Edmond Public Schools Disease and Illness Health Guidelines

Revised March 2017 EDMOND PUBLIC SCHOOLS DISEASE AND ILLNESS HEALTH GUIDELINES

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

Blood and body fluids, • Unexplained fevers. sexual intercourse, sharing AIDS • Fatigue. needles. Practice Standard

• Enlarged lymph nodes. Universal Precautions. (ACQUIRED IMMUNE Not spread through typical Individual case consideration. • DEFICIENCY SYNDROME) Swollen salivary glands. classroom activities, such as Wear gloves when • Frequent infections, including contact with surfaces handling any body fluids. diarrhea, thrush, pneumonia. touched by infected individuals.

NOT spread from person to • Itchy bites, often in a straight line, person. on areas that are exposed during Provide enough space the night. During the daytime bedbugs between each child’s BEDBUGS • Bites often have red dot in the do not remain on the NO EXCLUSION. belongings so they do not middle of raised red bump. affected person. touch. • Difficult to distinguish from other May hide in belongings. insect bites. Crawl at speed of ladybug.

• Small raised lesion at the site of the scratch. Protect from cat scratches • Low grade fever, headache, muscle Scratch or bite of an and bites. CAT SCRATCH FEVER soreness, poor appetite, fatigue. NO EXCLUSION. infected cat. • Within 2 weeks enlarged, painful Avoid contact of open lymph node in the area of bite or wounds with cat saliva. scratch.

• Slight fever, runny nose, cough. Readily communicable by If high fever or severe EXCLUDE 5 DAYS FROM • Skin eruption of small blisters CHICKEN POX airborne droplet, direct illness, consult a physician. APPEARANCE OF BLISTERS which scab. contact, or by articles OR UNTIL ALL LESIONS ARE • May be in stages of pimple, blister, All eligible individuals (VARICELLA) freshly soiled by discharge CRUSTED OVER OR DRY and scab at the same time. should receive the vaccine from chickenpox blisters. (SCAB). • Child does not feel well. series.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

Good hand washing is the best way to prevent Symptoms occur 3-12 infection.

weeks after infection. Virus Wear disposable gloves NO EXCLUSION FROM WORK CMV • Most people with CMV do not may remain in the body when handling body fluids. OR SCHOOL, IF become ill. throughout a person’s life TEMPERATURE HAS BEEN Pregnant women should o (CYTOMEGALOVIRUS) • Fever, sore throat, swollen glands, without symptoms. LESS THAN 100 F FOR 24 wash hands after handling and tiredness may be present. HOURS WITHOUT FEVER- Virus may be found in urine wet diapers or contact with REDUCING MEDICATIONS. or saliva of infected persons saliva or urine. They with or without symptoms. should notify their personal physician about CMV infection.

• Runny or stuffy nose. • Sneezing. • Irritated throat. If high fever or severe • Cough. Close person-to-person symptoms, consult a EXCLUDE IF TEMPERATURE COMMON COLD • Watery eyes. contact, respiratory droplets, physician. 100o F OR ABOVE. • Fever. direct contact. • Chills. Good hand washing. • Headache. • Earache.

EXCLUDE UNTIL NO • Frequent loose, watery stools. GOOD PERSONAL Varies with causative agent DIARRHEA AND/OR FEVER DIARRHEA • Abdominal pain and/or cramping. HYGIENE AND HAND or disease. FOR 24 HOURS WITHOUT • Fever. WASHING. MEDICATION.

EXCLUDE IF ORAL TEMPERATURE IS 100o F OR ABOVE. Temperature below 100o F, CHILD MAY RETURN TO FEVER • Oral temperature 100o F or above. Varies with cause of fever. children may stay in SCHOOL WHEN HE/SHE HAS school. BEEN FEVER FREE FOR 24 HOURS WITHOUT MEDICATION.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

• Fever. • Fatigue. • Irritability. FEVER BLISTER Direct contact with • Tender, swollen lymph nodes. contaminated saliva and Good hand washing. NO EXCLUSION. • (HERPES SIMPLEX I VIRUS) Blisters on or inside the mouth and open sores. on the gums and lips. • Blisters weep clear fluid, bleed and are slow to scab over.

