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Anyone, 6 months of age and older, is eligible to receive the COVID-19 vaccine. Find your nearest vaccination location at vaccines.gov.

Communicable Disease School Nurse Guidance

Eye, Ear, Nose, Throat, and Respiratory

Teach effective, handwashing, good respiratory hygiene and cough etiquette
Colds are caused by viruses; antibiotics are not indicated.

For all diseases:

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens; proper disinfection of surfaces and toys; cough into elbow or clothing when tissues unavailable.

Bronchiolitis, Bronchitis, Common Cold, Croup, Ear Infection, Pneumonia, Sinus Infection and Most Sore Throats (Respiratory diseases caused by many different viruses and occasionally bacteria)

Mode of Transmission

Breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs -Direct contact with respiratory secretions from an infected person -Touching a contaminated object then touching mouth, nose or eyes

Symptoms

Variable, including runny nose, watery eyes, fatigue, coughing, and sneezing. May or may not have fever

Incubation Period

Variable

Period of Communicability

Variable, often from the day before symptoms begin up to 5 days after onset

Criteria for Exclusion from School

No exclusion unless febrile or other symptoms meeting exclusion criteria are present

Reporting Requirement

May depend of etiology/organism

Report unusual illness, clusters of cases above baseline for group and time of year, or increased/unusual severity of illness to the local health department

Conjunctivitis, Bacterial or Viral (Pink eye)

Mode of Transmission

Contact with an infected person’s skin, body fluid or though contact with a contaminated surface and then touching mucus membranes/eyes

Symptoms

Red eyes, usually with some discharge or crusting around eyes; may be itchy, sensitive to light, or watery

Bacterial: may have yellow/greenish discharge; may affect one or both eyes

Allergic and chemical conjunctivitis usually affects both eyes

Incubation Period

Bacterial: Unknown

Viral: Varies with etiology

Period of Communicability

Bacterial: from onset of symptoms until after start of antibiotics, or as long as there is discharge form the eye

Viral: variable, before symptoms appear and while symptoms are present
(Allergic and chemical conjunctivitis is not contagious.)

Criteria for Exclusion from School

Bacterial, Viral, or unknown etiology: Exclude if conjunctivitis is accompanied by symptoms of systemic illness or if the child is unable to keep hands away from eye.

Childcare rules: exclude if purulent drainage until after 24 hours of treatment
http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Reporting Requirement

Not required to be reported

May notify local health department of large clusters of cases or cases with unusual severity of illness

Influenza

Mode of Transmission

Person to person by respiratory droplets created by coughing or sneezing, or though contact with a contaminated surface and then touching mucus membranes/eyes The virus can live on surfaces for several hours.

Symptoms

Sudden onset of fever, chills, headache, malaise, body aches, and nonproductive cough

Incubation Period

1-4 days

Period of Communicability

Variable, from 24 hours before onset of symptoms, peaks during first 3 days of illness through 7 days

Criteria for Exclusion from School

Until fever-free for 24 hours

Criteria may differ in pandemic or novel/variant strain influenza situation.

Reporting Requirement

Influenza deaths in persons<18 years of age. ICU admissions are reportable within 24 hours.

Influenza A, variant virus cases are required to be reported immediately within 3 hours by healthcare providers.

Prevention & Control Measures

Annual influenza vaccine recommended for everyone 6 months and older

Mumps

Mode of Transmission

Contact with droplets from eyes or mouth of infected person

Symptoms

Fever with swelling and tenderness of one or both parotid glands located below and in front of the ears Unrecognized mild cases without swelling may occur.

Incubation Period

12 to 25 days (usually 16 to 18 days)

Period of Communicability

Peak infectious time begins 1 to 2 days before swelling to 5 days after, but may range from 7 days before to 9 days after. For the purpose of contact tracing and exclusions, the infectious period is 2 days before to 5 days after parotitis.

Criteria for Exclusion from School

Until fever-free for 24 hours

Criteria may differ in pandemic or novel/variant strain influenza situation.

Reporting Requirement

Influenza deaths in persons<18 years of age. ICU admissions are reportable within 24 hours.

Influenza A, variant virus cases are required to be reported immediately within 3 hours by healthcare providers.

Prevention & Control Measures

Annual influenza vaccine recommended for everyone 6 months and older

RSV

Mode of Transmission

Highly contagious; contact with droplets from nose, eyes or mouth of infected person; virus can live on surfaces (toys, tissues, doorknobs) for several hours

Symptoms

Fever, runny nose, cough. May have wheezing

Incubation Period

2 to 8 days (4 to 6 days most common)

Period of Communicability

Variable, from the day before until 3 to 8 days or longer; may last up to 3 to 4 weeks

Criteria for Exclusion from School

No exclusion unless febrile or other symptoms meeting exclusion criteria are present

Reporting Requirement

Individual cases do not have to be reported.

