New Au Pair Has Whooping Cough and Will Be Infectious for Up to 12 Weeks!

by cv harquail on May 9, 2016

Seriously Host Parents — can’t you send me emails about dilemmas that can be announced with catchy headlines???

4500147224_716b7684b4_mVery rarely am I able to say — “I never heard of a problem like this before.”  While I like novelty as much as the next American, I’m not happy to see this problem now.

This is a doozy, because it touches on all sorts of issues — Agency screening, Au Pair health, Host Family needing support,  American Culture, and more  — all at the same time.

There are two levels of solutions that are needed here, too. First,

What should the Host Family do?

Longer term, what should be the responsibility of Au Pair Agencies?

If Au Pairs are not currently required to be vaccinated for pertussis, should they be?

(What if an unvaccinated and infectious Au Pair arrived in a home with an infant! Or a home with a medically fragile older child or adult?)

Dear AuPairMom — 

Our new au pair arrived one week ago from the rematch pool, and our children took to her immediately on the first night she was here.  We were thrilled!

The second day she came down ill and has been sick ever since.  She did not want to go to the doctor (she is not from a European country and has cultural views on seeing doctors), but we finally convinced her to go yesterday. The suspected diagnosis is whooping cough (pertussis).  

<cv notes: Pertussis is difficult to diagnose positively, in its earliest stages. So, they can’t know for sure whether the Au Pair has a communicable illness that’s fatal to unvaccinated babies, or not.>

This is a big deal for a couple of reasons:

1. We live in a city with low vaccination rates (although our kids are vaccinated against it, which is also not 100% effective);
2. This illness can last up to 12 weeks; and
3. We essentially cannot risk exposing anyone to our new au pair for the duration (no kids in our home, au pair cannot do her job because she can’t be near kids).  UGH.  I’m so upset.

< cv notes: “Unvaccinated or incompletely vaccinated infants younger than 12 months of age have the highest risk for severe and life-threatening complications and death from pertussis”, says the Center For Disease Control. >

What is potentially more upsetting is that I’ve since learned that immunization records are not required for entering the au pair program with our (large) agency. How is this possible?!?!
So here we are….we welcomed a seemingly lovely au pair into our home who is now ill with an illness that can be quite dangerous to small children and elderly in our community, and have no idea how long she will be unable to work.  I’m so upset and frustrated.
My questions are:

What do we do?!?!  It seems unfair to end the match when she is clearly so ill, and yet, I desperately need childcare.  This doesn’t even touch on the issue of exposing our family and anyone who come over to the illness by living in our home.

What exactly DOES that au pair medical screen entail?!?!?!  Is it useful at all?!?!?

Thank you so much for any thoughts that might be helpful.  I have no idea what we should do.



Image: “I’m sick” by Christi on Flickr


Should be working May 9, 2016 at 9:42 pm

Yeah, this is a doozy. Now I have a new question to add to my interview: What vaccines have you had, exactly?

First, get a second opinion. If it seems to truly be whooping cough, I think she has to leave and go home. 12 weeks is too long for an AP to be sick in your home, AND to risk infecting unvaccinated and frail people. I guess if she is well enough, and is able to care for only your kids in your home, then she could stay and do that childcare. But 12 weeks in the house seems like a long time.

I would like to hear from agencies as to their response. They don’t require vaccinations? They do require APs check a box if they HAVE had some of those diseases, at least CCAP does.

Years ago we would get the actual doctor’s report for the APs. Now we get a cleaned-up agency form with checkboxes.

Ultimately it is the agency’s problem as to how to get her home, but it still will stink for her. I’m so sorry for all of you!!

Taking a Computer Lunch May 9, 2016 at 10:19 pm

I think I’d ask the agency to pay for a second opinion (or you pay for it and have the agency give you an equal credit toward the fees for your next AP). You don’t want to be on lockdown, and chances are she will not remain in lockdown (even if she doesn’t share a sip of a drink or taste a friend’s food). So sorry, there are no easy answers.

My only similar experience is with strep. During the year in which child #2 was in kindergarten, it passed around the class endlessly. The Camel, who is medically fragile not only got it every time child #2 did, she required 2-3 rounds of antibiotics each time to clear it up. Of course the AP got it (and we paid 100% of the fees associated with her medical care and then filed for her insurance for a small refund). The Camel ended up having emergency surgery because of a secondary infection caused by her weakened immune system. Of course it was different, because it was my child and his classmates causing it.

You would think an agency hiring childcare workers would require all major vaccinations – or to require an AP to explicitly state that she is not vaccinated. It would be a no-go in my house. Twelve weeks is a really long time. If you decide that she’s worth the effort, then now is the time to learn if she’s been vaccinated at all. If the answer is “No,” I’d personally question continuing the relationship.

