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Communicable Disease Exclusion Guidelines for Schools and Child Care Settings

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Communicable Disease Exclusion Guidelines for Schools and Child Care Settings Deschutes County Health Services COMMUNICABLE DISEASE EXCLUSION GUIDELINES FOR SCHOOLS AND CHILD CARE SETTINGS Symptoms requiring exclusion of a child from school or childcare setting until either diagnosed and cleared by a licensed health care provider or recovery. FEVER: ANY fever greater than 100.5 F., may return when temperature decreases without use of fever-reducing medicine. VOMITTING: > 2 in the preceding 24 hours, unless determined to be from non-communicable conditions. May return when resolved. DIARRHEA: 3 or more watery or loose stools in 24 hours. May return when resolved for 24 hours. STIFF NECK: or headache with accompanying fever. May return after resolution of symptoms or diagnosis made and clearance given. RASHES: ANY new onset of rash if accompanied by fever; may return after rash resolves or if clearance given by health care providers. SKIN LESIONS: Drainage that cannot be contained within a bandage. JAUNDICE: Yellowing of eyes or skin. May return after diagnosis from physician and clearance given. BEHAVIOR CHANGE: Such as new onset of irritability, lethargy or somnolence. COUGH /SOB: Persistent cough with or without fever, serious sustained coughing, shortness of breath, or difficulty breathing. SYMPTOMS or complaints that prevent the student from active participation in usual school activities, or student requiring more care than the school staff can safely provide. Inform local county health department, (LHD), of all diseases listed as reportable. The local county health department should be consulted regarding any written communication that may be developed to inform parents/guardians about disease outbreaks, risk to students, families, and staff and/or control measures specific to an outbreak. DISEASE / CONDITION EXCLUDE SYMPTOMS TRANSMISSION PREVENTION RECOMMENDED SCHOOL COMMON NAME RESTRICTION INCUBATION PRECAUTIONARY CONTROL MEASURES MEDICAL TERMINOLOGY REPORT COMMUNICABILITY MEASURES ABSCESSES / BOILS EXCLUDE: For open Open, pimple-like sores Direct contact with Cover wounds. No foodservice duties while lesions are DRAINING WOUNDS draining wounds, that are swollen, infectious bodily fluids. present. tender; may be crusted Proper handwashing. STAPH SKIN INFECTION RESTRICTION: MAY or draining pus. Indirect contact with Good personal hygiene. INCLUDING MRSA ATTEND: articles contaminated with If drainage can be drainage. Proper handwashing contained within bandage; Communicable as long as or lesion is dry and sores are open, draining and crusted without drainage. untreated REPORT: NO AIDS / HIV EXCLUDE: NO HIV infection in Bloodborne Pathogen Children infected with Standard Precautions while dealing children is a broad Sexual contact, mucous HIV are at an increased with blood or body fluids. ACQUIRED IMMUNE RESTRICTION: NO spectrum of disease membrane contact with risk of experiencing DEFICIENCY SYNDROME REPORT: YES HCP and clinical course. blood or other body fluids severe complications from Report all exposures of body fluid should report NOT AIDS represents the with high titers of HIV, infections such as contact to broken skin / mucous school nurse to LHD most severe end of the percutaneous (needles or varicella, tuberculosis, membranes to Risk Management. In the absence of blood clinical spectrum of other sharp instruments), measles, CMV and herpes exposure, HIV infection is not this disease. and mother-to-infant. simplex virus. See: “Guidelines for Schools with acquired through the types of contact that usually occur in a Schools should develop Children who have bloodborne school setting; including Communicable lifetime; procedures for notifying infections” – Oregon Health Division. contact with saliva or tears. With changing infectivity parents of communicable Hence, children with HIV based on viral load. diseases such as varicella infection should not be and measles. excluded from school for the protection of others. AAP-Redbook 2006, p.396 2018-19 School and Childcare Guidelines - 1 - DISEASE / CONDITION EXCLUDE SYMPTOMS TRANSMISSION PREVENTION RECOMMENDED SCHOOL COMMON NAME RESTRICTION INCUBATION PRECAUTIONARY CONTROL MEASURES MEDICAL TERMINOLOGY REPORT COMMUNICABILITY MEASURES ATHLETE’S FOOT EXCLUDE: NO Scaling, cracking skin Direct contact with lesions Proper foot hygiene. Routine disinfection of school showers between toes with Clean, dry feet and socks. and floors with approved antifungal TINEA PEDIS RESTRICTION: NO burning and itching. Indirect contact with agents. Fungal infection of the feet. REPORT: NO Similar in nature to Tinea Blistering with thin contaminated articles Use of drying absorbent watery fluid. (shower and gym floors). antifungal powders. Recommend use