Communicable Disease Control

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

A communicable disease is any illness or disorder transmitted from a person or an animal to another person directly by contact with excreta or discharges from the body, or directly by substances or inanimate objects. Many communicable diseases are present at any given time whenever children are in close proximity of each other, as in schools. Students in close contact with each other should be observed routinely for signs and symptoms of communicable diseases. When a suspected communicable disease is observed, that student should be referred to the school nurse for assessment. After assessment, notification should be made to the student’s primary provider, the teacher, and the principal if the illness is a suspected reportable communicable disease. As part of a preventative health program, the primary provider and the teacher should be given exclusion and re-admittance parameters. Periodic information from the school to parents/community regarding the signs and symptoms, treatment, and exclusion and re- admittance criteria for the more common “childhood” communicable diseases will help to foster the home-school partnership bond and alleviate fears and uncertainties within the community.

The school nurse should coordinate with the local medical treatment facility regarding reportable communicable diseases, signs and symptoms, treatment, and parameters for re-admittance to school.

At all times the privacy of the student and his or her family should be of the utmost importance. Faculty and staff may need to be reminded that this information is confidential and is being shared with them on a need-to-know basis.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

COMMUNICABLE DISEASE CHART DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Chicken pox Average 14–16 Day before to Slight fever and Observe for Airborne Exclude at least 5 See CDC: (Varicella zoster days for new about 6 days after eruptions eruptions during respiratory, i.e. to 7 days or until http://www.cdc.g virus) exposures. lesions appear. progress from incubation directly from all pustules are ov/chickenpox/ab May be prolonged red bumps to period. person to person dry, longer for out/ in altered small blisters and through immuno- immunity. pustules to discharges of compromised crusts. All forms nose and throat. persons. Exclude of rash may be immuno- seen at the same suppressed time. children who are non-vaccinated with negative history during outbreaks.

Chlamydia If symptoms Untreated sexual “Silent disease”— Sexual contacts. Sexually Treat with antibiotics. See CDC (Chlamydia occur, they partner transmits 75% of women and transmitted If untreated, causes http://www.cdc.g 50% of men have no severe reproductive Trachomatis) usually appear the bacteria during symptoms. Most (acquired) and other health ov/std/chlamydia/ within 1–3 weeks vaginal, anal, or infected people are bacterial problems including stdfact- of exposure. oral sex. not aware of their infection. pelvic inflammatory chlamydia.htm Highly contagious, infection. disease (PID). Critical Untreated men may link to infertility and immediate have urethral tubal pregnancy. May infection. infection and swollen also cause adverse and tender testicles. outcomes of Women may have pregnancy (neonatal vaginal discharge or conjunctivitis and burning sensation pneumonia). with urination. With infection spread there may be pain, nausea, and bleeding. Permanent and irreversible damage can occur. Screening yields definitive diagnosis.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Conjunctivitis, 24–72 hours. Until discharges Redness of sclera Observe for Contact with eye Exclude until See CDC: Bacterial/viral and symptoms with tearing and symptoms. discharges and completion of 24- http://www.cdc.g (Pink eye) have cleared. irritation, swelling articles soiled hr. effective ov/conjunctivitis/ of lid, sensitivity with discharge. treatment with about/symptoms. to light, and thick Contagious, but ophthalmic html purulent transmitted less solution, until discharge with easily than viral discharge and crusting during form. signs of infection sleep. Itchiness have cleared. may be present. Hand washing.