Prevention & Control Measures

Avoid sharing linens, toys, and other items

Strep throat/Scarlet Fever

Mode of Transmission

Contact with droplets from nose and mouth; close crowded contact, direct contact

Symptoms

Fever, sore throat with pus spots on tonsils, tender swollen glands

Scarlet fever has above symptoms plus a sandpaper-like rash Symptoms may vary.

Incubation Period

2 to 5 days

Period of Communicability

Highest during acute infection; no longer contagious within 24 hours after antibiotics

Criteria for Exclusion from School

Schools: Until after 12 hours of effective antimicrobial therapy and afebrile for 24 hours without the use of fever-reducing medications.

Child Care: rules: Exclude until 24 hours after treatment has been initiated and until the child has been without fever for 24 hours;
http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Reporting Requirement

Clusters of 10 epidemiologically linked cases of strep throat/scarlet fever within a 10 day period are reportable to the local health department.

Invasive disease from streptococcal bacteria is reportable.

Prevention & Control Measures

Avoid kissing, sharing drinks or utensils; exclude infected adults from food handling; symptomatic contacts of documented cases should be tested, and if results are positive, should be treated.

TB (tuberculosis)

Mode of Transmission

Airborne inhalation of droplets from nose and mouth of diseased person (children usually contract TB from close contact with a diseased adult)

Symptoms

Fever, fatigue, weight loss, cough (lasting 3+ weeks), night sweats, loss of appetite

Incubation Period

2 to 10 weeks to years; risk of developing disease is highest 6 months to 2 years after infection

Period of Communicability

Individuals with infection but without active disease (latent TB) are not infectious. 

Individuals with active disease are infectious until treatment.

Criteria for Exclusion from School

For active disease: after therapy started, adherence documented, symptoms diminished, and determined to be non-infectious; consult with public health officials; no exclusion for latent infection

Reporting Requirement

Report suspect or confirmed TB cases to local health department within 7 days

Prevention & Control Measures

Routine TB skin testing is not recommended at this time for children; however, it is recommended that all adults who have contact with children in a child care setting are screened for TB; local health department personnel should be informed for contact investigation.

Pertussis (Whooping Cough)

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person

Symptoms

Initially cold-like symptoms, later cough; may have inspiratory whoop, post-tussive vomiting

Incubation Period

5 to 21 days (usually 7 to 10 days)

Period of Communicability

Before cough onset (with onset of runny nose), continuing until child has been on antibiotics for 5 days

If untreated, infectious for 3 weeks after cough begins

Criteria for Exclusion from School

School exclusion: Cases must be excluded from school until 5 days of appropriate antibiotic treatment is completed or 21 days after cough onset if no treatment is received.

Susceptible contacts do not need to be excluded unless they become symptomatic.

Reporting Requirement

Report as soon as possible, within 24 hours

Outbreaks: Five or more cases epidemiologically linked

Prevention & Control Measures

Timely immunization beginning at age 2 months; booster dose of Tdap is recommended at 11 years. All adults caring for children younger than 12 months should receive a booster dose of Tdap. Close contacts that are unimmunized should have pertussis immunization initiated. Chemoprophylaxis is recommended for targeted groups of close contacts regardless of age and immunization status. Contact the local health department for more information.

Novel Coronavirus SARS-CoV-2 (COVID-19)

Mode of Transmission

Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.

Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.

Touching eyes, nose, or mouth with hands that have the virus on them.

Symptoms

May have no symptoms or can have any of the following: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea, dermatologic manifestations

Incubation Period

2-14 days

Period of Communicability

From 2 days before symptom onset through Day 10 after symptom onset

Criteria for Exclusion from School

Refer to COVID-19-specific guidance at the ISBE website:
https://www.isbe.net/Pages/covid19.aspx

Reporting Requirement

Report case to local health department within 3 hours.

