What is it?
Middle ear infrction (otitis media) is a common illness in infants and toddlers.  It can be caused by viruses or bacteria, and often follows a cold.  Symptoms include earache, fussiness, pulling at the ears, and fever.  It may also be accompanied by decreased appetite, vomiting, and loss of balance.

Children commonly have several ear infections within their first few years of life.  Some children are more susceptible to ear infections, due to the anatomy of their ear/nose/throat, immunity, allergies, or other factors.  Ear infections are less common in children over 3-5 years of age.

Prompt treatment for ear infections is important.  Without treatment, the infection can cause more severe infections of the ear, mastoid bones, and covering of the brain (meninigitis).  Untreated and/or repeated ear infections can also lead to hearing loss.

How is it Spread?
Ear infections and/or the orinigal cold are spread by contact with mucus from the nose of saliva.  They can be spread by coughing and sneezing, kissing on the lips and sharing food, eating utensils, and moughed toys.  They are also spread by touchingyour hands to your nose and mouth, reusing tissues, and forgetting to wash your hands after blowing noses. They spread most easily in crowded, poorly ventilated rooms.

When is it Contagious?
Ear infections and/or the original cold, are probably contagious 1-2 days before the symptoms start and in the first 1-2 days of the illness.  They become less contagious over the course of the illness.  After exposure to the ear infection and/or cold, it usually takes several days to a week to become ill.

How is it Diagnosed and Treated?
Ear infections are diagnosed by examination of the ear by a health provider.  If the health provider diagnoses only fluid in the ear, antibiotics may not be prescribed.  If an infection of the ear is diagnosed, it is treated with antibiotics.  Even though the child usually feels better after 1-2 days, the whole course of antibiotics should be completed.  A follow up exam is important to ensure that the infection is cleared.

Children who have persistent or frequently recurring ear infections may be treated with daily antibiotics at a lower dose to prevent infection.  If ear infections persist, surgery to insert tiny tubes in the eardrum (tympanostomy) can help to prevent further infection.

Should the Child Stay Home?
A child with an ear infection does not need to stay home as long as s/he feels well enough to participate in the program's activities.

How Can We Limit the Spread?

• Cough and sneeze into your elbow and away from people.  If you cough or sneeze into your hand or a tissue, wash your hands afterwards.
• Wipe runny noses with a clean tissue, throw the tissue away, then wash your hands.
• Don't share food, pacifiers or bottles.  Wash eating utensils and drinking cups well between uses.
• Clean and disinfect mouthed toys and dining tables after each use.  Clean and disinfect water fountains, telephone receivers, and other frequently handled items daily.
• Discourang nose picking.  Try to limit touching the eyes, nose and mouth.
• don't kiss children on the mouth - hug them and kiss them on the forehead instead.

Information provided on this page is not intended to provide medical advice or take the place of medical treatment.  The recommendations do not indicate a course of treatment or medical care.

These are guidelines to develop policies and procedures for preventing, recognizing and managing communicable disease in child care.  If the children in your care have been exposed to this disease, you may copy this exposure notice and hand out to your day care parents.

This Exposure Notice has been copied from "Keeping Kids Healthy, Preventing and Managing Communicable Disease in Child Care", a project of the The Center for Health Training funded by the California Department of Education, Child Development Division.