Guidelines for Schools and Child Care Centres on Communicable Diseases and Other Childhood Health Issues This resource is intended to provide school principals, teachers, directors of child care centres (CCCs) and health care professionals with guidelines on communicable disease prevention and control in schools and CCCs. Any child who is ill and unable to participate fully in regular activities should be cared for at home. Ottawa Public Health recommends that individuals who may have been exposed to a communicable disease and have specific health concerns, such as pregnancy and immunosuppression, be assessed by a health care professional. Proper hand hygiene is the most effective way to prevent the spread of communicable diseases. May 2017 CRITERIA FOR REPORTING OUTBREAKS TO OTTAWA PUBLIC HEALTH For reporting of gastroenteritis outbreaks, see page 5. For reporting of respiratory infection outbreaks, see page 11. Schools must report when they have greater than 10% absenteeism due to similar symptoms in the school on the same day OR a sudden or unusual increase in absenteeism due to similar symptoms in students/staff in a class or school on the same day. Child care centres must report when they have 10% or more children/staff ill with similar symptoms or absent on the same day. Report all outbreaks immediately to the Outbreak Reporting Line at 613-580-6744, ext 26325, Monday to Friday 8:30 a.m. to 4:30 p.m. or 3-1-1 after hours. 1 Period of Reporting Disease Cause/Symptoms Transmission Incubation Exclusion Communicability Requirements Amebiasis Parasite. Fecal-oral route. Few days to several During the period that CCCs: exclude Report to 613-580-6744, Abdominal distension, Food and water months to years, most cysts are passed, which symptomatic cases ext. 24224 within 1 cramps, diarrhea or contaminated by an commonly 2 to 4 weeks. may continue for years. (children and staff, business day. constipation, and rarely infected food handler or including food handlers), fever or chills. May be fecal matter. May also be until 24 hours after symptom free. transmitted sexually by diarrhea resolves or until fecal-oral contact. 48 hours after completion of antibiotic treatment. Bite (Animal) or There is a risk of rabies Animal saliva introduced Rabies: Usually 3-8 Rabies: Rabid animals Not required. Report immediately to exposure to a potentially from the bites of bats, by a bite or scratch. weeks; rarely as short as are infectious from the 613-580-6744, ext. rabid animal (Rabies) cats, dogs, ferrets, 9 days or as long as 7 time the virus reaches 23806 during regular groundhogs, muskrats, years. the salivary glands and business hours or 3-1-1 racoons, skunks and up until death. Death after hours to begin other wild mammals. usually occurs within 1 rabies immunization, if Bites of gerbils, week of onset of clinical needed, and/or to hamsters, mice, moles, signs. quarantine the biting rabbits and squirrels do animal, if available. not have to be reported unless the animal’s behaviour was very abnormal. Bites and scratches from animals may also result in infection, especially to young children, if not treated promptly. Young children are more at risk to injury to their face and neck. Bite (Human) If the skin is broken, Contact of contaminated Depends on the disease. Depends on the disease. Not required. Not required unless there may be a risk of blood with a break in the either person is known to transmission of hepatitis skin or blood inside of be infected with hepatitis B, hepatitis C, and HIV the mouth. B, hepatitis C or HIV. from an infected person. If so, report immediately to 613-580-6744, ext. 12580 during regular business hours or 3-1-1 after hours. 2 Period of Reporting Disease Cause/Symptoms Transmission Incubation Exclusion Communicability Requirements Campylobacter Bacteria. Ingestion of Ranges from 1 to 10 Several days to several CCCs: exclude Report to 613-580-6744, Diarrhea (may be undercooked meat or days; usually 2 to 5 weeks, as long as symptomatic cases ext. 24224 within 1 bloody), abdominal pain, poultry, unpasteurized days. bacteria is excreted in (children and staff business day. malaise, fever, nausea milk, contaminated food feces. Without treatment including food handlers), and vomiting – may be or water or by direct bacteria may be until symptom free for 24 mild to severe. contact with fecal excreted for 2 to 7 hours or 48 hours after material from infected weeks. completion of antibiotics animals (especially pets or antidiarrheal and farm animals). medications. Candidiasis Fungus. Person to person by Variable, 2 to 5 days for While lesions are Not required. Not required. (Thrush, Diaper Rash) Thrush: Thin white layer direct contact with the thrush in infants. present. Avoid sharing on tongue and inside of mouth, skin or bodily bottle nipples and For more information, cheeks. May cause secretions containing the soothers between visit caringforkids.cps.ca difficulty with feeding. fungus. children. Diaper rash or other skin rash: Well demarcated, red