Outbreaks: Two or more individuals who are laboratory positive for SARS-CoV-2 by antigen or PCR testing AND

  • Are epidemiologically linked to the outbreak setting,
  • Have onsets of illness or positive SARS-Co-V test (if asymptomatic) within a 14- day period
  • Do not share a household
  • Are not listed as a close contact of each other outside of the outbreak setting
Prevention & Control Measures

Refer to COVID-19-specific guidance at the ISBE website:
https://www.isbe.net/Pages/covid19.aspx

Gastrointestinal Illnesses

For all gastroenteritis diseases: Good handwashing and hygiene; proper disposal of dirty diapers; proper disinfection of changing tables, toys and food preparation areas. Avoid potentially contaminated beverages, food and water; divide food preparation and diapering responsibilities among staff

Enhanced environmental cleaning with EPA registered product labeled for efficacy against organism

Acute gastroenteritis cluster is defined as 4 or more persons with acute onset of vomiting and/or diarrhea (3 or more loose stools in a 24 hour period) in a classroom or otherwise defined group of students, or cases in more than 10% of the school/daycare’s census in a single day. Consult with Local Health Department for requirements for cases and contacts to return to work, school, and daycare settings

Gastroenteritis-(Vomiting and/or diarrhea): Bacterial

Proper cooking/handling of meats and raw eggs; Reptiles should not be permitted in child care centers.

Campylobacteriosis

Mode of Transmission

Ingestion of undercooked meat, contaminated food or water, or raw milk

Symptoms

Diarrhea (may be bloody), abdominal pain, malaise, fever

Incubation Period

1-10 days, usually 2-5 days

Period of Communicability

Throughout illness (usually 1-2 weeks, but up to 7 weeks without treatment)

Criteria for Exclusion from School

Exclude until diarrhea has ceased for at least 24 hours; additional restrictions may apply.

Reporting Requirement

Cases of campylobacteriosis are reportable to the local health department within 7 days.

C. diff (clostridium difficile) infections

Mode of Transmission

Person-to-person through inadequate handwashing or on contaminated objects or surfaces, and ingestion of spores

Symptoms

Diarrhea, may have fever, nausea, abdominal cramping

Incubation Period

Unknown, likely less than 7 days

Period of Communicability

During active infection (while symptomatic); can continue to shed spores when asymptomatic

Criteria for Exclusion from School

Exclude while symptomatic and until diarrhea has ceased for 24-48 hours

Reporting Requirement

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Prevention & Control Measures

Alcohol-based hand hygiene products do not inactivate C. difficile spores; soap and water must be used. Sporicidal or bleach-based products are recommended for cleaning and disinfection.

E. coli (Escherichia coli) infections

Mode of Transmission

Fecal-oral: person-to person, from contaminated food or liquids, contact with infected animals

Symptoms

Profuse, watery diarrhea, sometimes with blood and/or mucus, abdominal pain, fever, vomiting

Incubation Period

Variable, usually 2-10 days; for E. coli O157:H7 commonly 3-4 days

Period of Communicability

For duration of diarrhea until stool culture is negative

Criteria for Exclusion from School

Medical clearance required; exclude until diarrhea has ceased for at least 24 hours; additional restrictions may apply Release specimens may be required.

Reporting Requirement

Report cases as soon as possible within 24 hours.

Salmonellosis

Mode of Transmission

Fecal-oral: person-to person, contact with infected animals or via contaminated food

Symptoms

Abdominal pain, diarrhea (possibly bloody), fever, nausea, vomiting, dehydration

Incubation Period

Average 12-36hrs (range: 6hrs-72 hours)

Period of Communicability

During active illness and until organism is no longer detected in feces

Criteria for Exclusion from School

Release specimens may be required. Exclude until diarrhea has ceased for at least 24 hours Additional restrictions may apply.

Reporting Requirement

Report cases as soon as possible within 7 days

Shigellosis

Mode of Transmission

Fecal-oral: frequently person-to-person; also via contaminated food or water

Symptoms

Abdominal pain, diarrhea (possibly bloody), fever, nausea, vomiting, dehydration

Incubation Period

Average 1-3 days (range 12-96hrs)

Period of Communicability

During active illness and until no longer detected; treatment can shorten duration

Criteria for Exclusion from School

Medical clearance required; exclude until diarrhea has ceased for at least 24 hours; additional restrictions may apply.  Release specimens may be required.