ChicagoHostMom May 10, 2016 at 12:40 am

Wow – this is a tough one. I am inclined to think that the agency is responsible for placing healthy Au pairs. She came to you from the rematch pool, so she’s apparently been in the country a while, but if she isn’t healthy and safe to work when she comes to you in rematch, she cannot provide care and the agency has to address this. I know there have been similar situations for au pairs who have broken bones etc and are unable to fully work for weeks at a time.

I expect the agency’s responsibility ultimately takes the form of sending the au pair home for medical care. I can appreciate and have seen a wide variety of au pair attitudes toward health care and vaccinations.

Personally, for our family, this would be a non starter. We need a healthy caregiver who can supervise play dates, taxi to activities, and help us with our active kiddos. Although this is unfortunate for the lovely au pair, who may simply have to return home, and this may sound callous, but I would file this under “stuff happens” and go back to the rematch pool.

It is just a bad scenario and you are obviously a caring human, but you are entitled to an au pair who can do the job and you should not feel guilty for needing a good match for your family.

Dorsi May 10, 2016 at 1:48 am

A few clarifications-

Pertussis is difficult to clinically diagnose. That means, you can’t listen to someone describe their symptoms and decide that they have Pertussis. You need a test! The test is accurate after the onset of symptoms, though it may have a 2-4 day turn around time. If this Au Pair has pertussis, the family will know for sure in a few days, assuming the appropriate test was done.

People who take antibiotics because they are sick with whooping cough are allowed to return to work after 5 days. Even if they work in around babies. So, the worry about exposing others is much, much smaller than described. If the Au Pair turns up positive, everyone in the house gets antibiotics, too. When I was exposed many years ago, I picked up my antibiotics Monday, and went back to work (at a children’s hospital!) on Tuesday.

It is very likely that you Au Pair has been vaccinated against Pertussis or has had it at some point in her life. While it is true that the vaccine is <100% effective, it is believed that vaccinated people who get the illness will not have a long course of the illness. She may be back on her feet quite quickly.

Take a deep breath, take some azithormycin and see if she turns up positive. Physicians like to tell you what they suspect – and sometimes they make it a hard sell to encourage you to have the appropriate testing. In my experience, 10% of the people with suspected Pertussis are positive. If she is positive, the health department will be happy to provide you with all kinds of advice.

hostmama in CA May 10, 2016 at 1:52 am

Don’t freak out yet. Pertussis may have a lingering cough that lasts 12 weeks, but your au pair will not be contagious that long and she will be able to return to work much sooner. Pertussis is contagious for about 2 weeks without treatment, much less if she is taking antibiotics (about 5 days after starting treatment). (CDC website)
Definitely a good interview question and if a candidate isn’t vaccinated, ask her to get the vaccination at least two weeks before arrival.

AuPair in the Netherlands May 10, 2016 at 3:05 am

Granted I am an aupair in Europe right now and not America but my medical requirements were simply to have a doctor sign off saying I am healthy enough to go away for a year and proof that I had the TB shot no other shots were required.

Dorsi May 10, 2016 at 11:06 am

Funny about the TB shot – people born in the US never get this, so it is not something that most host families would screen for (or even know about).

HRHM May 10, 2016 at 12:06 pm

Interestingly, the reason we don’t get the BCG (TB) vaccine here is that it’s main use is against TB meningitis in children.(little incidence of that in the US) It’s actually not useful against adult pulmonary TB. (main form of TB in the US) In addition, once you’ve had the vaccine, you will test positive (pretty much forever) for the main diagnostic test we use in the US, the ppd skin test. The vaccine makes you react to ppd and then no one knows if you actually have TB or not.

AuPair in the Netherlands May 10, 2016 at 3:06 pm

I actually did not have to get it because I am American but I had to have a doctor sign off saying that I am American which is why I don’t need it I just know for many countries it is a requirement and it was listed on my aupair app that I must have proof that I have had the shot or proff that I am from one of the listed approved countries.

German Au-Pair May 10, 2016 at 6:40 am

I got a terrible, 12-week long cough when I was in the US, too (and that wasn’t the first time) and when I had the same issue a couple of years back, people assumed it COULD be whooping cough,too. No one cared enough to test it though and it disappeared by itself after a while, after all the meds did nothing but give me side affects. So when Dorsi says you need a test to be sure -get the test.
The point I am wondering about is “we live in an area with a low vaccination rate”. That should not be your or your APs problem. When someone chooses not to get vaccinated then that’s their choice and they are the ones dealing with the consequences. Not you or your AP.