Fifth Disease 1–2 weeks. Most contagious Fever, malaise, Watch those Droplets of Exclude until See CDC: (Erythema just before onset headache, most likely to respiratory fever free for 24 http://www.cdc.g Infectiosum) of fever, gradually “Slapped-face” have secretions or hours. ov/parvovirusB19 declining during erythema of complications. secondarily by Emphasize /index.html the following cheeks, lace-like Persons with hands. importance of week, and low to rash on arms, anemia or hand washing. absent by the time trunk, chest, immuno- Concern for the rash appears. thighs, deficiencies and immuno- Disease often extremities. non-immune suppressed occurs in late Rash may recur pregnant women persons. winter and spring, 1–3 weeks or may choose to Pregnant women so Dx may be longer if exposed avoid exposure who become suspected in pre- to sunlight or to contacts. infected in the rash infective heat; arthritis They should be first 4–5 months stage if it has may be a advised to are at risk for occurred in other complication. consult with their spontaneous family members. Fifth disease may physician. abortion. Advise These children be sub clinical. pregnant staff to should not be in consult their school. doctor.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Hand/Foot/ Usually 3 – 5 Most contagious Usually starts Observe for An infected There is no See CDC: Mouth Disease days post during the first with a fever, poor symptoms. person may specific treatment http://www.cdc.g (HFMD) exposure. week of illness. appetite, malaise, Exclude those spread the for hand, foot ov/hand-foot- (Coxsackievirus People can and sore throat. with fever, sore viruses that cause and mouth mouth/index.html A16 or sometimes be One or 2 days throat and hand, foot, and disease. Enterovirus 71) contagious for after fever starts, blisters. Stress mouth disease However, some days or weeks painful sores good hand through: things can be after symptoms go usually develop in washing. done to relieve  close away. Some the mouth symptoms, such personal people, especially (herpangina). as: contact, adults, who get They begin as  Taking over- infected with the small red spots  the air the-counter viruses that cause that blister and (through medications hand, foot, and that often coughing or to relieve mouth disease become ulcers. sneezing), pain and may not develop The sores are  contact with fever any symptoms. often in the back feces, (Caution: However, they of the mouth. A Aspirin may still be skin rash  contaminated should not be contagious. This develops over 1 objects and given to is why people to 2 days. The surfaces children.) should always try rash has flat or