• Fever. Contagious a week before • Headache. FIFTH DISEASE the rash appears. NO • Tired, muscle aches. Person to person through LONGER CONTAGIOUS • (ERYTHEMA Red "slapped cheek" appearance. body fluids such as saliva or ONCE RASH APPEARS. ONLY EXCLUDE FOR FEVER INFECTIOSUM) • Lace-like rash which spreads to the sputum. o 100 F OR ABOVE, COUGH OR rest of the body. The rash comes Pregnant employees SORE THROAT. and goes with environmental Direct contact with airborne (SLAPPED CHEEK) droplets. should check with their changes. Sunlight or warmth can physician when an make rash worse for weeks or even outbreak occurs at school. months.

• Sudden onset of symptoms. • Fever. • Chills. • Headache. FLU Same as the common cold. • Extreme tiredness. Same as the common cold. • Muscle or body aches. Person to person by direct EXCLUDE UNTIL FEVER (INFLUENZA) • Sore throat. contact, airborne droplet, or Vaccination recommended FREE FOR 24 HOURS

• Nasal congestion. by contact with articles for most individuals over 6 WITHOUT MEDICATION. (RESPIRATORY contaminated by months of age. INFLUENZA) • Cough. • Croup/bronchiolitis/pneumonia. nasopharyngeal secretions. • Mild pink eye. • Abdominal pain. • Nausea, vomiting, and/or diarrhea.

HAND, FOOT & MOUTH • Fever. DISEASE • Small sores or blisters in mouth, on Spread by secretions in the Practice good hand NO EXCLUSION. hands, and feet. throat or feces (stool). washing. (COXSACKIE VIRUS) • Looks like chicken pox at first.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

Consult physician.

Most contagious 1-2 weeks before onset of symptoms; risk of transmission is minimal 1 week after onset • Fever. of jaundice. • Loss of appetite. HEPATITIS A Person to person usually by • Nausea and/or vomiting. GOOD PERSONAL fecal-oral route. PHYSICIAN’S RELEASE • Abdominal discomfort. HYGIENE AND HAND (HAV) NECESSARY FOR RETURN TO • Tiredness. Direct contact, diaper WASHING BEFORE SCHOOL. • Dark brown urine. changing, or food prepared AND AFTER USING (INFECTIOUS HEPATITIS) by infected food handlers. • Jaundice (yellowing of the skin THE RESTROOM.

and white of eyes). Immunization is the most effective method for prevention.

Report to Health Department.

• Jaundice. Contamination from blood Consult physician. • Nausea/vomiting. or body fluids of an infected HEPATITIS B • Muscle aches. person. Immunization is the most

• Anorexia (loss of appetite). effective method for (HBV) Sexual intercourse with an NO EXCLUSION. • Fatigue. prevention. infected person. • Joint pain. (SERUM HEPATITIS) Report to Health • Often by contaminated Rash. Department. • Fever. needles and syringes.

EXCLUDE UNTIL UNDER • Blister like sores that develop Contagious until treated MEDICAL TREATMENT FOR into yellow crusting skin lesions. Direct or indirect contact with antibiotics for over 24 24 HOURS. PHYSICIAN’S IMPETIGO • Usually around the mouth, with lesions. hours or all lesions are RELEASE NECESSARY FOR nostrils, hands, elbows, and gone. RETURN TO SCHOOL. knees. LESIONS MUST BE COVERED.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