Reporting Requirement

Report cases as soon as possible within 7 days

Gastroenteritis- (Vomiting and/or diarrhea): Viral

Norovirus

Mode of Transmission

Contact with food, water or surfaces contaminated with vomit or feces, person-to-person, aerosolized vomit

Symptoms

Nausea, vomiting, watery diarrhea, abdominal pain, possibly low-grade fever, chills, headache

Duration of symptoms usually 12-72 hours

Incubation Period

Average 24-48hrs (range: 12-72hrs)

Period of Communicability

Usually from onset until 2-3 days after recovery; typically, virus is no longer shed after 10 days

Criteria for Exclusion from School

Exclude until diarrhea and vomiting have ceased for 24 hours

Exclude from food handling for 48 hours after recovery

Reporting Requirement

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Prevention & Control Measures

Norovirus is highly infectious and is frequent cause of outbreaks.  Staff cleaning vomitus/stool spills should wear mask as aerosolization of virus can occur; cleaning and disinfection with product with EPA label for norovirus or use bleach solution.  Contact local health department for guidelines

Rotavirus

Mode of Transmission

By the fecal-oral route through direct contact or contact with contaminated hands, objects, food, or water

Symptoms

Diarrhea, nausea, vomiting, fever, abdominal pain; may have loss of appetite and dehydration

Incubation Period

Average: 2 days

Period of Communicability

Usually from onset until 3 days after recovery

Criteria for Exclusion from School

Exclude until diarrhea has ceased for 24hours

Exclude from food handling for 48 hours after recovery

Reporting Requirement

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Prevention & Control Measures

Spreads easily; good handwashing helps prevent spread. Vaccination is available for infants.

Hepatitis A

Mode of Transmission

By the fecal-oral route through direct contact, person to person, or ingestion of contaminated food or water

Symptoms

Fever, loss of appetite, nausea, abdominal discomfort and weakness followed by jaundice.

Many unrecognized mild cases without jaundice occur, especially in children

Incubation Period

From 15-50 days, average 28-30 days

Period of Communicability

Communicability greatest in 2 weeks before onset of illness, and through 7 days after onset of jaundice

Criteria for Exclusion from School

Exclude from school and daycare for 7 days after onset of jaundice or for two weeks after onset of symptoms if no jaundice present

Exclude food handlers, healthcare workers, or workers in sensitive occupations for 7 days after onset of jaundice, or two weeks after onset of initial symptoms, if jaundice is not present

Reporting Requirement

Report cases as soon as possible within 24 hours.

Outbreaks: Two or more cases linked by time and place.

Prevention & Control Measures

Timely immunization at 12 months of age; consider hepatitis A vaccine for caregivers; infected caregivers should not prepare meals for others. Contact local health department for guidance

Gastroenteritis: Parasitic

Giardiasis

Mode of Transmission

By the fecal-oral route, ingestion of contaminated food or water, person-to-person transmission of cysts from infected feces; contaminated water (e.g. water play tables)

Symptoms

Nausea, bloating, pain, and foul-smelling watery diarrhea, excessive flatulence, nausea and stomach cramps; symptoms can recur several times over a period of weeks. May be asymptomatic.

Incubation Period

Average 7-10 days (range 3-25+ days)

Period of Communicability

Highly variable but most infectious during diarrhea phase.

Criteria for Exclusion from School

Exclude until diarrhea has ceased for at least 24 hours; may be relapsing; additional restrictions may apply

Reporting Requirement

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Cryptosporidiosis

Mode of Transmission

By the fecal-oral route, ingestion of fecally contaminated food or water, contact with infected animals, consumption of contaminated unpasteurized food and drinks

Symptoms

Diarrhea, which can be profuse and watery, preceded by loss of appetite, vomiting, abdominal pain; asymptomatic cases can spread the infection to others; symptoms can come and go for up to 30 days

Incubation Period

Range 1-12 days

Commonly 7 days

Period of Communicability

As long as the oocysts are being shed, typically days to weeks. Shedding may persist after symptoms resolve.

Criteria for Exclusion from School

Exclude until diarrhea has ceased for at least 24 hrs; exclude from food handling and working in sensitive occupations for 48 hrs after recovery; exclude from swimming in public pools (or any recreational water venue) while symptomatic and for 2 weeks after symptoms resolve

Reporting Requirement

Report cases as soon as possible within 7 days

Prevention & Control Measures

For people with weakened immune systems, symptoms can be severe and could lead to severe or life-threatening illness. Alcohol-based hand sanitizers are not effective against Crypto. Contact local health department for guidelines

Pinworms (Enterobius vermicularis)

Mode of Transmission

Pinworms lay microscopic eggs near rectum, causing itching; infection spreads through ingestion of pinworm eggs, after contamination of hands by scratching

Symptoms

Often asymptomatic, but itching around the anus is a common symptom

Incubation Period

1 to 2 months or longer

Period of Communicability

Eggs may survive up to 2 weeks after appropriate therapy and resolution of rectal itching; re-infection is common

Criteria for Exclusion from School

None

Reporting Requirement

Not reportable

Prevention & Control Measures

Frequent, good handwashing, particularly by infected child and any caregivers assisting with toileting; keep fingernails clean and short; prevent fingers in mouth; bed linen and underclothing of infected children should be handled carefully, not shaken and laundered promptly

Meningitis

Bacterial Meningitis

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person

Symptoms

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Incubation Period

Hib: Unknown (usually 1 to 10 days)

Period of Communicability

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Criteria for Exclusion from School

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

Reporting Requirement

H. influenza, Invasive disease and meningitis, Reportable as soon as possible, within 24 hours

Prevention & Control Measures

If meningitis is suspected, follow up with a healthcare provider should occur as soon as possible.