of thongs in showers. corporis (ringworm of skin). Communicable until treated Use own towels and Prohibit walking barefoot, sharing of with antifungal medications. socks. towels, socks or shoes. CHICKEN POX Rash is a thin-walled, easily ruptured, blister-like Direct contact with Vaccine recommended to The vaccine is 95% effective in VARICELLA rash, or red rash usually beginning on trunk; blisters infectious body fluids, individuals 12 months preventing MODERATE to SEVERE Primary infection results in scab over. Heaviest on trunk. drainage from blisters. and older. DISEASE, but only 70% to 85% a generalized rash. Indirect contact with items effective in preventing MILD to EXCLUDE: YES, contaminated with secretion. Good Handwashing MODERATE disease. See Also SHINGLES Airborne Chickenpox may Avoid touching sores. The recurrent infection with CASE: until a minimum of 5 days after first vesicles be transmitted through nasal Cases of varicella may occur in some the virus is called shingles. (pox) appear, or until all pox are dry. Whichever secretions. Cover mouth and nose vaccinated persons following exposure occurs last. when coughing, or to wild-type virus. This is called The virus is believed to have Incubation 14-16 days sneezing. breakthrough infection. Breakthrough a short survival time outside CONTACTS: In an outbreak situation consultation range 10-21 days. infection is varicella to wild-type the infected host. Humans with LHD for exclusion. Teachers of young varicella zoster virus and usually are the only source for this Communicable for 5 days children and women of results in mild illness. Nonetheless, before rash until at least 5 childbearing age should breakthrough varicella is contagious disease. REPORT: YES, for outbreak situations. days after rash appears. know their immune and can lead to transmission of virus CDC Pink book status or be immunized. to those unvaccinated and at risk for www.cdc.gov/nip/diseases/varicella/ complications, such as adults, immunocompromised individuals, and pregnant women. 1%-4% of vaccines may have a varicella-like illness, with fewer than 10 lesions post-vaccination. CMV EXCLUDE: NO Asymptomatic Direct contact with mucous Good handwashing, Standard Precautions when dealing infections are common. membranes, saliva. personal hygiene. with body fluids CYTOMEGALOVIRUS RESTRICTION: NO A mononucleosis-like Vertical from mother to REPORT: NO Caused by a human herpes illness with fever may fetus/infant. Cover mouth and nose Women of childbearing age or virus. Most severe form of occur. Incubation variable, 3 weeks when coughing, or immunocompromised individuals the disease affects to 3 months following blood sneezing. should consult with personal physician perinatally infected infants, transfusion, longer for saliva, regarding risks while caring for premature infants, and the household or vertical No food sharing. children identified as carriers of CMV. immunocompromised. transmission. AAP-Redbook 2006, p332 Communicable Virus Most children will be asymptomatic secreted in saliva/urine for and undiagnosed. many months, and may persist for years. 2018-19 School and Childcare Guidelines - 2 - DISEASE / CONDITION EXCLUDE SYMPTOMS TRANSMISSION PREVENTION RECOMMENDED SCHOOL COMMON NAME RESTRICTION INCUBATION PRECAUTIONARY CONTROL MEASURES MEDICAL TERMINOLOGY REPORT COMMUNICABILITY MEASURES COLD SORES EXCLUDE: NO Blister-like sores Direct Contact from sores to Good Handwashing Avoid contact sports while blisters are erupting around mucous membranes such as Avoid touching sores present. E.g. wrestling, rugby. HERPES SIMPLEX RESTRICTION: YES mouth. kissing, or to abraded skin Avoid sharing lip balms, Oral HSV infections are Limit PE activities that such as contact sports such lipsticks, etc. DO NOT share sports bottles. common among children. would involve physical as wrestling. Most are asymptomatic, contact if active lesions Incubation 2 – 12 days Limit/restrict P.E. Appropriate cleaning of wrestling mats with shedding of the virus cannot be covered. in saliva in the absence of Communicable most activities that would at least daily and preferably between REPORT: NO infectious during blister involve contact while matches. (Bleach ¼ cup to 1 gallon clinical disease. phase, can be spread at blisters are present. water) AAP Redbook other times. COMMON COLDS - RTI EXCLUDE: if fever is Runny nose and watery Direct contact with nose Cover mouth and nose Practice good personal hygiene. RESPIRATORY TRACT present. May return when eyes, cough, sneezing, and throat secretions when coughing and INFECTIONS fever resolves. possible sore throat, Airborne droplets. sneezing. Cover mouth and nose when coughing, chills, general malaise Indirect contact with sneezing. RHINOVIRUSES RESTRICTION: Consider contaminated articles. Good Handwashing. ADENOVIRUSES if number of cases in Fever uncommon. Incubation 12-72
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