Download bps communicable disease reference chart for school personnel

07/2015
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
Chickenpox*
(Varicella)
Conjunctivitis,
Acute Bacterial
(Pink Eye)
INCUBATION
PEROID
From 10-21
days, usually 1416 days (May be
prolonged by use
of VZIG).
Usually 24-72
hours.
TRANSMISSION
COMMON SYMPTOMS
RECOMMENDATIONS
From person-to-person
by direct contact and
droplets or by airborne
spread of vesicular fluid
or secretions of the
respiratory tract.
Sudden onset with slight fever and itchy
eruptions which become vesicular (small
blisters) within a few hours. Lesions
commonly occur in successive crops,
with several stages of maturity present at
the same time. Communicable for as
long as 5 days (usually 1-2 days) before
eruption of vesicles until scabs have
formed (usually 5 d.)
By contact with
discharges from the
conjunctivae or
contaminated
articles.
Pink or red eyeball with swelling of the
eyelids and eye discharge. Eyelids may
be matted shut after sleep.
CASE: Exclude from school until
all lesions dried and crusted .
Obtain previous varicella hx.
Report to BPHC, HS.
CONTACTS: With BPHC (1)
identify students and staff who
may have been exposed
(contagious 1 day before rash and
until all lesions have dried and
crusted),(2) implement control
measures (1e, exclude
susceptibles, recommend varicella
vaccine within 3-5 days of
exposure, if susceptible, Identify
known susceptibles and refer to
primary care, (3) identify if
streptococcal disease is in school.
Conduct surveillance for 42 days
after last exposure.
CLEANING
LETTER:
CASE: Exclude from school
while symptomatic or until 24
hours of antibiotic treatment has
been completed.
CONTACTS: School exclusion
not indicated.
CLEANING
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
INCUBATION
PEROID
TRANSMISSION
COMMON SYMPTOMS
Coxsackie
(Hand Foot and
Mouth)
The incubation
period is 3-6
days after
exposure;
contagious 2
days before to 2
days after the
mouth sores
develop.
Contact with
secretions, feces
contagious when the first symptoms
appear and may continue until the
blister-like skin lesions disappear. The
virus has been known to be shed in the
stool for up to several weeks.
Fifth Disease
(Erythema
Infectiosum)
From 4-20 days
Primarily through
contact with
respiratory
secretions.
Mild illness without fever. Rash
characterized by a vivid reddening of the
skin, especially of the face, which fades
and recurs; classically, described as a
“slapped face appearance.”Frequently6
associated with lace-like rash on trunk
and extremities that fades and may
recur.
Measles*
(Rubeola, Red
Measles)
From 7-18 days,
usually 8-14
days.
Airborne by droplet
spread or direct
contact with nasal or
throat secretions of
an infected person.
RECOMMENDATIONS
LETTER
CASE; exclude until fever free
CONTACTS:no exclusion if not ill
CLEANING: regular Universal
Precautions
LETTER: not mandatory
CASE: Exclusion from school not
indicated. Use standard infection
control measures.
CONTACTS: School exclusion
not indicated. Pregnant women
and immunocompromised persons
should seek medical advice.
CLEANING
LETTER
Prodrome characterized by fever
CASE: Exclude from school until
followed by reddened eyes, runny nose, at least 4 days after appearance of
cough. Dusky-red blotchy rash appears the rash. Check immunization
on day 3 or 4 and lasts 4 -7 days. Highly records of all students.
communicable from 4 days before rash
Immediately report to BPHC and
appearance to 4 days after appearance
HSA
of the rash. Immunocompromised
CONTACTS: Check records of
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
INCUBATION
PEROID
TRANSMISSION
COMMON SYMPTOMS
people can be infectious throughout
illness.
Invasive
Meningococcal
infections
caused by N.
Meningitis
From 1-10 days, By direct contact or
usually 2-4 days. droplet spread of
nasopharyngeal
secretions of an
infected person.
May present as meningitis, bacteremia,
sepsis or pneumonia. Sudden onset of
fever and intense headache. Delirium
and coma often appear early; a
characteristic (measles-like) rash usually
follows. Can be fatal despite prompt
diagnosis and treatment.
MRSA
variable
Skin sores
Direct contact with
lesions or
contaminated
RECOMMENDATIONS
all students/staff, including
volunteers, (2) implement control
measures as per BPHC, (3) refer
pregnant women,
immunocompromised people or
infants <12 months to PMD and
exclude susceptibles.