to maintain good raised red spots,  Using hygiene (e.g. hand sometimes with mouthwashes washing) so they blisters. The or sprays that can minimize their rash is usually on numb mouth chance of the palms of the pain spreading or hands and soles getting infections. of the feet; it may also appear on the knees, elbows, buttocks or genital area.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Head Lice The louse cycle: Contagion remains Lice don’t carry Observe for Direct contact Personal treatment: See CDC: (Pediculosis Eggs (nits) hatch possible as long as disease, but a presence of nits with infected non- prescription lice http://www.cdc.g capitis) in 7–10 days; the louse or nits are sensitivity or or lice. Treat person, linens, shampoos and ov/parasites/lice/ generic equivalents female is able to present on allergic reaction household and brushes, hats, kill lice but not all head/ lay eggs 10 days infected persons. to the saliva of personal and scarves. nits. They must be later and has a Repeat the louse’s biting contacts if Head-to-head used as directed on life span of 30 shampooing is the scalp causes findings positive. contact - fabric dry hair, not days. Adults can essential to control itching. Screening of items may be previously conditioned. Re- survive 1–2 days newly hatched Scratching the whole considered direct shampooing in 7–10 off a human host. nymphs. scalp can result classrooms is no contact. Non- days is necessary to Both the nymphs in secondary skin longer practiced. fabric items are kill newly hatched and adult lice feed infection and However, a low risk, such as nymphs. on human blood. enlarged lymph notice to the headphones, solid Environmental nodes. Newly whole school to helmets, and vinyl treatment: Hot laundry (130˚ F for laid nits are remind parents headrests. at least 5 minutes) located on the These should be and dryer for bed hair shaft at the cleaned for linen, night clothes, scalp. Nits 3–4 general hygiene. washable head mm from the wear, helmet liners, scalp are etc. Dry cleaning or storage in a bag for considered non- 2 weeks for un- viable. Nits and washable items. Hot egg casings may water (130˚ F) stay on the hair soaking of combs shaft as it grows. and brushes. Fumigation or The presence of insecticide sprays nits alone is not are not advised; indicative of a vacuuming is live infestation. sufficient. Educate Nits do not need families to treat to be removed promptly so the infected child can for school return to school the attendance. same day, no later than the next day.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Hepatitis A=2–6 weeks. A=may be short. When any one of A=IG for close A=Fecal-oral, Universal See CDC: A, B, C B=1–6 months. B=may be long. the Hepatitis contacts, transmitted by precautions. http://www.cdc.g C=7–9 weeks. C=unknown. viruses invades household food and water. Physician referral. ov/hepatitis/ the body, it members. Virus is shed in A=Immune affects the liver Exposure at stool of infected globulin is and produces school not person; blood and protective if given similar considered close secretions may be within 10–14 symptoms, which contact. infectious. days of exposure. may include rash, +Vaccine B, C=Contact Return to school achy joints, fever, preventable. with blood and as soon as fever, malaise, B=sexually other body fluids. jaundice is over jaundice, dark transmitted and appetite has urine, light stools, disease. Drug returned. headache. users are at B=post-exposure higher risk. 10% prophylaxis of infected (HBIG) is people develop effective because chronic disease of long incubation and become period. carriers. C=Mild clinical +Vaccine course. preventable. Most infections C=associated are lifelong with blood without transfusion. significant Contaminated damage. needle piercing and tattooing Chronic liver implicated. infection can No vaccine result in cancer currently or liver failure. available.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Herpes First episode Throughout period Most have no or Sexually Direct sexual Oral acyclovir See CDC: Simplex, Type 2, usually occurs of sexual contact minimal transmitted contact. prescribed to http://www.cdc.g Genital within 2 weeks with infected symptoms. When disease. Newborn baby suppress painful ov/std/herpes/std after the virus is partner, from viral symptoms occur, No school may acquire lesions. fact-herpes.htm transmitted. shedding and they are blisters exclusion. infection during There is no cure. herpes sores. on or around the vaginal delivery if genitals or mother has active rectum. Blisters lesions. break, leaving sores that may take 2–4 weeks to heal on first occurrence. Outbreaks may occur, usually less severe than the initial episode. Herpes Simplex, First episode While lesion is Blister usually on Observe for Direct contact Oral-base topical See CDC: Type 1, Oral usually occurs active with virus- or around, throat, symptoms. with fluid- pain reliever. http://www.cdc.g within 2 weeks containing fluid. lips, and facial containing blister. Cold compresses ov/std/herpes/std after virus is areas. Blisters to reduce fact-herpes.htm transmitted. break, leaving swelling. crusted sores. Applying petroleum jelly to infected area to prevent cracking.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION HIV Variable. Infected persons Minimal to no Sexually Direct sexual Due to the See CDC: Human are considered symptoms transmitted contact with current advances http://www.cdc.g Immunodeficien contagious with present at disease by infected persons; in medical ov/std/hiv/default cy Virus direct/indirect infection. contact with sharing needles treatment and .htm contact. infected blood, or syringes with the constantly semen, vaginal infected persons; changing regimen fluid, and breast transfusions of of care, milk. See route infected blood. treatment of infection. Babies born to modalities are No school HIV-infected not listed in this exclusion. women may document. become infected before or during birth or through breast milk. Condoms (latex), properly Used, provide a degree of protection against HIV infection. Impetigo, 4–10 days. Until lesions are Blister-like Observe for Contact with Exclude for 24 See CDC: Streptococci or clear, usually 1 –2 lesions, which symptoms. discharge from hrs. And http://www.cdc.g Staphylococcus weeks. develop into Emphasize lesions or articles prescribe ov/ncidod/dbmd/ (MRSA) pustules, most personal soiled by ointment or oral diseaseinfo/group commonly on cleanliness. discharges or antibiotic for astreptococcal_g. hands and face. Stress hand nasal carriers. moderate to htm or May occur washing and severe cases. http://www.cdc.g anywhere on avoidance of Cover dressing is ov/ncidod/disease body. common use required for s/submenus/sub_ items. school staphylococcus.ht attendance. m

