8450 - MANAGEMENT OF SELECTED CASUAL-CONTACT DISEASES

Cedar Springs Public School District

Administrative Guidelines

8450 - MANAGEMENT OF SELECTED CASUAL-CONTACT DISEASES

Diseases spread by airborne and/or direct contact with germs from sneezing, coughing, and speaking.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

CHICKENPOX (Varicella)	General discomfort, slight to high fever, headache, and loss of appetite. Lesions appear in bunches with most on upper body. Face and extremities are less affected. Typical lesions have teardrop shape surrounded by reddened area. Blistered (new) and broken and crusted (old) eruptions are on the skin at the same time.	10-21 days av: 14-16	5 days before rash to 6 days after rash first starts.	When lesions are dry and crusted and no new eruptions. At least 7 days after rash first appears.


FIFTH DISEASE (Erythema Infectiosum)	Rash begins as a solid red area on cheeks ("slapped cheek" appearance), spreading to upper arms and legs, trunk, hands and feet.	6-14 days	Probably 2 days.	Exclude for diagnosis. Before rash and 4-5 days later. Usually no treatment needed. Cause unknown.


INFLUENZA (Viral Influenza)	Starts suddenly with chills, fever, headache, muscle pains, and coughing. Followed by other cold symptoms.	24-72 hours	About 3 days from first symptoms.	About 3 days, at discretion of school nurse or principal.


SCARLET FEVER (Scarletina)	Begins with fever and sore throat. Rash appears as a pink-red flush which looks like a sunburn with goose pimples, that spreads to all parts of the body. Afterward, the skin peels off like a sunburn. Often the tongue has a "strawberry" appearance.	1-7 days av: 2-4 days	Variable. If not treated, can be contagious for months.	Exclude until 48 hours after treatment completed.


DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

SPINAL MENINGITIS (Meningococcal) and (Haemophilus)	Sudden onset of high fever, headache, and stiff neck. In severe cases, delirium stupor or coma can also occur. In meningococcal meningitis small purplish spots are occasionally seen in skin and mucous membranes.	1-10 days av: 2-4 days	Unknown. Probably throughout the duration of symptoms.	Requires doctor’s note for re-admittance.


STREP THROAT (Streptococcal sore throat)	Similar to scarlet fever but without a rash. A sore throat and fever are the most pronounced symptoms.	1-7 days av: 2-4 days.	Same as above.	Same as above.


ROSEOLA (Exanthem Subitum)	Sudden high fever (104° -105° F.) which falls with the appearance of a rash on about the third or fourth day. Rash consists of small rose-pink spots which first appear on the chest and abdomen but may spread to the face, legs, and arms. Rash is usually limited to only one or two days.	5-15 days	Unknown. The disease does not appear very contagious.	Until no symptoms.

RUBELLA (German Measles)	Rash begins on the face and spreads to the rest of the body within 24 hours and is usually gone by the end of the third day. Often present is a pronounced swelling of the lymph nodes behind the ear and at the base of the skull. Mild coughing, sneezing, and reddened eyes are common early in the course of the illness.	14-21 days av: 16-18 days	7 days before to 7 days after rash onset.	7 days after rash onset.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

MEASLES (Rubeola)	Begins 3 to 4 days of gradually increasing fever, runny nose, (red) inflamed eyes, and especially coughing. Rash usually begins around ears and hairline, spreading down to cover face, trunk and arms by second day. Rash is initially bright pink with distinct raised spots. Tiny blue-white pinpoint-sized swelling inside the cheeks may be observed a day before the rash first appears. The rash usually last about five days. Sensitivity to light is also common.	8-13 days av: 10 days	4 days before rash and for up to 4 days after disappearance of the rash.	4 days after disappearance of the rash.

MUMPS (Infectious Parotitis)	Onset is gradual. There may be chills, discomfort, headache, pain below ears accompanied by a moderate fever of 101^{o -}102^oF. or higher followed by swelling of one or both salivary glands. Swelling is below and in front of ear. Usually swelling in one gland subsides as the other begins to swell. The ear lobe is often pushed forward by the swelling of the gland. Swelling usually lasts 5 to 7 days.	2 to 3 weeks av: 18 days	Usually 5 but may be as long as 7 to 9 days prior to the onset of salivary gland swelling.	5-9 days after onset and no symptoms.

