Had a 3yo with an eruption last week, sent home early on Friday when it became apparent what it was and he was compulsively rubbing it. Mom want to know if he can come back in now that it's scabbed over. I don't think a scab is going to stay on there with this kid! He's not going to let it heal, and I don't know what that means for transmission of the virus.

What would you do?

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Personally I’d exclude until the sore is gone

Here’s the info I get about it and it says exclude a child unable to control his/her saliva

https://www.hennepin.us/-/media/henn...BF1F3BE8112838

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I used to get cold sores a lot and they are contagious until that sore is basically gone (scab falls off naturally to reveal new skin). They are actually contagious even without a sore present, but much more with one, so if he cant keep his hands clear and clean, I would exclude. I think parents who have kids with cold sores, need to treat it seriously everytime. Certain diets, preventative treatment, and a consistent plan of treatment when one shows up, is really imperative. The virus is fairly common, but cold sores can disrupt life a lot...work, daycare, school, the serious risk to infants, ect. They suck.

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I told her he could come in if she was confident that it was healed over and if he wasn't going to pick at it, but that I'd contact her for pickup if he couldn't leave it alone. She's a great client. She did bring him in. It's raw but not scabbed or open. He had a rough dropoff and had his hand in his mouth while he cried. He is also swiping his arm across his mouth over and over. I've got him in his own gated area with hard toys and he's eating alone at a table of his own. I'll monitor him closely today.

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I allow back if the scab is covered with something (bandaid or liquid skin) and then let them know that if it breaks open they need to pick up.

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Aaarghh now there's another one forming on his other lip.

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Eek! I also have coldsores and know they are extremely contagious. I’ve had them since I was a small child and just a few years ago I was getting them back to back. As soon as one would heal, another one would come through. I was put on valtrex to get it under control. Anytime I get them now, I cover with a giant clear plastic bandaid during daycare hours just in case it gets bumped of baby flings their hand at my mouth. I’m so overly cautious with my own children that I do not kiss them on the face ever because they can spread before it appears on the mouth.

If it’s possible to exclude him until the scabs falls off and heals, i would. Especially if he can’t keep his hands from his mouth or still puts toys in his mouth etc. I would be too worried if other kids also getting them.

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Yes, I texted the mom that if it's open tomorrow he'll have to stay home! It's been a heckuva couple of weeks for them. Head lice, conjunctivitis, herpes simplex, and hand foot and mouth disease all hit over four days.

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All one family? How awful.

My first family that ever left in a huff was over cold sores. It was hard for me--and still kinda is--to exclude for such a long time as is needed for those things to heal. It's so common. But in the end, my own family said that they didn't want to catch it themselves, and the dcg wouldn't keep her bandage on.

I think that it it comes up again, I will still exclude. It's in my policies, so it's not like I haven't warned.

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