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Measles 7–14 days from 1–4 days before High fever*, Observe and Respiratory Exclude at least 5 See CDC: Rubeola Virus exposure to onset onset of fever to severe cough, exclude those droplets and less days after rash http://www.cdc.g of first symptoms 2–4 days after coryza and with fever, rash. common airborne unless ov/measles/ - fever, cough, appearance of conjunctivitis, droplets; direct unvaccinated; runny nose; 3-5 rash. deep red contact with nasal then exclude for days after the maculopapular or throat 14 days after start of rash; becomes secretions. onset of symptoms, a red confluent. Rash +Vaccine symptoms. No or reddish-brown at end of 2nd or preventable. specific antiviral rash appears. 3rd day during therapy. height of fever. Exposure is not a Leukopenia. contra-indication Symptoms are to vaccination; if usually severe. vaccinated within 72 hours of exposure, may provide some protection. Meningitis Dependent upon Dependent upon High fever*, Observe for Some forms are Dependent upon See CDC: (Viral or pathogen. pathogen. headache, and stiff symptoms. contagious pathogen. http://www.cdc.g bacterial neck (in children Exclude those through exchange ov/meningitis/ind infection) over 2 years old). with symptoms. of respiratory and ex.html May develop over Streptococcus- throat secretions several hours or 2 Pneumonia & days. Symptoms (e.g., coughing, Neisseria may include kiss-sing). Other Meningitidis nausea, vomiting, forms (N. men- photophobia, ingitiis, HIB) confusion, and spread by close sleepiness. contact with Infants may appear infected persons. inactive, irritable, or exhibit vomiting or feeding problems. May progress to seizures.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Mumps May occur 14–25 Three days before Fever*; swelling Observe for Spread through Exclude 9 days See CDC: Parotitis days after to the 4th day of and tenderness symptoms. respiratory after onset of http://www.cdc.g Paramyxovirus exposure. active disease. of parotid (30- Exclude those droplet or direct parotid gland ov/mumps/ Virus has been 40%) or salivary with fever. contact with swelling. For isolated from glands; orchitis saliva. outbreak control, saliva 7 days (testicular +Vaccine may consider before to 9 days inflammation) preventable. excluding those after parotid usually unilateral not immunized swelling. in post-pubertal until at least 26 males (20%- days after the 50%) or onset of parotitis oophoritis in the last person (ovarian with mumps in inflammation) in the affected post-pubertal school. females (5%) Pinworm 2–8 wks. is As long as females Itching around the If pinworm Pinworm eggs are Children may return See CDC ; Enterobius estimate from discharge eggs anus, disturbed infection occurs infective within a to school after the http://www.cdc.g sleeping, and first treatment dose, Vermicularis acquisition of and eggs are again, all family few hours after ov/healthywater/ irritability. members. bathing, and trimming infection and viable. Adult worms may be being deposited and scrubbing nails. hygiene/disease/p Playmates and deposit of eggs seen at night directly on the skin. They Treat with either inworms.html schoolmates by female worm; in bedclothes or can survive up to prescription or over- around the anal area. should be the-counter anti- eggs infective If pinworms are considered. 2 weeks on enterobius drugs. within a few hrs. suspected, Each infected clothing, bedding, Consult health care after being transparent adhesive person should or other objects. provider prior to deposited, usually tape (Scotch tape receive the usual Infection occurs initiating treatment. test) or a pinworm 2-dose treatment. Treatment is a 2-dose in area of anus; paddle are applied to after accidentally course. The second eggs may remain the anal region. Test In some cases it swallowing dose should be given infective in an should be done as may be necessary infective pinworm 2 weeks after the to treat 4–6 times, indoor soon as waking in the eggs from first. morning, prior to with treatments environment up bathing or bowel spaced 2 weeks contaminated Bath upon to 2 to 3 weeks movement. Samples apart. Humans are surfaces of awakening; change off host. taken from under the only known hosts. fingers. and wash underwear fingernails may also each day; change contain eggs as a nightclothes result of scratching. frequently. Institute