Haemophilus influenzae type B (Hib bacteria)

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person

Symptoms

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Incubation Period

Unknown (usually 1 to 10 days)

Period of Communicability

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Criteria for Exclusion from School

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

Reporting Requirement

H. influenza, Invasive disease and meningitis, Reportable as soon as possible, within 24 hours

Prevention & Control Measures

Vaccination is recommended for children <age 5 years and for certain at-risk groups. Exposures may need antibiotic prophylaxis.

Neisseria meningitidis (Meningococcal bacteria)

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person

Symptoms

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Incubation Period

1 to 10 days (usually less than 4 days)

Period of Communicability

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Criteria for Exclusion from School

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

Reporting Requirement

Reportable as soon as possible, within 24 hours

Prevention & Control Measures

Contacts with saliva contact/exposure should receive antibiotic prophylaxis. Vaccination is recommended for children and teens, and certain at-risk groups.

Streptococcus pneumoniae (Pneumococcal bacteria)

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person

Symptoms

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Incubation Period

Variable (usually less than 4 days)

Period of Communicability

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Criteria for Exclusion from School

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

Reporting Requirement

Reportable when invasive disease is present in children less than 5 years of age within 7 days

Prevention & Control Measures

Treatment of contacts is not recommended. Vaccination is recommended for children and certain at-risk groups.

Viral (usually enterovirus) Meningitis

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person or fecal material, often from healthy people

Symptoms

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck, behavioral changes

Incubation Period

3 to 6 days

Period of Communicability

Viral shedding can occur from the day before illness until up to 2 weeks after onset.

Criteria for Exclusion from School

Exclude until fever resolved for at least 24 hours without the use of fever-reducing medication.

Reporting Requirement

Individual cases are not reportable. 

Clusters of cases are reported to local health department.

Prevention & Control Measures

no specific treatment, no treatment for contacts recommended; teach importance of basic hygiene, hand hygiene, covering mouth and nose when coughing and sneezing, proper disposal of used Kleenex/tissues

Skin Conditions and Rashes

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

Chickenpox (Varicella)

Mode of Transmission

Contact with the chickenpox rash or breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs

Symptoms

Fever and generalized rash.

There are usually two or three crops of new blisters that scab over then heal, sometimes leaving scars.

Disease in vaccinated children can be mild or absent of fever with few lesions, which might not be blister-like.

Incubation Period

Range 10-21 days

Commonly 14-17 days

Period of Communicability

Until lesions have crusted

Criteria for Exclusion from School

Exclude until all lesions have crusted (and at least 5 days)

For vaccinated children with atypical rash: exclude until afebrile and no new lesions have developed for at least 24 hours

Day Care licensing requirements: exclude at least 6 days after rash onset  http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

No exclusion of susceptible contacts unless in a healthcare facility/setting.

Reporting Requirement

Cases are reportable as soon as possible but within 24 hours.

Outbreaks are defined as 3 or more cases that are epidemiologically linked.

Prevention & Control Measures

vaccination recommended prior to school entry; susceptible contacts: families should be notified of risk of chicken pox and monitor for symptoms.

Fifth Disease (Human Parvovirus)

Mode of Transmission

By breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs

Symptoms

Redness of the cheeks and body, "slapped cheek” rash.

May have mild fever, runny nose, headache

Rash may come and go for weeks

Incubation Period

Range 4-20 days

Period of Communicability

Until rash appears

In immunosuppressed persons, communicability may last months-years

Criteria for Exclusion from School

No exclusion unless febrile or other symptoms meeting illness exclusion criteria are present

Reporting Requirement

Not reportable

German Measles (Rubella)

Mode of Transmission

Contact with droplets from nose, eyes or mouth of infected person; may be transmitted to fetus across the placenta

Symptoms

Red or pink rash appearing on face then spreading down the body; sore throat;  swollen glands behind ears; low grade fever; may have joint pain

Incubation Period

14 to 23 days (usually 16 to 18 days)

Period of Communicability

From 7 days before until 7 days after the rash appears

Infants with congenital rubella can shed the virus for months.

