8450 - MANAGEMENT OF SELECTED CASUAL-CONTACT DISEASES

Sheridan Community School Corporation

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	48 hours before rash to 5 days after rash first starts or until all vesicles have scabbed.	When lesions are dry and crusted and no new eruptions. At least 5 days after rash first appears.


FIFTH DISEASE (Erythema Infectiosum) (Hungarian measles)	Rash begins as a solid red area on cheeks ("slapped cheek" appearance), spreading to upper arms and legs, trunk, hands and feet.	4-14 days can be as long as 20 days	Exact duration unknown. Greatest before rash onset. Probably not communicable after rash onset.	Fever and signs of illness other than rash are no longer present.


INFLUENZA (Viral Influenza)	Fever, headache, muscle aches. Sore throat, and cough (25% of school age children may have nausea, vomiting, and diarrhea).	1-5 days	Probably 3 to 5 days from onset in adults; up to 7 days in young children.	Fever no longer present.
*Some of this information was taken from the publication. Communicable Disease Flipcart for School Personnel. Indiana State Department of Health, 1995

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 usually not on face, palms of hands or soles of feet. Afterward, the skin peels off like sunburn. Often the tongue has a "strawberry" appearance.	1-3 days	In untreated, uncomplicated cases, 10-21 days or until under adequate antibiotic treatment for 24-48 hours.	Adequate treatment for 24-48 hours fever no longer present.


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.	2 -10 days av: 2-4 days report to Health Department	Until the meningococcus is no longer present in discharge from nose and mouth. Usually will disappear within 2 hrs. after appropriate antibiotics.	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.	1-3 days av: 2-3 days.	Weeks or months without medical treatment or with antibiotic treatment 24-48 hours.	Adequate treatment for 24-48 hours. Fever no longer present.


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.	When fever no longer present.

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: 14-17 days report to Health Department.	7 days before to 4 days after rash onset.	2 days after rash onset.

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

MEASLES (Rubeola)	Begins 2 to 4 days of gradually increasing fever, runny nose, (red) inflamed eyes, and especially coughing. By the 3rd day, rash usually begins around ears and hairline, spreading down to cover face, trunk and arms Within 24-28 hrs. 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 7 days. Sensitivity to light is also common.	7-18 days av: 10 days usually report to Health Department REMOVE FROM SCHOOL IMMEDIATELY	1-2 days before beginning of symptoms and for up to 4 days after rash appears.	Exclude for at least 4 days after appearance of rash. Requires doctor's note for re-admittance.

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 7-10 days.	12-25 days av: 18 days Report to Health Department EXCLUDE FROM SCHOOL	Usually 5 but may be as long as 7 to 9 days prior to the onset of salivary gland swelling and up to 9 days after swelling first appears.	9 days after onset of swelling 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 Report to Health Department EXCLUDE FROM SCHOOL	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)	Redness of eyes, runny nose, low grade fever. 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.	6-20 days av: 10 days Report to Health Department	Untreated-from early throat inflammation to 3 weeks after typical cough symptoms occur. Treated-the period of infectiousness extends 5 days after onset of treatment.	3 weeks from onset of cough symptoms, if untreated or until after 5 days of treatment.

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.	4-10 days Tinea Capitis 10-14 days Tinea Corporis 4-10 days Tinapedis unknown	As long as any untreated lesions are present and spores persist on contaminated materials.	Under medical care. While under treatment, infected children should be excluded from gymnasiums, swimming pools and activities likely to lead to exposure of others.


PINWORM	Itching in anal areas, disturbed sleep, irritability and local irritation due to scratching	2-6 weeks	As long as eggs are being laid on perianal skin. Eggs remain infective indoors about 3 weeks.	Under medical care.

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: 1-7 days	Throughout the illness. And as long as organisms are in stool. 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.	5-25 days after exposure av. 7 days. EXCLUDE FROM SCHOOL	Entire period of infection. May last 2-6 weeks.	Requires doctor's note for re-admittance.