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION personal hygiene and hand washing. Trim fingernails short. Eggs are light sensitive, so open blinds/curtains in the daytime. Ringworm 10–14 days. Viable fungus may Asymptomatic in Observe for signs Direct skin Exclude until under See CDC: (Tinea Capitis) May persist 3 persist on early stages, but of infection. contact with medical care. http://www.cdc.g Fungal infection months to several contaminated scalp or back of Household lesions of infected Require written ov/fungal/dermat years. materials for long neck may itch. contacts, persons or medical statement ophytes/ Balding patches of treatment and periods. especially cats, animals and (round or oval) on return. Treatment scalp. Characteristic may be carriers. fomite is a combination of “black dots” where contaminated oral (griseofulvin) hairs break close to articles (combs, and topical scalp within the hats, backs of antifungal cream, patch. Patches theater seats, lotion, or shampoo. may be small barber clippers), Oral treatment is (1–2 cm), bedding, and necessary because moderately large clothing the fungus invades (up to 10 cm), or the hair shaft and confluent so they goes beneath the appear irregularly skin. Griseofulvin shaped. Scalp may is taken once or be smooth or scaly twice daily for 4–8 with pustules and weeks and may be crusting. Tender, continued until boggy lesions cultures are (kerion), negative. surrounded by Additional topical pustules are due to treatment hypersensitivity to (selenium sulfide) fungus. Swollen reduces infectivity, posterior neck so the student can lymph nodes. return to school as soon as treatment has begun.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Ringworm 4–10 days. As long as lesions Flat, ring-like Observe for Direct and Corporis: May See CDC: Tinea (fungal are present and lesions on symptoms. indirect skin-to- exclude to initiate http://www.cdc.g infection of the viable fungus exposed skin skin contact with treatment. ov/fungal/dermat skin) persists on areas. Edges are infected persons, Affected area ophytes/ Classification contaminated reddish brown animals, or soil. should be 1. Pedis materials. with small blisters Monitor for covered with a (athlete's foot) or pustules. secondary topical fungicide 2. Cruris Lesions may be infection. and a loose (Jock itch) dry and scaling or dressing or 3. Corporis moist and clothing for (Body) crusted; scaly school; institute 4. Onychomy macules cleaning at cosis (nails) gradually expand school. outward, clearing in the middle. Itching is common. Scabies (Mites) Several days to 6 Until mites and Typical lesion is a Frequently found Direct skin-to-skin Exclude from See CDC: Sarcoptes weeks. Itching eggs are destroyed “burrow” (tiny, in other family contact; can be school. May http://www.cdc.g scabiei var. may persist a by treatment, pale, irregular members. acquired during return 8 hours ov/parasites/scabi hominis month after usually 1–2 line that marks sexual contact; after first es/ treatment. courses of the path of the mites can burrow prescription treatment a week mite). Rash: tiny under skin in 2–5 treatment. apart. (1–2 mm) minutes. Steroid ointments erythematous or lotions are papules, vesicles, contraindicated. pustules, and Anti-scabietic scabs. Intense lotions should not itching, especially be used more at night. than twice in a month. Watch for secondary infection.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Scarlet fever 2–5 days. From first day Streptococcal: Observe for Person-to-person Curable with See CDC: (Scarlatina) before fever to sore throat, symptoms. carriers: articles penicillin/antibioti http://www.cdc.g Group A after 24 hours on sudden onset of Exclude those soiled by nose cs. ov/features/scarle streptococcus antibiotics or 1 fever. with fever and and throat Complications tfever/ week after onset Rash is reddish- sore throat. secretion droplet; (nephritis, of rash. blue “goose food may be carditis) are rare flesh” and fades contaminated. but severe. on pressure. Return to school Rash appears when fever-free first on upper and after 24 chest and face, hours of and then spreads antibiotics. to lower chest, abdomen, and arms. Rash and fever begin on 1st day; 5–7 days later, skin peels or flakes. Tuberculosis In a small Active tuberculosis Positive Persons with Airborne, inhaled. Children who See CDC: number of bacilli in the tuberculosis skin whom the child In practically all convert are usually http://www.cdc.g Myco-bacterium children the infected person. test. Most cases has frequent cases, children treated with ov/tb/ tuberculosis germs set up a NOTE that in most develop no contact should who develop the isoniazid (INH), by mouth for 6–12 (Childhood- low-grade children who further symptom be skin tested. disease catch it months. primary) infection in the inhale the disease, of TB in their from prolonged Sometimes lymph nodes in their body’s lifetime. About household Rifampin is given the center of the defenses vanquish 5% of skin contact, not from alone or with other chest. In 6–8 all the germs. converters casual or sporadic medication weeks the body develop more contact such as at preventively. defenses wall off serious forms of school, on the Preventive therapy the infection with TB in their lungs bus, at parties, or is designed to scar tissue, and or other parts of at picnics. reduce the risk of more serious there are no the body, which, disease. For further if untreated, can Risk of infection is children with active