As for the medical screening…my doctor hardly spoke any English so I filled out the form and translated my diseases and she signed it. No tests or anything. Some Aps I know had to get a special check up test but nothing out of the ordinary. I honestly don’t even know if I am vaccinated against whooping cough though I AM vaccinated against something.
If you have an infant or a medical fragile child it may make sense to require the AP to send you a photocopy of their vaccination passport thingy. I was never asked about my vaccinations.

NBHostMom May 10, 2016 at 9:08 am

As others have said, request a blood test. I was diagnosed with whooping cough back in November, even though I’m vaccinated. When I managed to get an appointment with my doctor, she doubted the diagnosis and ordered a blood test. Came back negative. She diagnosed a respiratory infection (aka “a cold”). I had a lingering cough for about 3 months, but felt 100% after the first week. On follow up visits, I was reassured that I was not contagious, but it was a just a lingering cough from the original infection.

Hopefully this is a similar case of misdiagnosis! This IS however an important reminder to me to ask specifics to my next AP about her vaccination status!

Sleepytime May 10, 2016 at 10:49 am

To my recollection, APIA and APC do not ask about vaccinations. I am certain that the DOS does not require them for a J1 visa. I did ask about pertussis vaccination when I interviewed for IQ , but not since. I think that vaccination information is one more area where the oversea recruiters and agencies fail to provide basic information that is readily available to them.

Mimi May 10, 2016 at 4:13 pm

The DOS does not require them, but any student being sponsored by a University will have to provide documentation of compliance with that state’s immunization laws. I presume that the logistics of multi-state placement makes it impossible for AP agencies to require immunizations since they all differ by state, but I’m not sure by how much. I think it’s unfortunate because there are criteria for immigration visas that would at least be a starting point, and for parents needing IQ care it can be very important.

WarmStateMomma May 10, 2016 at 4:21 pm

I’ve seen vaccination records as part of the Chinese AP profiles with API (do not recommend), APC and (I think) CCAP. This may vary by AP country, though.

Schnitzelpizza May 19, 2016 at 4:05 am

Immunisation status is not part of the recruiting. We ask for health issues (allergies, chronic diseases) but not vaccinations. I agree that vaccinations should be part of the health questionnaire – though my doctor suggested and advised it (MMRV & DTaP) when I went to have him fill and sign it.

When I recently switched GPs with an “unclear immunisation record” (lost it but haven’t been vaccinated since… I was 18) I was also advised the get at least another DTaP and MMR immunisation.

LallyAP June 14, 2016 at 12:37 pm

I was asked to provide my vaccination background. I’m APIA.
And when I sent it and it seemed incomplete the asked me to complete and upload the vaccinations that were missing. There is a huge checkbox that the doctor has to check. And here in Brazil it’s hard to find a doctor that’s going to sign without all the vaccines required.
In Brazil most of the families are really concerned about it. So most of the babies and young children are fully vaccinated with the required ones.

momo4 May 10, 2016 at 11:52 am

On the subject of vaccinations, I have never asked about my AP’s vaccination history, nor would I expect most of them would be able to tell me what vaccines they’ve had, they would have to get records and depending on their country that might be all but impossible. Different countries have different attitudes regarding vaccinations, and different requirements, so many APs would never have had to get some of the vaccinations that are considered standard here, just as we have not had many of the vaccinations recommended in other countries. If the government does not require them for entry under a J1 visa, I see no reason why the agencies would require them of applicants, and who is going to pay for these vaccines? I realize that this may seem rather cynical, but I’m sure agencies do not want to spend any more money than absolutely necessary, or decrease the size of their applicant pool by setting up more requirements than necessary for applicants.

With my insider knowledge of healthcare, I doubt that the health screening consists of anything more than a short physical exam and form filled out stating that the AP *appears* to be in good health and “free from infectious disease”. There are any number of conditions the AP could have, unknown, or develop after the exam that could go completely undetected. It sounds like this AP probably got pertussis (assuming she really has it) while in the US if she is in rematch, so no agency health screening would matter anyway.

I do ask that my APs get the flu shot (which I pay for), explaining to them how dangerous the illness can be to small children, not to mention how miserable they will be if they come down with it, and none of them have ever objected to getting one. When I’ve had a newborns in the house I’ve usually had APs from the EU who had had the pertussis vaccine, my Thai AP had no idea what vaccines she’d had but agreed to get the DTaP for the baby’s safety.

I agree with the other posters who recommend waiting for definitive test results. If she really has it, you’ve all be exposed already anyway and will get antibiotics, then you can get on with your lives and enjoy your great AP.

momo4 May 10, 2016 at 11:55 am

Sorry, that should be Tdap.

