It’s been over a year since the first confirmed case of COVID-19 in Australia, and since then, we’ve all learnt a lot about hand hygiene, social distancing and infection control.
At child care, your under five has been taught to wash their hands properly, and educators are experts in the art of keeping surfaces clean. So, it might be surprising to see a spike in gastro outbreaks at child care centres around the country.
Here, we look at the illness that’s plaguing early childhood education and care (ECEC), and see what services are doing to manage it.
What is gastro?
Viral gastroenteritis is an unpleasant illness that can spread quickly in ECEC services and everywhere. It’s caused by a highly contagious virus called norovirus, and gastro symptoms includes nausea, vomiting, diarrhoea, fever, stomach pain, headache and muscles aches.
Gastro can take up to three days to develop, and although it usually lasts between one or two days, symptoms may linger for longer, and it’s possible to recover from one bout of gastro, then get hit with another.
Why is gastro so widespread in ECEC services?
Child care centres have a strong focus on hygiene, but the nature of norovirus and the habits of young children can make gastro hard to manage.
Professor Raina MacIntyre from the University of New South Wales' Kirby Institute says, ‘You can find [norovirus] on the walls, on the tap, on the sink, everywhere, so unless you're thoroughly cleaning and disinfecting everything around you, that risk will still persist’.
At child care, under fives don’t always keep their distance or remember to wash their hands well, and SA Health says, ‘Viral gastroenteritis is spread through contamination of hands, objects or food with infected faeces or vomit. The virus is then taken in by the mouth. Viral gastroenteritis may also be spread through coughing and sneezing.’
Dr Bruce Bolam from Victoria's Department of Health and Human Services said the risk of gastro cases ‘inevitably increased’ as youngsters returned to daycare last year, and it doesn’t take much to get the illness.
The best defence is thorough handwashing with soap and water for at least 20 seconds (or two renditions of ‘Happy Birthday’), and it’s important to know that soap is more effective than hand sanitiser to prevent the spread of gastro.
Dr Bolam says, ‘Alcohol-based sanitisers are not effective against many of the bugs that cause gastro in childcare. Hand-washing is the bulwark. We must not treat things like masks and hand sanitisers as if they magically mean we won't spread a bug.’
How much gastro are we seeing in child care centres?
Since late last year, there’s been a spike in gastro outbreaks at ECEC services in Queensland, Victoria, New South Wales, the Australian Capital Territory, Western Australia and, most recently, South Australia.
ABC News reports that:
- There were 446 outbreaks in south-east Queensland centres between October and December 2020, compared with 113 during those months the year before.
- The number of outbreaks at New South Wales child care centres rose to 221 last December, then dropped to 76 in January this year.
- Centres in the ACT reported 68 gastro outbreaks between October and December 2020, with a significant drop in January.
- Victorian ECEC services reported 27 gastro outbreaks in January.
- South Australia had 60 outbreaks in January, compared with just seven at the same time last year. There were four outbreaks reported in November 2020 and 17 in December, but because norovirus isn’t a notifiable condition in that state, the government suspects the true figures to be higher.
And if you’re wondering why rates of influenza and COVID-19 have dropped in Australia, while gastro rates have skyrocketed, it’s because those illnesses spread through respiratory transmission – meaning measures like social distancing and mask-wearing have been effective in warding them off.
How are ECEC services managing gastro?
Quality ECEC services are vigilant about health and hygiene, and they’re taking the advice of health departments to limit the spread of gastro amongst children, educators and families.
In South Australia, SA Health has issued this advice:
- ECEC services should advise parents/care-givers to keep young children home while they’re unwell. Children shouldn’t return to child care until they’re well and have not had any vomiting or diarrhoea for at least 48 hours.
- Services should advise that anyone recovering from gastro should also avoid visiting hospitals and aged care facilities until they’re full recovered.
- ECEC services should advise parents/care-givers to get further medical advice if gastro symptoms persist or they’re very bad (see here for severe symptoms).
- Services should provide parents/care-givers with gastroenteritis fact sheets.
- ECEC staff who present with gastro should be tested and given fact sheets with advice on exclusion and management.
- Services should follow good hand hygiene (using soap and water), reinforce cleaning and sanitising measures, and refer managers to this publication about infection prevention.
SA Health says diarrhoea and vomiting can also point towards COVID-19, so if in doubt, educators and families should get a COVID-19 test.
As a parent, it’s important to heed the advice of your ECEC service and follow good hygiene practices at home.
Dr Bolam says that although COVID-19 has made Australians more aware of hand hygiene, ‘It doesn't necessarily mean [we’re] practising it all the time or universally.’
Gastro is no fun for little ones – or anyone – so it is really important to wash hands well and work with your ECEC services to handle this spike in the illness.