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION consequences be serious. related to disease, 3–4 other than a exposure. The medications may permanent risk of developing be given positive disease is related concurrently. Multidrug-resistant tuberculin skin to the health of strains of TB test. This person the infected bacteria have is a skin person and is recently developed. converter (SC) greater for BCG vaccine is and has latent children under used in many infection. age 3, the elderly, countries to those who are prevent immuno disseminated TB in suppressed or infants. A history of BCG does not undernourished, contraindicate PPD diabetics, and testing nor alter the substance interpretation. abusers.

Venereal warts Warts may Infected partner Most HPV-infected Sexual. Sexually Visible warts may See CDC Human appear within can transmit at persons have no No exclusion transmitted be removed, but http://www.cdc.g symptoms but can papillomavirus several weeks any contact. transmit the virus to a needed. disease. no treatment is ov/std/hpv/stdfac (HPV) after sexual 30 strains of HPV sex partner. Warts Condoms may better than t-hpv.htm contact with are sexually appear as soft, moist, reduce, but do another, and no infected person transmitted. pink or red swellings; not eliminate, the single treatment may be raised or flat, or may take Diagnosis usually single or multiple, risk of is ideal for all months to made on the basis small or large. Some transmission to cases. appear. of abnormal Pap cluster together, uninfected No cure. smears. forming a cauliflower- partners. Infection usually like shape. They may appear on the vulva, goes away on its in or around the own. Cancer- vagina, anus, cervix, related types are penis, scrotum, groin more likely to or thigh. May lead to cervical persist. cancer.

School Health Services Guide: Communicable Disease, Control of Revised: May 2014 I-9

DISEASE INCUBATION CONTAGIOUS SYMPTOMS CONTACTS ROUTE OF TREATMENT REFERENCE PERIOD PERIOD INFECTION Whooping Usually 7–10 Three weeks from Cold-like Exclude non- Droplet: person Exclude from See CDC: Cough days, rarely more early cold-like symptoms with immune children to person contact school for (+) http://www.cdc.g Pertussis than 21 days. symptoms or after irritating cough for 14 days. with nasal and culture, then ov/features/pertu onset of that becomes a pharyngeal exclude for 5 ssis/ paroxysms paroxysmal discharge. days of a 14-day (approximately 21 series of coughs antibiotic days). followed by high- +Vaccine treatment. All pitched whoop or preventable. household crowing, often contacts and followed by other close vomiting. contacts, such as Adolescents and those in adults may not childcare, have “whoop.” regardless of age Classic pertussis and vaccination is 6 to 10 weeks; status, should many may be also receive less than 6 antibiotics weeks. treatment.

*Elevated temperature of 100˚ F or greater demonstrates the need to exclude the student from the school setting. This student should be fever free (an oral temperature below 99˚ F) for 24 hours before returning to school without the aid of antipyretic medications. See: Selekman, Janice. Common Complaints, Fever, in School Nursing a Compressive Text (2013). Philadelphia, PA: F.A. Davis.

+Vaccine preventable. CDC vaccine preventable immunization schedule: http://www.cdc.gov/vaccines/schedules/

The above information was compiled from the CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) 2013 Features pages. http://www.cdc.gov/features/index.html

This guidance was formulated by review of the material to be utilized as a ready reference for DoDEA school nurses.