Mimi May 10, 2016 at 11:57 am

We ask about vaccinations for a variety of reasons including having an infant and my own compromised immune system. Dorsi shares some great info and I agree that unless you’ve had specific testing done, you should have a second opinion. With the proper precautions, this is manageable, even if you have children under the age of 1. The concern I would have is if your AP doesn’t take all her antibiotics and doesn’t practice good hygiene/ take health precautions to give her body time to heal and gets run down.

Emerald City HM May 10, 2016 at 12:12 pm

A lot of our things have changed based on the ages of our children. If they are not old enough to be vaccinated against the ones that are most common to the area (measles, pertussis, flu) then the au pair must be vaccinated. We would not accept an au pair that is not vaccinated for MMR. The pertussis one is a bit tricky since not every country is having the booster issue that we are and that might depend on the formulation of their childhood vaccine for it, but we have asked 1 au pair to get it and it was not a problem. We have also asked that if our incoming au pair has not had an adult booster that she also gets it on arrival since the baby will only be a month old, but I did just get the booster so that should offer at least some immunity to the baby. If the children are fully vaccinated, we don’t worry about it. We still offer to pay for their flu vaccine if they want it.

Quirky May 10, 2016 at 12:30 pm

Although I agree that whooping cough is not contagious after a certain point in the treatment program, be aware that contagiousness notwithstanding, it can be extremely debilitating for weeks. My mom had whooping cough several years ago (her vaccination immunity had probably long since worn off), and her doctor (wrongly) would not test her for it on the (unwarranted) assumption that since she had been vaccinated (many many years ago) it could not possibly be whooping cough. Now of course she is a lot older than any AP would be, but it left her without energy for months, and was a turning point for her between being an older, active adult and actually being an elderly woman.

Which is by way of saying — your AP may not be up to doing the job you are paying her for even after the point of non-infectiousness. In my opinion you need to be hard-nosed about the decision of whether you can get the childcare you need and are paying for. I am sure your AP is great, and you are very concerned for her well-being, but you have to consider whether it’s better for *your* family to pull the ripcord and send her home now. I’m especially thinking of how hard it may be on your kids to have to go through another transition to a new AP if your sick AP isn’t better in say a month or two and you’ve reached the end of your rope.

The other thing I will say is that if you have young babies, you and your spouse should have already had pertussis boosters. The pertussis vaccine is notorious for wearing off comparatively quickly. Adults can also have much milder cases that present as bad colds, so your co-workers could very well be exposing you to pertussis unwittingly.

WarmStateMomma May 10, 2016 at 12:40 pm

I look over the vaccination records carefully for anyone we are seriously considering but we’ve had infants all three years we’ve hosted. I require Pertussis and annual flu vaccines as a condition of matching and I offer to pay for that when they arrive. I prefer the vaccines done here but I wouldn’t require a new pertussis if they had it in the last two years (same as my OB demands of expectant parents). No one has balked at that but we only host from China and I hear the schools vaccinate kids without parental permission so it’s not controversial there.

Some TB vaccines won’t give a false positive on TB tests. My exchange students and APs have all had the vaccine and cleared the required TB tests here.

Thanks to Dorsi for the good info – I would rematch with someone who was contagious for 12 weeks but it sounds like this may not be the case here.

HMof2 May 11, 2016 at 3:09 pm

When I had infants, I required AP to agree to get TDap and flu shots, as a condition of matching. I did not want to run the risk. I take the AP to get the shots ASAP upon arrival and I paid for it. I take everything in the AP profile with a grain of salt. I have found stretching of the truth or outright lies in some of these profiles. It is very hard to tell what is true or not. If I were given paperwork documenting the AP vaccination history, I wouldn’t rely on it. It is either self-report (which is not reliable) or came from an overseas medical system that I cannot verify. I would rematch given the new information that the AP has a belief about not taking any medications. You will not be able to change her beliefs. Even if you work through this situation, there may be future health situations and you will be battling the same problem again – that AP refuses to take medication because of her beliefs.

ChiHostMom May 10, 2016 at 12:43 pm


As a mom of an infant, this scares me. I agree with Dorsi – get the test. For a good AP, I’d be willing to wait until the antibiotics kicked in. I got the booster when pregnant and had our AP check her vaccination records for more current TDaP. We pay for and require the flu shot since my husband works in a hospital setting and can’t go to work with the flu. We had an AP who didn’t want to get it because it wasn’t in their culture to get the flu shot. We had to explain why but it in the end it worked out.

If you’re breastfeeding – keep it up – you can get some immunity transfer that way.

LeftCoast Mama May 10, 2016 at 1:10 pm

OP here. Thanks so much for all of these thoughtful replies and for sharing your stories and what you might do moving forward. I have to say that even with the possibility that it is *not* pertussis, the issues this experience has brought up are feeling significant.
1. Our au pair arrived ill. I guess there is not much way to avoid that if they are already in rematch and have a ticking time clock on their visa, but still….it’s upsetting.