Criteria for Exclusion from School

Exclude cases for 7 days after the onset of the rash.

Exclude susceptible contacts from school or the workplace from days 7-23 following rash onset after last exposure.

Reporting Requirement

Reportable as soon as possible, within 24 hours

Hand, Foot & Mouth Disease (Coxsackie Virus and Enterovirus Diseases)

Mode of Transmission

By breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs -Touching feces or objects contaminated with feces, then touching mouth

Symptoms

Rash in mouth, hands (palms and fingers), and feet (soles); fever; loss of appetite; may be asymptomatic.

Incubation Period

Range 3-5 days

Period of Communicability

Most commonly during the first week of illness.  Can persist days to weeks after symptoms resolve.

Criteria for Exclusion from School

Exclude with febrile illness or other symptoms meeting illness exclusion criteria. 

Exclude if child cannot maintain hygiene (e.g. excessive drooling) or avoid contact with others.

Reporting Requirement

Individual cases are not reportable.

Clusters of 10 epidemiologically linked suspect or confirmed cases within a 10 day period should be reported to local health department.

Head Lice (Parasite)

Mode of Transmission

Direct close person to person contact; less commonly through contact with contaminated objects 

Symptoms

Itching and scratching of scalp; presence of live lice or pinpoint-sized white eggs (nits) that will not flick off the hair shaft

Incubation Period

Commonly 7-10 days

Period of Communicability

While live lice are present

Criteria for Exclusion from School

Childcare rules: exclude until the morning after the first treatment

http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

CDC advises that students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun.

Reporting Requirement

Not reportable

Herpes Simplex (cold sores, skin lesions) HSV1 (cold sores) HSV2 (genital lesions)

Mode of Transmission

Direct person to person contact with lesions, secretions form lesions, or saliva 

Symptoms

Primary infections may have no symptoms; may have fever or malaise; may or may not have rash, vesicular lesions, or ulcers at site, “fever blister”/cold sore

HSV 1 and HSV2 lesions can appear on other parts of the body.

Incubation Period

2-12 days

Period of Communicability

Most infectious while vesicular lesions are present. 

May be present with no symptoms

Criteria for Exclusion from School

Exclude from wrestling or contact sports (including practices) if lesions are present on the body (outside the genital area)

If large areas of lesions cannot be covered or if exposure to infectious lesions by other students cannot be avoided, the student should be excluded until lesions are dried and crusted.

Reporting Requirement

Individual cases are not reportable.  Clusters of 2 or more suspect or confirmed cases within a 5 day period that are epidemiologically linked should be reported to the local health department.

Impetigo (Staphylococcus or Streptococcus bacteria)

Mode of Transmission

Direct skin contact (especially through contaminated hands) or nasal discharge or contaminated surfaces

Symptoms

Small red pimples or fluid filled blisters with crusted yellow scabs; most often found on face but may be anywhere on body

Incubation Period

7 to 10 days

Period of Communicability

Until active crusting lesions are gone or after 24 hours on antibiotics

Criteria for Exclusion from School

Sores should be covered and child excluded at the end of the day, to return 24 hours after treatment is started.

Reporting Requirement

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Measles (Rubeola virus)

Mode of Transmission

Airborne or direct contact with droplets from nose, eyes or mouth of infected person

Symptoms

Cough, runny nose, conjunctivitis, fever, rash that starts at head and spreads down and out on body; sore throat; may have Koplik’s spots

Incubation Period

7 to 21 days (usually 8 to 12 days)

Period of Communicability

From 4 days before until 4 days after rash onset.

Extremely contagious!

Criteria for Exclusion from School

Exclude for at least 4 days after start of rash.

Susceptible contacts: Those who do not receive vaccine within 72 hours of exposure shall be excluded for 21 days after onset of last case.

Reporting Requirement

As soon as possible, within 24 hours.

Prevention & Control Measures

Vaccination is recommended prior to school entry.

MPV (Human Monkeypox)

Mode of Transmission

Direct skin contact with infected persons rash, scabs or body fluids, touching objects, fabrics (clothing, towels, bedding) and surfaces that have been used by someone with MPV or contact with respiratory secretions.

Symptoms

Fever, headache, muscle aches/backache, swollen lymph nodes, chills, exhaustion, respiratory symptoms (sore throat, nasal congestion, or cough), and a rash that may be located on or rear the genitals or anus but can be located other places like the hands, feet, chest, face and mouth. The rash might look like pimples or blisters and may be painful or itchy.