TUBERCULOSIS (TB)	Starts with fever, night sweats, and weight loss early. Later symptoms include a persistent non-productive cough, chest pain, hoarseness, and coughing of blood.	2-10 weeks	Variable. After starting treatment with anti TB drugs, a patient may become non-infectious in as little as two weeks.	Requires a doctor’s note for re-admittance.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

WHOOPING COUGH (Pertussis)	Coughing and sneezing followed 1 to 2 weeks later by breathing characterized by a series of short convulsive-like coughs, and a high pitched gasp of air called a whoop.	7-10 days av: 7 days	Early, when the patient has common cold-like symptoms. The patient becomes less infectious as the convulsive-like coughs begin. Infectious stage ends in about four weeks.	Requires doctor’s note for re-admittance.

Diseases spread by contact with tiny parasites on contaminated belongings of others.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

RINGWORM (Tinea Capitis; Tinea Corporis)	Ringworm of the scalp begins as a small pimple which grows and spreads, leaving scaly patches of temporary baldness. Ringworm of the body appears as flat, spreading, ring-shaped lesions. The outside is usually reddish and filled with pus while the skin on the inside tends to return to normal.	4-14 days	As long as any untreated lesions are present and spores persist on contaminated materials.	Return after treatment has begun—cover with bandaid or clothing, when possible.



PINWORM	Itching in anal areas, disturbed sleep, irritability and local irritation due to scratching	3 weeks to 3 months	As long as the female worm survives in the intestine.	Return after treatment.

Diseases spread by the fecal-oral route – contamination of food, drink or objects placed in the mouth.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

CAMPYLOBACTER (Vibriosis Vibrionic Enteritis)	Sudden onset of fever and abdominal pain and diarrhea which may be severe. May also be vomiting and sometimes blood in the stools.	1-10 days av: 3-5 days	Throughout the illness (1 to 4 days). If not treated, up to 7 weeks.	Requires doctor’s note for re-admittance.


GIARDIASIS (Protozoan Diarrhea)	Chronic, intermittent diarrhea, bloating, foul-smelling stools and fatigue and weight loss. Sometimes observable symptoms are not present.	1 to 4 weeks after exposure	Entire period of infection.	Same as above.


SALMONELLOSIS (Acute Gastro Enteritis) (Food Poisoning)	Sudden onset of fever, Abdominal cramps, diarrhea, and possibly vomiting.	6-72 hours av: 12-36 hours	Variable. Throughout course of illness.	Same as above.


SHIGELLOSIS (Bacillary Dysentery)	Sudden onset of fever, diarrhea, abdominal pain. Loss of appetite and vomiting may also occur. There may be blood, mucous, or pus in the stools.	1-7 days av: 2-3 days	From onset of illness until 4 weeks later.	Same as above.


VIRAL GASTROENTERITIS (Viral Diarrhea; Winter Vomiting Rotoviral Diarrhea)	Abrupt onset of nausea, vomiting, diarrhea, abdominal pain, and discomfort. Fever, if present, is usually low grade. Very contagious.	24-48 hours	From onset of illness until symptoms subside.	Same as above.

Hepatitis A (Infectious Hepatitis) (Epidemic Jaundice)	Sudden loss of appetite, nausea, and abdominal pain or discomfort. Within a few days, jaundice occurs with yellowing of eyes and skin and darkening of urine.	15-40 days av: 28 days	10-15 days before symptoms appear until the first few days of jaundice.	Same as above.

Diseases spread by direct skin contact with wounds or discharges from an infected person.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

IMPETIGO (Impetigo Contagiosa)	Isolated pus filled spots which become crusted and break releasing a straw-colored fluid. Occurs principally around the mouth and nostrils.	4-10 days	As long as pus filled lesions continue to drain.	Return when lesions are dry, there is no seeping and under treatment. Cover, if possible, while at school.


PINKEYE (Epidemic Form of Acute Conjunctivitis)	Irritation of the eye accompanied by tears, swelling of the lids, extreme sensitivity to light, and a buildup of a sticky fluid that dries to a straw-colored, crusty material accumulating at the corners of the eye.	27-72 hours	During the period of active infection. Some children recover in only a few days but many cases take 2 to 3 weeks.	Until under treatment.