SALMONELLOSIS (Acute Gastro Enteritis) (Food Poisoning)	Sudden onset of fever, Abdominal cramps, diarrhea, and possibly vomiting.	6-72 hours av: 12-36 hours Report to Health Department EXCLUDE FROM SCHOOL	During acute infection and until organism no longer in feces. Usually several weeks.	Exclude until symptoms are gone. Exclude from certain activities based on Health Department recommendation.


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.	av: 2-4 days EXCLUDE FROM SCHOOL Report confirmed cases	During acute infection and until organism no longer in feces. Usually several weeks.	Exclude until symptoms are gone. Exclude from certain activities based on Health Department recommendation.


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.	12-72 hours EXCLUDE FROM SCHOOL Report to Health Department	From onset of illness until symptoms subside.	Exclude until symptoms are gone.

Hepatitis A (Infectious Hepatitis) (Epidemic Jaundice)	Onset is usually abrupt with fever, malaise, anorexia, nausea, and abdominal discomfort, followed within a few days by jaundice.	15-50 days av: 25-30 days EXCLUDE FROM SCHOOL Report to Health Department	Greatest risk is in 2 weeks preceding onset of jaundice, risk is minimal after 1 week after the onset of juandice.	Same as above. Exclude from school during infectious period.

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.	1-3 days streptococcus 4-10 days staphylococcus	As long as pus filled lesions continue to drain.	Under medical care and lesions are healing and no new lesions appear. Draining lesions must be covered and contained.


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.	24-72 hours, bacterial 12 hrs.- 3 days viral	During the period of active infection. Some children recover in only a few days but many cases take 2 to 3 weeks.	Until under medical care.

Mononucleosis, Infectious	Fever, sore throat, and enlarged lymph glands.	4-7 weeks after exposure.	Indeterminate; pharyngeal excretions may persist for 1 many months after infection.	Under medical care and physician has given permission to return.

Pediculosis (Head Lice)	Appearance of lice and/or nits is the hair, commonly at nap of neck and/or behind the ears. Nits are fastened firmly to the hair.	Eggs hatch in 7 days; maturity reached 8-10 days after hatching.	Until lice and viable eggs are destroyed.	Treated and lice no longer present.

Herpes Simplex	Superficial clear blisters on a red base which crust and heal within a few days.		Secretion of virus in the saliva has been reported for as long as 7 weeks after recovery from infection.	None recommended.

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

DISEASE	SYMPTOMS	INCUBATION PERIOD	CONTAGIOUS PERIOD	RETURN TO SCHOOL

Scabies	Rash, small raised bumps, blisters or linear tracts containing mites or their eggs, found commonly between the fingers, on wrists, or waistline. Cause severe itching especially at night.	First exposure, 2-6 weeks; subsequent exposure, 1-4 days	Until mites and eggs are destroyed, usually after 1-2 treatments.	Day after treatment is completed. Occasionally a second treatment is needed.

Hand, Foot, and Mouth	Papulovesicular lesions appear on the buccal surfaces of cheeks and gums and on sides of the tongue. Lesions may also appear on palms, fingers, and soles and last 7-10 days. Fever may also occur.	3-6 days	Acute stage of illness and perhaps longer.	When fever no longer present weeping lesions or excessive drooling.

Hepatitis B (Serum Hepatitis	Onset is usually insidious with anorexia, vague abdominal, nausea, and vomiting, sometimes arthralgias and rash, often progressing to jaundice. Fever may be absent or mild.	45-180 days; average is 60-90 days	Weeks before onset and throughout clinical course. Carrier state may persist for years.	Healthy enough to return without danger to self. Carrier status should be individually reviewed. Note from physician is recommended.

Additional information obtained from – Indiana State Department of Health http://www.in.gov/isdh/23291.htm "Communicable Disease Reference Guide for School Personnel: 2002", ISDH: Rash Illness Chart, ISDH: Quick Reference Chart.

Revised 8/26/10