EXCLUDE UNTIL TREATED WITH A PEDICULOCIDE SHAMPOO AND LICE DECLARED TO BE FREE FOR READMISSION TO OF LICE BY A HEALTH SCHOOL, THE STUDENT (PEDICULOSIS) PROFESSIONAL* OR AUTHORIZED MUST PRESENT A SIGNED An Edmond Public Schools • Adult lice found in hair. REPRESENTATIVE OF STATEMENT FROM A Direct contact with infected Nurse* will be available to verify • Nits (eggs) closer than 1 cm. to THE STATE HEALTH PROFESSIONAL* OR individuals (touching head absence of lice and issue the the scalp. DEPARTMENT OF AUTHORIZED to head) or indirectly by required signed statement for re- • HEALTH. REPRESENTATIVE OF THE Can affect scalp, body, pubic contact with infected admission to school at the areas. RETREATMENT STATE DEPARTMENT OF articles of clothing, RECOMMENDED IN 7-10 following time and location: • Intense itching, irritation, headgear, furniture, or DAYS FOR MOST HEALTH DECLARING THE

secondary infections may occur bedding. SHAMPOOS TO STUDENT TO BE FREE OF *Special Services Center with scratching. PREVENT LICE. th 53 E 12 Street REINFESTATION. Edmond, OK 73034 Louse life cycle is about 1 *See availability of Edmond Public Every School Day month. Incubation period Schools Nurse in column one. 7:30A to 8:30A of louse eggs is 6-10 days. Lice mature in 2 weeks. Head lice are a nuisance, not a health hazard.

Consult physician BACTERIAL: Person to immediately. • Abrupt onset of fever. person through droplets of • Blood red rash. respiratory secretions. This Can develop over several • Intense headache. hours or take 1-2 days. can occur through coughing, • Nausea and/or vomiting. kissing, and sneezing. Immunization is the most EXCLUDE IMMEDIATELY. • Loss of appetite. MENINGITIS effective method for • Sometimes a stiff neck. VIRAL: Direct contact prevention. PHYSICIAN’S RELEASE • Irritability/behavioral changes. with an infected person’s (BACTERIAL AND VIRAL) NECESSARY FOR RETURN TO • Sensitivity to bright light. stool. Changing diapers of GOOD PERSONAL SCHOOL. • Confusion. an infected person. Direct HYGIENE AND HAND • Drowsiness. or indirect contact with WASHING. CLEANING • Seizures. respiratory secretions CONTAMINATED SURFACES, SUCH AS • Coma. (saliva, sputum, or nasal mucus). HANDLES AND DOORKNOBS.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

Consult physician.

Contagious period is • Small, flesh colored, dome unknown. shaped bumps on the skin. Direct or indirect contact NO EXCLUSION. MOLLUSCUM • Lesions are commonly located with shared items, such as GOOD PERSONAL CONTAGIOSUM on the face, eyelids, neck, clothing, towels, and HYGIENE AND HAND MUST KEEP LESIONS underarms, thighs, or genital washcloths. WASHING. DO NOT COVERED. areas. SHARE WASHCLOTHS, TOWELS OR CLOTHING.

• Symptoms may be mild or not at all in younger children. Consult Physician. MONO • Fever. Close person to person EXCLUDE IF Avoid transfer or contact • Sore throat. contact via saliva, i.e. saliva SYMPTOMATICALLY ILL, with saliva. (MONONUCLEOSIS) • Swollen lymph glands. on hands/toys, or kissing on FEVER, SORE THROAT, OR • Fatigue. the mouth. Practice good hand PHYSICIAN’S ADVICE. • Occasional rash. washing. • Jaundice.

• Most cases, swollen glands EXCLUDE. below and in front of ears, under

jawline. Consultation with local public health • Fever. Spread via respiratory route, authorities may be considered • Headache. Immunization is the most contact with droplets regarding excluding unimmunized MUMPS • Earache. effective method for formed when infected child individuals if case of mumps is • Painful swelling of testicles may prevention. coughs, sneezes or talks. documented in the school occur in teenage males. population. • Abdominal pain due to swelling

of ovaries may occur in teenage ENFORCE IMMUNIZATIONS. females.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

• Red or pink, tearing, swelling, burning, itching of eye(s). • More than a tiny amount of thick Consult Physician. CHILD MAY RETURN TO PINK EYE yellow/green discharge from Direct or indirect contact SCHOOL 24 HOURS AFTER eye(s). Readily communicable in with eye drainage. ANTIBIOTIC DROPS HAVE (CONJUNCTIVITIS) • Affected eye(s) may be crusted the classroom. BEEN INITIATED. shut in the morning. • Sensitivity to light. • May affect one or both eyes.