2. We have spent a large part of the past 8 days trying to understand what is going on for her, rearranging our weekend travel plans to accommodate her illness, and arranging visits to doctors, labs, and the pharmacy to support her healing. All of that was okay and part of the role of hosting an au pair, in my opinion, BUT we learned last night that after all of that her religion does not allow her to take medication. Sick people are taken to the church to be healed. SO, she now has antibiotics and several other medications that she will not choose to take. She is choosing to “let it pass” all the while exposing our family to illness and not being able to work. I feel incredibly frustrated that this wasn’t revealed in our interviews (of which there were many!) when we discussed our differences in religion and viewpoints.

I guess this is another learning opportunity for things we need to be asking in the interviews, but I can’t help feeling that we were lied to. Thanks again for all of your advice.

Emerald City HM May 10, 2016 at 1:15 pm

Knowing this, I would rematch. Even with just older kids. She can’t work, possibly for an extended period of time, end of story.

Mimi May 10, 2016 at 1:28 pm

This is a huge flag for me. We experienced this with AP#6 and it became a huge safety issue for us.

This is one of those things that APs don’t often realize will be an issue for them, or they don’t understand the potential for conflict of core values enough to disclose it. She is not likely to compromise her beliefs and trying to work through this is more than I would attempt.

WarmStateMomma May 10, 2016 at 4:15 pm

I would rematch. What is she going to do – just lay around in bed hoping to get better? And she likely has NO vaccinations if these are her family’s beliefs. She likely hasn’t considered the risk to your kids because she doesn’t believe in the risks.

I’d also be wary about non-medical issues – what is she going to teach my kids with beliefs (and values) so different from ours? YMMV.

momo4 May 10, 2016 at 4:22 pm

I’m a very bend-over-backwards-for-the-AP sort of HM, but with this additional information I say rematch.

I know it can be tempting to stick it out given all the time and energy you’ve put into the situation and since she otherwise seems like a nice person, but I suspect this sort of thing may come up again with her later in the year.

Don’t be too hard on yourself for not discovering this issue until she arrived. I’m currently interviewing for our 10th AP and if I tried to anticipate every single problem that has ever come up with any of my APs (and which I later wondered if I should screen for) I think I would spend months interviewing each candidate and there would still be some new issue that was unique to the latest AP and which I never thought to ask about.

LeftCoast Mama May 10, 2016 at 4:26 pm

Thank you so much for saying this. I AM really upset that we didn’t catch this, and I’m feeling sad and upset about the entire situation. And, yet, so many of these comments on here resonate with me and are spot on. This is our 5th au pair and our track record has not been stellar…..I’m really not sure that we have the energy to stay in the program at this point.

momo4 May 12, 2016 at 9:18 pm

There is always the potential for deal-breaker issues that you would never think to ask about. I would NEVER have thought to ask AP candidates whether they had religious beliefs that precluded taking medications – and I work in the medical field!

There are some great ideas on this site for interview questions and interviewing processes, but I simply don’t have the energy for many of these strategies, and I tend to become too attached to APs I’ve spend a lot of time interviewing and it ends up feeling like dumping or being dumped when I choose another or am passed over by an AP.

Over the years I’ve just gotten less and less interested in portraying my family/kids in anything but the harsh light of reality. I always include photos of my kids covered in mud and other realistic portrayals of daily life with us. I have 4 kids. I live in a large city, but it isn’t in NY/CA/FL etc. I’ve also restricted myself to APs from the western EU. Nothing against APs from other regions, it’s just that there is only so much cultural exchange I have the energy to deal with year after year. I know that European APs have the stereotype of being spoiled princesses, but the real spoiled princesses have no interest in a family with 4 kids in an un-glamorous city. I used to envy the people who live in desirable locations, now I feel lucky since it weeds out a lot of bad matches!

Still, every year I dread the finding-a-new-AP process, the anxiety, reading all these profiles that sound completely alike, the awkward phone calls…. And every year I wonder whether I have the energy to do the whole AP thing for another year.

Back when there really wasn’t a viable alternative for us due to our work schedules and the impossibility of calling off on short notice (we HAD to have someone available to cover on a few hours notice even if it almost never came up) I would just grit my teeth and get through the process, hoping for the best. Now I work part time and could theoretically get by with after-school programs and/or nanny and/or babysitters, but now I’m so used to the convenience of an AP that it’s hard for me to give it up! It helps that our current AP is fabulous and an all around great person.