rash with white flaky border, usually in skin folds. Painful when comes in contact with urine. Chickenpox (Varicella) Virus. Person to person by 10 to 21 days; commonly As long as 5 days, but No exclusion, children Report, by mail or fax, Fever. Blister-like rash direct contact with virus 14 to 16 days. usually 1 to 2 days can return with rash. number of cases and occurs over 5 to 6 days. through droplet or before onset of rash, Contact with ages, using the Chicken Scabs form after the airborne spread of blister until all blisters are immunocompromised Pox Weekly Reporting blister stage. Rash fluid or respiratory crusted, usually about 5 individuals, pregnant Form, available online at usually appears first on secretions. Indirectly days after the onset of women, particularly OttawaPublicHealth.ca the body, face and scalp, through freshly rash. those in the third and then later spreads to contaminated objects trimester, or newborns the arms and legs. and surfaces. should be avoided. Children should be seen by a physician as soon as possible if: 1) fever (>38.3°C) lasts for more than 3 days or recurs, 2) redness, swelling, and severe pain develop around a blister. 3 Period of Reporting Disease Cause/Symptoms Transmission Incubation Exclusion Communicability Requirements Cold Sores (Herpes) Virus. Person to person by 2 to 12 days. While sores are Not required. Not required. Small blisters appear direct contact with saliva. apparent, however, virus If child has severe sores and then burst to form a may be transmitted even with fever and/or For more information, crust. Sores are usually when no visible sores excessive drooling, visit caringforkids.cps.ca around the mouth but are present. consider exclusion until can be around the nose fever free and able to and eyes. With the first participate fully in regular infection, sores may be activities without accompanied by fever, excessive drool. flu-like illness, and painful irritation. Reactivation of infection is common. Conjunctivitis-Bacterial Bacteria. Person to person by 24 to 72 hours. For duration of infection Exclude until treated with Not required. (Pink Eye) Pink or red conjunctiva direct or indirect contact or until 24 hours of antibiotic drops or (the white of the eye) with eye secretions. antibiotic treatment is ointment for 24 hours. For more information, with thick or crusty white completed. visit caringforkids.cps.ca or yellow discharge (pus), occasionally accompanied by fever. Conjunctivitis-Viral Virus. Person to person by 12 hours to 12 days. For duration of infection. Not required if no eye Not required. (Pink Eye) Pink conjunctiva (the direct or indirect contact discharge. Otherwise, white of the eye) with a with eye secretions. children can return upon For more information, clear, watery eye approval by healthcare visit caringforkids.cps.ca discharge. Often occurs provider. at the same time as a cold. Coxsackie Virus Virus. Person to person by Usually 3 to 5 days. Most infectious during Not required. Not required. (Hand, Foot and Mouth Sudden onset of fever, direct contact with fluid the first week of illness Disease) sore throat, rash on from sores, respiratory while experiencing For more information, palms of hands, fingers, secretions and fecal-oral symptoms. Transmission visit caringforkids.cps.ca and on soles of feet with route. Although most via stools and throat or without painful sores common in young secretions may persist inside the mouth. Usually children, asymptomatic for several weeks. occurs in children, adults can also spread particularly in the infection. summer months. Cryptosporidiosis Parasite. Fecal-oral route, 1 to 12 days with an From onset of symptoms CCCs: exclude Report to 613-580-6744, Frequent watery diarrhea including person to average of 7 days. up to several weeks after symptomatic cases ext. 24224 within 1 with abdominal pain, person, animal to symptoms resolve. (children and staff, business day. 4 Period of Reporting Disease Cause/Symptoms Transmission Incubation Exclusion Communicability Requirements fatigue, vomiting, and person, waterborne including food handlers), weight loss. May be (recreational or drinking until 24 hours after symptom free, which can water) and foodborne diarrhea resolves. be a source of infection transmission. Cases are not to use for others. recreational waters for 2 weeks after symptoms resolve. Diarrhea See Gastroenteritis E. Coli 0157:H7 Bacteria. Contaminated water or 2 to 10 days, usually 3 to 1 week or less in adults, CCCs: exclude all cases Report immediately to (Verotoxin-producing Diarrhea (may be food (e.g., undercooked 4 days. but can be 3 weeks in (children and staff, 613-580-6744, ext. Escherichia coli) bloody), severe meat, especially one third of children. including food handlers) 24224 during regular abdominal cramps, hamburger and poultry, HUS typically develops 7 until 2 negative stool business hours or 3-1-1 vomiting, fatigue, unwashed raw fruits and days (up to 3 weeks) cultures are obtained, at after hours.