What You Should Know About... Cold Sores in the Child Care Setting Cold sores are usually caused by type 1 of the herpes simplex virus. Children often become infected with this virus in early childhood and many have no symptoms. When symptoms do occur, they may include fever, runny nose, and painful lesions (fever blisters or cold sores) on the lips or in the mouth. The blisters or cold sores usually form scabs and heal within a few days. Cold sores are spread by direct contact with the lesions or saliva of an infected person. Spreading the virus within families is common. To prevent the spread of herpes simplex virus in the child care setting: Make sure all children and adults in the facility use good handwashing practices. Do not allow children to share toys that can be put in their mouths. (Virus may be present even though sores are absent or not noticeable.) After a child has mouthed a toy, remove it from the play area and put it in a bin for toys to be disinfected at day's end. Only exclude a child with open blisters or mouth sores if the child is a biter, drools uncontrollably, or mouths toys that other children may in turn put in their mouths. Do not kiss the child or allow the child to kiss others where direct contact with the sore may occur. Use gloves if applying medicated ointment to the sore.