Interestingly, another thing that has really helped this year is that we decided to get a bro-pair. I don’t know why this has made such a difference, but I have found the whole reviewing profiles and interviewing process more interesting and less stressful, maybe because there are fewer to choose from? We have 2 strong candidates that I’m talking with, and I think either one would be good fit. In fact, if they’re both interested in matching I’ll feel bad turning one of them down!

Hosting an AP takes a lot of energy, not to mention everything it takes to choose one in the first place. After all these years I am still feeling it’s worth it (at least this year ;) but there is always a level of uncertainty, and you can’t blame yourself for not anticipating every possible element of mismatch that could possibly arise. The weird thing is, it seems once you deal with a particularly aggravating issue, it never seems to come up with future APs (who have their own constellation of issues) so you never really get to feel that you’ve “got it”!

Should be working May 13, 2016 at 12:10 pm

Now that we switched to bro-pairs, I find matching much less stressful as well. There aren’t that many to choose from, and they seem less fussy about their self-presentation so I feel like the photos are more representative of how they really are (not all those kissy girl AP photos with girlfriends and glamor). But we’ll see if I picked well for our second bro-pair, who knows if I’m wrong….maybe I just jinxed it.

Returning HM May 13, 2016 at 1:40 pm

We will welcome our fifth bro-pair in August, after six years of hosting females. I third the sentiment that it is much easier going through matching with males. First, there are fewer to screen (and I have a very specific set of criteria, so that narrows it down even further); secondly, we have found the males to be very motivated to talk to us and learn more about us, mainly because they are told when they sign up that there simply aren’t as many HFs looking for males; and thirdly, we have not found an entitled attitude at all among the males we have interviewed (not saying it’s not there, but somewhere in our screening process, we are weeding those candidates out), so the whole matching process has felt less exhausting and more fun.

MarHostMom May 19, 2016 at 11:10 am

Should be working – lol re the kissy face photos! Why do they think that’s cool?

Taking a Computer Lunch May 10, 2016 at 10:34 pm

I’d vote for rematch. And make sure when that you see the paperwork that your LCC submits to the agency that her religion does not permit taking medication, which was revealed to you after she arrived ill to your home, exposing your family at the least to an inconvenient virus with no care to warn you that she was sick. List her good qualities.

I’ll play bad parent/good parent here. Call the LCC now. Ask her to pick up the AP because you’ve learned information that has put your family at risk after juggling your work schedule to care for the AP. Document specifically the time you and your husband/partner have taken time off from work either a) to provide access to medical care for the AP or b) to care for your children while paying her salary. Calculate the number of hours she has actually worked since arriving at your home.

It does not matter how wonderful this person is. She cannot possibly, while caring for small children, keep herself healthy enough to avoid having her religion impinge on the health of your infant and young children. She might have better luck with older school-age children, who have been vaccinated and exposed to the gamut of childhood illnesses that allow them to withstand exposure to viruses with a minimum of inconvenience. Don’t feel a pang of guilt. Don’t have regrets. If she did not reveal her religious beliefs to you before she arrived, then you owe her nothing.

HRHM May 11, 2016 at 1:55 pm

This would be a show-stopper for me. I don’t know that I’ve ever seen a place where this would be revealed pre-match other than her mentioning her religion (Christian Scientist?) and then you knowing (or looking it up) about the medicine thing. Another thing to add to my interview questions… sigh.

But, having said that, I’d rematch now. Even once this passes, what if she gets strep or appendicitis later on? Potential train wreck ahead.

NBHostMom May 11, 2016 at 9:30 pm

Before this new piece of information, I was strongly leaning towards, this situation is not great but wait it out and it will pass. With this new information, that’s an instant rematch with a bonus LCC please pickup ASAP.

Refusal of needed medicine is an instant deal breaker. I’d feel I incrediblely sorry/guilty while essentially kicking her out of my house but that is well beyond the boundary of what I’m willing to accept into my home.

I’d also be raising a huge stink with the agency about this situation.

Anna May 10, 2016 at 1:29 pm

I would rematch immediately. I am all for freedom of religion (I am a minority religion myself) but I would not knowingly choose someone whose religion requires them to expose my kids to danger.
This is fundamental incompatibility.
Rematch, and don’t feel bad about it. It is better to nip it in the bud, because if that is what she chooses now, who knows what other judgments about your kids safety and childcare will she make that her religion dictates and you don’t know of?

Bat Mum May 10, 2016 at 2:14 pm

Totally agree – off with her head!

The non disclosure of these medical/religious beliefs would be a deal breaker for me especially since it puts your family at risk and precludes her from doing the job she was hired to do.
Send her home and remind her to pray for all the other passengers on the plane so that she doesn’t infect them and all.

