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Communicable Disease Reference Chart for School Personnel

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Communicable Disease Reference Chart for School Personnel Communicable Disease Reference Chart for School Personnel DISEASE INCUBATION PERIOD TRANSMISSION COMMON SYMPTOMS RECOMMENDATIONS Chickenpox* 10-21 days, usually 14-16 By direct contact with vesicular Sudden onset with slight fever, CASE: Exclude from school or child care until the rash of case with (Varicella) days. fluid or by airborne spread from other systemic symptoms and itchy uncomplicated varicella has crusted or, in immunized cases respiratory tract secretions. eruptions which become vesicular without crusts, until no new lesions appear within a 24-hour (Incubation period in (small blisters) within a few hours. period. Additionally, exclude from school for at least 5 days after persons who receive Infectious from 1 to 2 days before Lesions commonly occur in eruptions first appear or until vesicles become dry in VariZIG or IVIG extends rash onset until all lesions have successive crops, with several immunocompromised patients. Avoid exposure to women in through day 28.) dried/crusted over and no new stages of maturity present at the early pregnancy who have not had chickenpox and/or varicella lesions appear within a 24 –hour same time. Typically, vesicular rash vaccine. period (average is 4-7 days). consisting of 250-500 lesions in varying stages of development CONTACTS: Check vaccination status of contacts and (papules, vesicles) and resolution recommend vaccination if needed within 3 to 5 days after (crusting). Communicable for as exposure. For exposed contacts without immunity, airborne and long as 5 days (usually 1-2 days) contact precautions from 8 until 21 days after exposure and until before eruption of vesicles and until 28 days after for those who received VariZIG or IVIG. On all lesions are crusted (usually 5 appearance of symptoms, exclude from school. days). Communicability may be prolonged in immunocompromised people. Conjunctivitis, Acute Usually 1-3 days, but By contact with discharges from the Pink or red eyeball with swelling of CASE: Exclude from school while symptomatic or until 24 hours Bacterial (Pink Eye) variable depending on the conjunctivae or contaminated the eyelids and eye discharge. of antibiotic treatment has been completed. causative agent. articles. Eyelids may be matted shut after sleep. May involve one or both CONTACTS: School exclusion not indicated. eyes. Important to wash hands thoroughly after contact with eye drainage. Also, do not share any articles that have come into contact with the eyes. COVID-19 Usually 2-14 days Primarily by larger droplets (saliva, About 45% of patients have no CASE: Isolate student immediately and exclude from school until (Coronavirus 2019 respiratory secretions) that land on symptoms at all. Patients who student has met criteria to discontinue isolation. Depending on infection caused by another person’s nose, mouth or develop symptoms may have a severity of illness, refer student to their own medical provider, SARS-CoV-2 virus) eyes. Some evidence that SARS- wide variety of symptoms of urgent care center, or emergency department for further CoV-2 virus may spread by airborne variable severity. Symptoms may evaluation and treatment. In general, illness is less severe in transmission, but not felt to a include: children than adults. In general, student will be out of school for primary mode of spread. Also, Fever and/or chills at least 10 calendar days – this may vary depending on when some evidence that having virus on Cough student’s symptoms began if student was symptomatic. hands (after touching a Shortness of breath contaminated surface) and Headache CONTACTS: A close contact is defined as someone who was touching one’s nose, mouth, eyes Runny nose within 6 feet of an infected person (laboratory-confirmed or a may transmit virus. However, this is clinically compatible illness) for a cumulative total of 15 minutes Fatigue not considered a major mode of or more over a 24-hour period (for example, three individual 5- spread. Sore throat minute exposures for a total of 15 minutes). A close contact also Muscle aches/body aches includes someone who had direct exposure to respiratory New loss of taste or smell secretions (e.g., being coughed or sneezed on, sharing a drinking Nasal congestion glass or utensils, or kissing). In general, a fully vaccinated close Nausea and vomiting contact doesn’t need to quarantine, and a non-fully vaccinated Diarrhea close contact does. See VDH info for current guidance. NOTE: THESE RECOMMENDATIONS APPLY ONLY TO SHOOL-AGED CHILDREN - A more complete discussion of these conditions and other communicable diseases may be found in Control of Communicable Diseases Manual (2014) published by the American Public Health Association and the 2021 Report of the Committee on Infectious Diseases (The Red Book) published by the American Academy of Pediatrics. Additional information and consultation are also available through your local health department. * Officially reportable in Virginia to the local health department. All outbreaks and unusual occurrences of disease