POISON IVY Usually direct contact with Refer to physician if plants or resins. reaction is severe. USUALLY, NO EXCLUSION. • Itching, burning followed by POISON OAK The oils can stay on blisters and weepy skin. Reaction may begin in a contaminated objects for few hours to 4 days after MUST KEEP COVERED. POISON SUMAC long periods of time. exposure.

• Athlete’s foot: Peeling Athlete’s foot: Not excluded except crackling, itching, and blistering Athlete’s foot: Direct from activities where bare feet are of skin between and around toes. contact or from damp areas exposed. • Body: Ring like lesions usually such as shower rooms, Once medication on exposed skin; may be dry, swimming pools, etc. Body: Not excluded if under RINGWORM prescribed by the doctor scaling, or moist and crusted. Body: Direct contact with has been started, the medical treatment. Area must be Circular border becomes (ATHLETE’S FOOT) infected humans or animals. student is no longer covered. Consult physician if lesions progressively larger. Lesions considered infectious. are extensive. may itch, burn. Scalp: Direct contact or • Scalp: Loss of luster of hair, from contact with infected Scalp: EXCLUDE UNTIL scaling of infected areas, patchy hair, human, or animal. PHYSICIAN RELEASE. baldness, and brittle hair shafts.

• Fever. • Severe headache. EXCLUDE UNTIL FEVER • Nausea/vomiting. FREE FOR 24 HOURS • Care should be used in tick Muscle aches. WITHOUT MEDICATION. • removal. If possible, save ROCKY MOUNTAIN Characteristic rash which starts Transmitted to humans by on wrists and ankles and spreads tick. SPOTTED FEVER the bite of a tick. IF FEVER FREE, NO to trunk; palms and soles may be Report to Health EXCLUSION, SINCE DISEASE involved. Department. IS TRANSMITTED BY TICK • Rash is flat, frequently petechial BITE. (described as tiny purple blood blisters). 7

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

• High fever (above 103o F) NO EXCLUSION, BUT CHILD which lasts 3-7 days, followed Unknown, probably via SHOULD NOT BE AT SCHOOL ROSEOLA by rash lasting from hours to Rare after age 4 years. respiratory secretions. DURING ACUTE PHASE: days. HIGH FEVER AND RASH. • Seizure may occur due to fever.

• Slight fever. • Faint pink rash. RUBELLA • Joint aches. Direct or droplet contact Consult physician. Note: not same as Rubeola. • Headache. EXCLUDE 7 DAYS AFTER with nasopharyngeal • Discomfort. Report to Health APPEARANCE OF RASH. secretions. (THREE DAY MEASLES) • Runny nose. Department. • Reddened eyes. • Swollen lymph nodes.

• Fever. Consult physician.

• Cough. RUBEOLA Immunization is the most • Runny nose and eyes. Note: not same as Rubella. effective method for • Bluish-white spots inside the Person to person or droplet prevention. EXCLUDE AT LEAST 4 DAYS mouth/inner cheek area (Koplik (HARD MEASLES) contact with nasopharyngeal FROM ONSET OF THE RASH. spots). Children are contagious 4 (RED MEASLES) secretions through coughing • Fatigue. days before the rash starts (SEVEN DAY MEASLES) or sneezing. ENFORCE IMMUNIZATIONS. • Body aches. until 4 days after the (OLD FASHIONED MEASLES) appearance of the rash. Red raised rash beginning at hairline, spreading down over Report to Health the body on the third day. Department.

