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Infectious Diseases in Child Care and School Settings

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Infectious Diseases in Child Care and School Settings Infectious Diseases in Child Care and School Settings Guidelines for CHILD CARE PROVIDERS, SCHOOL NURSES AND OTHER PERSONNEL Communicable Disease Branch 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Phone: (303) 692-2700 Fax: (303) 782-0338 Updated March 2016 1 Acknowledgements These guidelines were compiled by the Communicable Disease Branch at the Colorado Department of Public Health and Environment. We would like to thank many subject matter experts for reviewing the document for content and accuracy. We would also like to acknowledge Donna Hite; Rene’ Landry, RN, BSN; Kate Lujan, RN, MPH; Kathy Patrick, RN, MA, NCSN, FNASN; Linda Satkowiak, ND, RN, CNS, NCSN; Jennifer Ward, RN, BSN; and Cathy White, RN, MSN for their comments and assistance in reviewing these guidelines. Special thanks to Heather Dryden, Administrative Assistant in the Communicable Disease Branch, for expert formatting assistance that makes this document readable. Revisions / Updates Date Description of Changes Pages/Sections Affected 2012 Major revision to content and format; combine previous Throughout separate guidance documents for child care and schools into one document Dec 2014 Updated web links due to CDPHE website change; updated Throughout several formatting issues; added hyperlinks to table of contents; no content changes May 2015 Added updated FERPA letter from the CO Dept of Education; Introduction added links to additional info to the animal contact section in the introduction; added new bleach concentration disinfection guidance Oct 2015 Corrected reporting information for aseptic meningitis Aseptic Meningitis Jan 2016 Added information on animals in child care centers; updated Introduction, various sections bleach recommendations and EPA cleaners link; ensured that these guidelines are consistent with the new child care center regulations; updated reportable disease list; guidance on Clostridium difficile These guidelines are not a substitute for the School and Child Care Facility Health and Sanitation Regulations Child Care Regulations: https://www.colorado.gov/pacific/cdphe/child-care School Regulations: https://www.colorado.gov/pacific/cdphe/schools 2 Table of Contents (alphabetically by disease name) Diseases in bold are conditions reportable to public health in Colorado. Any outbreak, regardless of etiology or setting, is reportable to public health. Diseases with an asterisk (*) are vaccine preventable diseases. Acknowledgements .................................................................................................. 2 Diseases Grouped by Type of Spread.............................................................................. 5 INTRODUCTION ....................................................................................................... 6 Infectious Disease in Child Care and School Settings ....................................................................... 6 Public Health Reporting Requirements, Case Investigation, and Outbreak Investigation ........................... 6 Schools, Public Health Reporting, and FERPA ............................................................................... 7 Informing Parents of Illness in the Facility .................................................................................. 12 Exclusion Guidelines for Children and Staff ................................................................................ 12 Considerations for Developmentally Disabled or Immunocompromised Children .................................... 13 Illness Transmission ............................................................................................................. 13 Appropriate Antibiotic Use ..................................................................................................... 15 Disease Prevention: Handwashing ............................................................................................ 15 Disease Prevention: Immunizations .......................................................................................... 15 Disease Prevention: Covering Coughs ........................................................................................ 16 Disease Prevention: Food Safety .............................................................................................. 16 Disease Prevention: The Facility Environment ............................................................................. 17 Resources ......................................................................................................................... 20 Animal Bites/Rabies .............................................................................................. 22 Bacterial Meningitis............................................................................................... 24 Bed Bugs............................................................................................................. 25 Campylobacter .................................................................................................... 26 Chickenpox (Varicella)* & Shingles (Herpes Zoster) ......................................................... 27 Chlamydia .......................................................................................................... 29 Clostridium Difficile .............................................................................................. 30 CMV (Cytomegalovirus) ........................................................................................... 32 Common Cold ....................................................................................................... 33 Croup ................................................................................................................ 34 Cryptosporidium .................................................................................................. 35 E. coli O157 & Other Shiga Toxin-Producing Bacteria ..................................................... 36 Fifth Disease ........................................................................................................ 38 Genital Herpes (Herpes Simplex Virus (HSV)) .................................................................. 39 Genital Warts (Human Papillomavirus (HPV)) .................................................................. 40 Giardia .............................................................................................................. 41 Gonorrhea .......................................................................................................... 42 Hand, Foot and Mouth Disease ................................................................................... 43 Head Lice (Pediculosis) ........................................................................................... 44 3 Hepatitis Hepatitis A* ..................................................................................................... 46 Hepatitis B* ..................................................................................................... 47 Hepatitis C ...................................................................................................... 48 Herpes (Cold Sores, Fever Blisters) ............................................................................. 49 HIV and AIDS ....................................................................................................... 50 Impetigo ............................................................................................................. 51 Influenza* .......................................................................................................... 52 Measles (Rubeola)* ................................................................................................ 54 Meningitis Bacterial Meningitis* .......................................................................................... 24 Viral Meningitis (Aseptic Meningitis) ......................................................................... 81 Molluscum Contagiosum........................................................................................... 55 Mononucleosis ...................................................................................................... 56 MRSA (Methcillin Resistant Staphylococcus aureus) & Staphylococcus aureus ............................ 57 Mumps* ............................................................................................................. 58 Norovirus and Other Viral Gastroenteritis ...................................................................... 59 Pertussis (Whooping Cough)* ................................................................................... 60 Pink Eye (Conjuctivitis) ........................................................................................... 61 Pinworm ............................................................................................................. 62 Pubic Lice (Crabs) ................................................................................................. 63 Rashes ............................................................................................................... 64 Ringworm (Tinea) .................................................................................................. 66 Roseola (Sixth Disease)............................................................................................ 67 Rotavirus ............................................................................................................ 68 RSV (Respiratory Syncytial
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