Should be working May 10, 2016 at 4:13 pm

And now I have another question to ask APs: What medicines do you take if you are sick? If they answer ‘I don’t’, I can ask if that’s a religious belief, or (more likely in northern European au pairs) some kind of “naturalism” model, or maybe she just has never been sick enough.

I have had an AP who didn’t like to give my kid basic cold medicines because she believed in the body curing itself. To paraphrase a famous presidential candidate, “I love medicines!”

Mimi May 10, 2016 at 4:36 pm

We have always had a scenario question about high fevers and head injuries to our screening and added info to our HH because of experience. You could go crazy with all the little variables, but what we look for is something that will show them the reality of a situation with our family and assesses their critical thinking skills. (My two best questions will always be “Why are manhole covers round?” and “If you could be a pirate or a ninja, which would you choose and why?”)

Emerald City HM May 10, 2016 at 4:50 pm

Interesting. The first one has an answer (well several) and I remember learning that in grade school, so I’m not entirely sure what I would glean out of asking that. Unless maybe other people didn’t learn this. The second is way interesting mostly because I’m not sure how I would even answer that myself. Haha.

Mimi May 10, 2016 at 5:06 pm

Many people never learned why, but it’s really more about their reaction. The second (IMO) reveals a lot about their personality and social habits. ;)

Emerald City HM May 10, 2016 at 5:40 pm

I do like that it is about their reaction as pointed out by Seattle Mom below.

I kind of wonder if I struggle with what I would answer for the second because I’m am ambivert. I really don’t have a “gut feeling” answer to that where I could easily say one or the other.

Seattle Mom May 10, 2016 at 5:27 pm

I love those questions. I think I will use them. The first one is great because it shows what someone does when they don’t know the answer- do they just say “I don’t know,” do they try to figure out the reason, do they make a guess, do they pretend they do know, do they get mad that you are asking them a weird question, etc. I think you could learn a lot about a person.

The second one is good too.

Should be working May 10, 2016 at 7:52 pm

I have no idea why manholes are round but I find myself imagining different possibilities. Yes, if an AP got defensive or cranky that would say a lot. Pirate or ninja is a pretty narrow range of choices, I don’t get it, but sure why

hOstCDmom May 10, 2016 at 8:26 pm

Geometry is your friend :) Think diameter vs hypotenuse (being the diagonal of a square or rectangle). [or cut a rectangle out of a piece of paper, then try to turn it on an angle and put it through the exact hole of the rectangle…now try that with a circle. One fits through, the other doesn’t ;)] When folks lift up manhole covers, pulling on one edge, we don’t want the possibility that the cover can fall through when it is perpendicular to the surface of the road.

Returning HM May 10, 2016 at 8:52 pm

My humanities-oriented brain had SUCH a different answer to the manhole question than hOstCDmom did…

And I have no easy answer to Ninja or pirate either, mainly because I don’t know whether concept of ninja is referring to the actual Japanese term, the definition of ninja as skilled, the turtles, or the cartoon. Which will show that as an academic, I tend to overthink things and give way too complex an answer to what is supposed to be an easy question, and that might well make me a crappy au pair for my own family. :-)

Mimi May 10, 2016 at 9:27 pm

I’ve had answers that range from “it’s prettier” to “round ones are easier to roll and move.” It gets them thinking.

The pirate/ninja is a team orientation indicator for me. (Think extroverts vs introverts.) Most ‘pirates’ like the idea of fun in a group setting and will talk about sea shantys and swashbuckling adventures. If someone chooses pirates because of rum, pillaging, and making people walk the plank…well, those are bad pirates. ‘Ninjas’ talk about discipline, honor, and skill. Bad ninjas talk about being sneaky and hiding.

(My apologies to CV and the OP for inadvertently hijacking the thread.)

Emerald City HM May 10, 2016 at 9:30 pm

Haha, yeah I think that’s why I have a hard time choosing one being an ambivert. :)

Should be working May 10, 2016 at 9:52 pm

I thought it was more a smartass answer: because manholes are cylindrical! I guess that says a lot about me.

HRHM May 11, 2016 at 2:02 pm

Re: the ninjas vs pirates, having met quite a few modern day pirates off the coast of Somali, and read a lot of military history regarding the origins of the privateer, anybody who chooses pirate either has no idea about real piracy (not Johnny Depp. LOL) or should be locked up immediately! ;)

WarmStateMomma May 12, 2016 at 8:16 am


You’ve met multiple Somali pirates?? Your life sounds way more interesting than mine. :)

HRHM May 13, 2016 at 9:17 am

Courtesy of the US Navy, unfortunately, yes I have. And for the record, “Ahoy me hardies” is not remotely in their vocabulary. ;)

WarmStateMomma May 13, 2016 at 12:23 pm


Yikes! I prefer charming fictional pirates to real-life criminals.

