Warts (Human Papillomavirus)—Child Care and Schools

What are the signs or symptoms?

• Dome-shaped growth inside the skin that may become a raised area with small bumps within it.

• Usually painless but may be painful when they occur on the feet.

• Often found on the hands and around or under fingernails.

• Black dots may appear in the warts.

What are the incubation and contagious periods?

• Incubation period: Unknown but estimated to range from 3 months to several years

• Contagious period: Unknown but probably at least as long as the wart is present

How are they spread?

Person to person through close contact

How do you control them?

• Perform hand hygiene after touching the warts.

• Do not share articles in contact with the warts of an infected child or teacher/caregiver.

• Do not scratch warts. Scratching could cause bacterial infection or spread of virus to other sites.

• The body may make antibodies to the virus so that, over time, the wart spontaneously resolves.

• Tissue-destructive treatments, such as medicated tape and liquid nitrogen, may activate the body's immune response to the virus that causes the wart and hasten resolution of the warts. However, treated warts may return and often require re-treatment.

• Although skin warts are caused by a viral infection, they are only mildly contagious. In children the skin wart virus most often spreads to other areas of the affected child's body rather than to other children. Warts do not need to be covered like shingles or other oozing sores. Treatment is a personal choice and is not required for infection control in a group care setting.

What are the roles of the teacher/caregiver and the family?

• After contact with the child's warts, use good hand hygiene technique.

• Do not let children pick at their warts because this may cause an opening in the skin, which may lead to bacterial infection.

Exclude from group setting?

No.

Comments

• Many people have warts at some time in their lives.

• Immunocompromised children, including those with HIV infection, may have more severe and widespread wart lesions.

• Genital warts and cervical cancer are caused by different HPVs than the ones that cause skin warts. The HPV vaccine protects against HPVs that cause most cases of cervical cancer and genital warts. Refer to the childhood and adult immunization schedules (www.cdc.gov/vaccines) to find out the recommended age groups for vaccinations.