Incubation Period

Roughly 1 to 2 weeks. If flu-like symptoms develop, they usually develop a rash 1 to 4 days later.

Period of Communicability

From onset of prodrome until the rash has healed, all scabs have fallen off and a fresh layer of skin has formed. This illness typically lasts 2 to 4 weeks.

Prodrome of fever, malaise, headache sometimes sore throat and cough, and lymphadenopathy usually occurs 1-2 days before rash onset.

Criteria for Exclusion from School

Exclude until the rash has healed, all scabs have fallen off and a fresh layer of skin has formed. 

Reporting Requirement

As soon as possible, within 24 hours.

MRSA (Methicillin-resistant Staph aureus) skin infections

Mode of Transmission

Direct skin contact with infected person, wound drainage or contaminated surfaces; increase risk in crowded conditions; occasional transmission by droplet over short distances

Symptoms

Skin lesions such as furuncles (abscessed hair follicles or “boils”), carbuncles (coalesced masses of furuncles), and abscesses; may have purulence (pus), yellow/white central point, redness

Incubation Period

Variable, usually 4-10 days and up to months; at times initially mistaken as spider bite

Period of Communicability

Duration of acute illness if wound drainage present Draining wounds are very contagious and should be covered at all times.

Criteria for Exclusion from School

Exclude if wound drainage cannot be well contained under a dressing

Exclude from high-risk activities such as contact team sports if wound cannot be completely covered with a secure bandage that will remain intact throughout sport activity, until completely healed

Exclude from use of pools/whirlpools, etc. until wounds are healed

Reporting Requirement

Individual cases are not reportable. 

Clusters of 2 or more cases with infections in a 14-day period and with an epidemiological link should be reported to local health department.

Prevention & Control Measures

Keep skin lesions covered.  Environmental cleaning and disinfection as recommended.

Molluscum contagiosum

Mode of Transmission

Person to person close contact;  through sharing of objects such as towels

Symptoms

Small flesh colored bumps on the skin that may have a tiny indented center

Incubation Period

2 to 7 weeks, as long as 6 months

Period of Communicability

When lesions are present; otherwise unknown

Criteria for Exclusion from School

No exclusion. 

Provide education on importance of hand hygiene and avoiding scratching areas.

Reporting Requirement

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Ringworm (e.g. tinea corporis, tinea capitis)

Mode of Transmission

Direct skin contact with infected person or animal, or contact with surfaces or objects contaminated with fungal spores

Symptoms

Skin: red circular patches with raised edges and central clear area; cracked peeling skin between toes;

Scalp: redness, patchy scaly areas with/without hair loss

Can occur in multiple sites on the body

Incubation Period

Typically 4 to 14 days after exposure

Period of Communicability

From onset of lesions until treatment begins and lesion begins to shrink

Criteria for Exclusion from School

If lesion can be kept covered, exclusion are not required.

If lesions can NOT be kept covered, exclude from school until 24 hours after treatment begins.

Reporting Requirement

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Scabies

Mode of Transmission

Prolonged skin-to-skin contact with infested individual; contact with bedding or clothes of infested person

Symptoms

Red bumps commonly found in skin folds; burrows appear as tiny whitish or gray lines on skin surface; intense itching, especially at night

Incubation Period

4 to 6 weeks, 1 to 4 days after re-exposure

Period of Communicability

From up to 8 weeks before skin rash appears until it has been treated with a scabicide

Criteria for Exclusion from School

Exclude from school and other extracurricular activities until the morning after treatment recommended by the child’s healthcare provider has been started.

Childcare rules: exclude until the morning after the first treatment. http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Reporting Requirement

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Shingles/Zoster

Mode of Transmission

Direct contact with the rash during blister phase

Symptoms

Painful rash that develops typically on one side of the body; may have fever, headache, chills, nausea

Incubation Period

None.

Anyone with history of chicken pox can develop shingles.

Period of Communicability

Shingles cannot be passed from one person to another, but during the blister phase of rash, direct contact with blister fluid of shingles rash can cause chicken pox in non-immune persons.  When crusted over, rash is no longer infectious.

Criteria for Exclusion from School

Exclude if rash cannot be covered, or if child cannot comply with keeping rash covered until crusted over.

Exclude if febrile or other symptoms meeting illness exclusion criteria are present 

Reporting Requirement

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Animal Bites

Bat Exposures/Animal Bites (Potential for Rabies)

Mode of Transmission

Contact with an infected animal’s saliva through a bite or scratch in the skin, or through mucous membrane exposure (e.g. eyes, nose, mouth); contact with an infected animal’s brain tissue or cerebrospinal fluid

Symptoms

In animals, behavior changes may occur, including seeing nocturnal animals during daylight hours, or wild animals allowing humans to approach.  Animal may have excessive salivation, difficulty walking, or a stunned appearance.  A domestic animal may be unusually aggressive or overly docile.  Bats may be on the ground due to difficulty flying. 