AuPair Paris May 11, 2016 at 4:41 am

Well… Manhole covers are round, because the manholes are round! If the manhole covers were square they wouldn’t fit! (Now if you’d asked why the manholes were round, that would be a different issue!)

HRHM May 11, 2016 at 2:00 pm

This was totally my answer! LOL

Frankfurt AP Boy May 11, 2016 at 1:55 pm

Those questions remind me of the sort of questions kids I have looked after have asked me. It would be good prep if your kids are the super curious types!

momo4 May 12, 2016 at 9:23 pm

Those are such great questions!

Anon for this one May 16, 2016 at 9:11 am

My “gut” question is this: if you were a cartoon character (not necessarily Disney, etc) which one would you be – NOT – which one is your favourite or do you like – but which one are you? I’ve had some brilliant responses – and then some complete let downs but again it is very telling – i.e. Minnie Mouse shows almost no imagination or effort whereas the best one was SpongeBob Squarepants, the reason being that this girl recognised that she was a bit naïve and tended to believe that everything would just works its way out in the end – she was a lovely girl, with a positive attitude and a pleasure to be around – and because she recognised she was a bit naïve she never put herself (or my children) in questionable circumstances – we all adored her..

Schnitzelpizza May 19, 2016 at 4:23 am

Modern day pirate or 14th to 18th century pirate?
I am not one for crowds, drinking, or pillaging but would still pick historic pirate :) I like the sea and ships and I want to travel the world. Somehow I always wanted to be a “Likedeeler” (the pirates – Vicutal Brothers – sailing with Störtebeker in the 15th century) when I was little. Mostly for the system of equality, loyalty, and support the had in their little group (unlike the rest of medieval and feudalistic Europe). I don’t know if ninjas actually ever got out of Japan?

Kiwigirl May 11, 2016 at 7:28 pm

Hi there! As a future Au Pair (and registered nurse from NZ) I’ve just been reading this blog and this post jumped out at me. The agency I’m using requires very strict medical screening before acceptance into the program. It doesn’t have any required vaccinations but it does ask you provide your vaccination history. I am not sure how much of this information host families have access to before hiring an Au Pair but I would highly recommend that you check your Au Pairs vaccine records. It safe to assume when hiring from countries such as AUS, NZ, UK that MOST Au pairs will have had all the pertinent vaccines but pertussis usually isn’t on the schedule and you do need a booster for it. Definitely if you have young infants request that your AP has a pertussis booster, if they haven’t had it at home maybe offer to pay for them to get it prior to arrival (and flu if they’re open to it) I’ve nursed too many babies with whooping cough to not advise caution on this one!

Janica May 20, 2016 at 12:54 am

I am an au pair with Euraupair.. We have to have a doctor check up and sign off on our immuniziation record. Get a second opinion, and have her checked out!

IndianaAdventure May 26, 2016 at 11:01 am

Not working for 12 weeks is too long. That’s a quarter of her year. I’m all for bending over for an au pair, but that’s way outside of reasonable. I’m also supportive of her choice to not take medication, but freedom of choice doesn’t mean freedom from the consequences of those choices. Yes, she’s a family member but her choice to not take medication means that she can’t participate in the program the way she is meant to.

Not helpful for the current family, but since I have babies (first au pair started when my first was 2 months old, second when we were planning on a new baby during her year) I require an up-to-date pertussis vaccination (within past 9 years because it’s only good for about 10 years) and ask if they are up-to-date on their country’s required vaccinations. One au pair had to get a pertussis booster but the other had their booster recently enough. I had a co-worker whose 2 month old caught it (from grandparents with a way out of date vaccination) and was hospitalized for 4 months so I’m a bit touchy on the subject. I also say prior to matching that we will require (and pay for) a flu vaccine once the fall comes. Most daycares/nannies in my area have similar requirements so I don’t feel bad about this since I mention it before matching.

I will say that if I didn’t have a new baby I wouldn’t have thought to ask about any of this. My doctor told me about 3 times to make sure any caregivers had up to date pertussis shots. They even had a poster about it in the office.

Another CA HM May 31, 2016 at 1:22 am

Our RN au pair arrived with BRACES!

I remember picking her up at the airport and my first thought was that there was no way this wasn’t going to be a problem. Her dentist apparently assured her she’d be fine for a year. Within a few months wires were popping off and she was in significant pain and I was researching dental clinics while she was considering flying home to have them removed (also diy youtube videos). She ended up meeting a dentist from her home country that removed them at no charge and fit her with a retainer. She’s currently completing her second year with us (third au pair and amazing).

So host moms- on top of immunizations you can add braces to your interview!

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