC PROGRAM
MANAGER, MRS. YVETTE WRIGHT, (202) 475-5159, OR
YVETTE.D.WRIGHT(AT)USCG.MIL. QUESTIONS REGARDING CHILD DEVELOPMENT
CENTERS MAY BE DIRECTED TO THE CDC PROGRAM MANAGER, MRS. MARTA
DENCHFIELD, (202) 475-5159, OR MARTA.E.DENCHFIELD(AT)USCG.MIL.
8. RADM MARK TEDESCO, DIRECTOR OF HEALTH, SAFETY AND WORK LIFE
SENDS.
9. INTERNET RELEASE IS AUTHORIZED.