In humans, the person may be apprehension. Symptoms include headache, fever, malaise, and subtle changes in personality or cognition.

Incubation Period

Humans: symptom onset usually from 1 to 8 weeks but can appear days to years following exposure

Bites to head and neck usually have sooner onset of symptoms. Once symptoms appear, rabies is almost always fatal.

Animals:  weeks to months

Period of Communicability

When the virus reaches the saliva of the infected animal

Virus excretion may be intermittent. Animal may or may not show symptoms.

Criteria for Exclusion from School

No exclusion.

If a bite or scratch occurs, notify parents and refer individual for medical treatment by or under the direction of a physician.

Reporting Requirement

Report potential human exposure to rabies as soon as possible, within 24 hours

Report animal bites or contact with a bat to the local public health department as soon as possible

Prevention & Control Measures

Bat exposures and animal bites occasionally occur on school grounds or while students are in route to school. 

Educate students to avoid any domestic or wild animal that is acting strangely, is sick, or is unfamiliar to them 

Teach students to report any contact with a wild animal or an unfamiliar domestic animal, and to report any bites or scratches from any animal 

If a bite or scratch occurs:

  1. Provide first aid to the child; flush the wound with lots of water; clean the wound with soap and water, then rinse it well; refer for medical treatment by or under the direction of a physician
  2. If you can, confine the animal; if not, note the size, appearance, and any distinguishing characteristics of the animal.  If available, write down the name, phone number and address of the owner and the events surrounding the bite. If the animal escapes, it is particularly important to get as much information as possible
  3. Report the bite to the local health department and animal control

Tips For Keeping Healthy

Hand washing is the single most important way to prevent the spread of communicable diseases

Use soap, warm water and disposable paper towels and wash your hands frequently. Teach children to wash their hands, too. Hand washing reduces the number of microorganisms on hands that can spread communicable diseases. It is recommended that:

  • Hands be washed when arriving for the day and leaving for the day and when moving between groups of children, and as follows:
    • Before and after eating or handling food, feeding a child, administering medication, or playing in water used by more than one person
  • After diapering or using the toilet; handling any bodily fluid, uncooked food, or animals; cleaning cages/litterbox; being outdoors, playing in sandboxes or at playgrounds; and/or cleaning or handling trash/garbage.

Open the window to let the fresh air in

Well-ventilated rooms help reduce the numbers of airborne germs inside. Airing out the rooms is important, even in the winter. Respiratory diseases easily spread from coughs and sneezes. Opening the window at least once a day lets the germs out and fresh air in.

Follow a good cleaning schedule and sanitize or disinfect in the proper way

Guidance on cleaning and disinfection in schools is available at http://www.cdc.gov/flu/school/cleaning.htm.

Consider utilizing a chart to ensure all areas are addressed for cleaning, identifying the appropriate sanitizing or disinfection method, and according to schedule.

Increase frequency of cleaning and disinfection during illness outbreaks, when there is known contamination, when there is visible soil, blood, or bodily fluids, or when recommended by the local health department.

Remember a surface must first be clean for a sanitizer or disinfectant to be effective. Follow product label instructions for use.

Require that children are up to date on immunizations

An immunization schedule is available at  https://www.cdc.gov/vaccines/schedules/. Check immunization records and update them regularly. When parents have questions or concerns about immunization safety, provide them with science-based educational materials available at CDC: http://www.cdc.gov/vaccines/parents/index.html and the Immunization Action Coalition at http://immunize.org/talking-about-vaccines/.

Do not share personal items among children and keep their belongings separate

Do not allow children to share belongings such as hair brushes, food, drinks, clothing, hats, pacifiers or other items; separate children's coats, hats, and bedding items.

Separate children by using space wisely

  • Maintain distance between sleeping areas, mats, cribs or cots.
  • Keep children in groups and consistently assign caregivers to the same group.
  • Keep diapered and toilet-trained children separate to prevent spread of diarrheal diseases.
  • When possible, staff responsible for food handling should not be involved in diaper changing, or at a minimum, should not perform diapering during times of food preparation and handling.

Exclude sick children and staff

Ensure that parents receive information on when to keep ill children at home and other school exclusion policies, sending a sick child home with his/her parent helps to prevent the other children from becoming ill with a communicable disease.