are also reportable. Page 1 of 8 July 30, 2021 Communicable Disease Reference Chart for School Personnel DISEASE INCUBATION PERIOD TRANSMISSION COMMON SYMPTOMS RECOMMENDATIONS Diarrheal Diseases* Campylobacteriosis: Primarily by the fecal-oral route Ranges from sudden onset of fever, CASE: Exclude from child care centers until stools are contained (Campylobacteriosis, Usually 2-5 days but can through direct contact or by abdominal pain, diarrhea, nausea, in the diaper or when continent cases no longer have fecal E. coli O157:H7, be longer (1-10 days). ingestion of contaminated (or and sometimes vomiting in accidents and when stool frequency becomes no more than 2 Giardiasis, improperly cooked) food or water. salmonellosis, to cramps and stools above normal frequency for the case, even if the stools Salmonellosis, E. coli O157:H7: Varies Occasionally, person-to-person bloody stools in severe cases of remain loose. Stress importance of proper handwashing. In an Shigellosis, etc.) from 1 to 10 days, usually among very young children. shigellosis and E. coli O157:H7. outbreak setting, consult local health department for clearance 3 to 4 days. Dangerous dehydration may occur to return to school / childcare setting. Please note that other in younger children. In giardiasis, resources advise no return to school until diarrhea has ceased for Giardiasis: Usually 1 to 3 persons may be asymptomatic or at least 24 hours. weeks. have decreased appetite and weight loss. CONTACTS: School exclusion and stool cultures not indicated in Salmonellosis: Usually, 6- absence of symptoms. Contacts who are symptomatic should be 72 hours, but periods of a Diarrhea, abdominal pain, malaise, excluded until stools are contained in the diaper or child is week or more have been and fever. Stools can contain visible continent and stool frequency is no more than 2 stools above reported. or occult blood. that child's normal frequency for the time the child is in the Immunocompromised hosts can program. Stool cultures are recommended for symptomatic Shigellosis: Varies from 1 have prolonged, relapsing, or contacts, and these children should be excluded from school to 7 days, typically 1-3 while evaluation pending. Consult with your local health extraintestinal infections. days. department for advice during suspected school outbreaks. Thorough hand hygiene and environmental cleaning is very important. Fifth Disease Between 4-14 days but By contact with respiratory tract Distinctive rash characterized by a CASE: Exclusion from school not indicated beyond school-based (Parvovirus B19, can be as long as 21 days. secretions and percutaneous vivid reddening of the skin, policies about fever. Erythema exposure to blood or blood especially of the face, which fades Infectiosum) products. and recurs; classically, described as CONTACTS: School exclusion not indicated. Pregnant women a “slapped cheek appearance.” The and immunocompromised persons should seek medical advice. rash can fluctuate in intensity and can recur with environmental changes, such as temperature and exposure to sunlight, for weeks to months. Mild symptoms of fever, body aches, and headache may occur 7-10 days before rash. Hepatitis A* From 15-50 days, By the fecal-oral route through Initial symptoms begin abruptly and CASE: Cases with acute HAV infection who work as food handlers average 28 days. direct contact or ingestion of include fever, nausea, vomiting, or attend or work in child care settings should be excluded for 1 contaminated food or water. anorexia, malaise, and abdominal week after onset of the illness. Serologic testing should be All suspected or pain or discomfort. Dark urine, pale performed to confirm HAV infection in suspected cases. Exclusion confirmed cases of People with HAV infection are most stools, and jaundice (yellowing of until 1 week after onset of illness is indicated. hepatitis A are rapidly infectious during the 1 to 2 weeks the skin or reportable to the local before onset of jaundice or eyes) might be present initially or CONTACTS: Determine if contact is immune to HAV through health department elevation of liver enzymes, when might develop a few days to a week immunization records and/or serologic testing (a positive Hep A concentration of virus in the stool is later. The likelihood of symptoms IgG). Contacts who are immune do not need additional follow- highest. Risk diminishes and is increases with age. up. Determine if contact meets criteria for HAV post-exposure minimal by 1 week after onset of prophylaxis (PEP). jaundice. Symptoms typically lasts less than 2 NOTE: THESE RECOMMENDATIONS APPLY ONLY TO SHOOL-AGED CHILDREN - A more complete discussion of these conditions and other communicable diseases may be found in Control of Communicable Diseases Manual (2014) published by the American Public Health Association and the 2021 Report of the Committee on Infectious Diseases (The Red Book) published by the American Academy of Pediatrics. Additional information and consultation are also available through your local health department. * Officially reportable in Virginia to the local health department. All outbreaks and unusual occurrences of disease are also reportable.
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