• Intense itching, especially at Consult physician. night. • Rash: raised bumps or small Contagious until treated by blisters, tiny burrow-like lines doctor. EXCLUDE UNTIL SCABIES Close personal contact. under the skin. PHYSICIAN’S RELEASE. Treated with lotion or • Commonly found between the cream containing a fingers, around wrists, belt line, scabicide. under arms, underneath bra line.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

• Often asymptomatic in both males and females. SEXUALLY TRANSMITTED • GONORRHEA: May have DISEASES: burning on urination, yellowish Consult physician or discharge. All forms by direct personal NO EXCLUSION UNLESS GONORRHEA Health Department. • SYPHILIS: May include contact. MEDICALLY Communicable for weeks painless sore at site where Sexual intercourse. RECOMMENDED. SYPHILIS to years if untreated. organism entered body. • HERPES SIMPLEX II HERPES SIMPLEX II: Very painful sores on or around genitalia.

• Loose, watery stools with blood or mucus. Good hand washing. • Fever. EXCLUDE UNTIL RELEASED SHIGELLA Fecal-Oral route. • Headache. Report to Health BY PHYSICIAN. • Convulsions. Department. • Abdominal pain.

• Rash of red bumps and blisters NO EXCLUSION. which may be painful or itchy. Direct by person to person Contagious until blisters SHINGLES • Typically in a narrow area along contact. are crusted over. Keep rash covered while at school. one side of the body.

STAPH INFECTION EXCLUDE IF WOUND (STAPHYLOCOCCUS • Skin infection that appears as a DRAINAGE (PUS) CANNOT BE AUREUS) bump. Skin to skin contact and COVERED WITH A CLEAN • May be red, swollen, painful, contact with surfaces that Practice strict hand DRY BANDAGE OR FOR MRSA warm to touch, full of pus or have come into contact with washing at all times. THOSE WHO CANNOT (METHICILLIN-RESISTANT drainage, accompanied by a someone else’s infection. MAINTAIN GOOD PERSONAL STAPHYLOCOCCUS fever. AUREUS) HYGIENE.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

Symptoms include some or all of the following: • Fever. • Headache. • Sore throat. STREP THROAT • Stomachache. Contact with respiratory

• Swollen lymph nodes in neck. secretions. EXCLUDE UNTIL ON (SCARLET FEVER) Consult physician. • ANTIBIOTICS FOR 24 HOURS. Decreased appetite. Close contact can facilitate (SCARLETINA) transmission. Diagnosis of strep throat is less likely if the following occur: • Runny nose. • Cough. • Congestion.

• Fatigue. • Weight loss. Treatment consists of TB • Fever. Spread by inhalation of antibiotics taken for 6-12 • Night sweats. EXCLUDE UNTIL RELEASED airborne droplet from one months. (TUBERCULOSIS) • BY PHYSICIAN. Chronic cough. person to another. • Chest pain, and/or coughing up Report to Health blood. Department. • Growth delay.

• Nausea. GOOD PERSONAL EXCLUDE UNTIL NO • Abdominal pain. Varies with causative agent VOMITING HYGIENE AND HAND VOMITING FOR 24 HOURS • Diarrhea. or disease. WASHING. WITHOUT MEDICATION. • Fever.

METHOD OF HOW TO DISEASE COMMON SYMPTOMS EXCLUSION TRANSMISSION CONTROL

• Cold like symptoms. • Severe coughing leading to:  Vomiting while coughing.  Loss of breath, difficulty catching breath. Consult physician. EXCLUDE  Cyanosis (bluish color). UNTIL STUDENT ON Close contact via Immunization is the most WHOOPING COUGH  Develops into violent ANTIBIOTICS FOR 5 DAYS OR respiratory secretions after effective method for coughing fits within 1-2 21 DAYS FROM ONSET IF NO an infected person coughs prevention. (PERTUSSIS) weeks. or sneezes. ANTIBIOTICS. • High pitched crowing/whooping Report to Health sound when breathing in after Department. ENFORCE IMMUNIZATIONS. coughing episode. • Coughing episodes last for weeks to months. • Usually low grade fever, if a fever occurs at all.

Revised: 3/2017

Source: Aronson, S. S., & Shope, T. R. (Eds.). (2013). Managing infectious diseases in child care and schools: A quick reference guide (4th ed.). Elk Grove Village, IL: American Academy of Pediatrics.