Conduct surveillance for 36 days
after last exposure.
CLEANING
LETTER
CASE: Immediately report to
BPHC and HS. Exclude from
school during acute illness. Noncommunicable after 24 hours of
appropriate drug therapy.
CONTACTS: School exclusion
not indicated. Work with BPHC to
identify close contacts, evaluate
chemoprophylaxis indications and
send parent/clinician notification
letters. Conduct surveillance of
S&S for 2 wks after case.
CLEANING
LETTER
CASE: Advise to keep area
covered; not necessary to exclude
or notify
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
INCUBATION
PEROID
TRANSMISSION
COMMON SYMPTOMS
surfaces
Mumps
From 12-25
By droplet spread or
days, usually 16- by direct contact
18 days.
with nasopharyngeal
secretions oof an
infected person.
Pediculosis
(Head Lice)
Under optimum
conditions, eggs
hatch in 7-13
days and reach
maturity in about
10 days.
By direct contact
with an infested
person or their
personal belongings
such as combs,
brushes, and hats.
Pertussis*
Commonly 6-21, By direct or droplet
usually 2-10
contact with
days.
nasopharyngeal
secretions of an
infected person.
Fever with swelling and tenderness or
one or both parotid glands located below
and in front of the ears. Unrecognized
mild cases without swelling may occur.
Communicable from 7 days before
swelling until 9 days after (initial day of
swelling counted as day zero).
RECOMMENDATIONS
CLEANING
LETTER
CASE: Report to BPHC and HS.
Exclude from school for 9 days
after the onset of parotid gland
swelling.
CONTACTS: School exclusion
not indicated. With BPHC, 1)
identify susceptibles, 2) implement
control measures, 3) exclude
susceptibles. Conduct surveillance
for 50 days after last exposure
CLEANING
LETTER
Severe itching and scratching, often with CASE: Exclusion until nit free is
secondary infection. Eggs of head lice
NOT indicated.
(nits) attach to hairs as small, round,
CONTACTS: Direct inspection of
gray lumps.
head. School exclusion not
indicated. Full school inspection
not usually recommended.
CLEANING
LETTER
The initial stage begins with upper
CASE: Notify BPHC and HS;
respiratory symptoms and increasingly
.Exclude from school until 5 days
irritating cough. The paroxysmal stage
after initiation of appropriate
usually follows within 1-2 weeks, and
antibiotic RX, or if not treating,
lasts 1-2 months. Paroxysmal stage is
until 21 days from cough onset.
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
INCUBATION
PEROID
TRANSMISSION
COMMON SYMPTOMS
characterized by repeated episodes of
violent cough broken by a high-pitched
inspiratory whoop. Older children may
not have whoop. Convalescence may
require many weeks.
Rubella*
(German
Measles)
From 14-23
By direct contact or
days, usually 16- droplet spread of
18 days.
nasopharyngeal
secretions of an
infected person.
Mild symptoms; slight fever, rash of
variable character lasting about 3 days;
enlarged head and neck lymph glands
common. Joint pain may occur,
especially in older children and adults.
Communicable for 7 days before onset
of rash and at least 14 days thereafter.
Scabies
From 2-6 weeks.
Begins as itchy raised areas around
finger webs, wrists, elbows, armpits,
By direct skin-toskin contact.
RECOMMENDATIONS
CONTACTS: With BPHC: 1)
identify all close contacts (direct
face to face contact or
nasopharyngeal secretions contact
or sharing indoor space for at least
10 hrs/wk) and refer to primary
care; 2) identify and asses
symptomatic students; 3)
implement control procedures; 4)
surveillance for all school for 42
days after cough and onset of last
case.
CLEANING
LETTER
CASE: Notify HS and BPHC.
Exclude from school for 7 days
after onset of rash. Avoid
exposure to women in early
pregnancy. Check immunization
records of all students. .
CONTACTS: Work with
BPHC.Those who are pregnant
and not immunized should be
urged to seek medical advice.
CLEANING
LETTER
CASE: Exclude from school until
24 hours of antibiotic treatment
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
INCUBATION
PEROID
TRANSMISSION
COMMON SYMPTOMS
belt-line, and/or genitalia. Extensive
scratching often results in secondary
infection.
Shingles
No shingles
person to person
transmission
BUT , if exposed
person has not
had varicella,
may devlop
chicken pox
Streptococcal
Diseases
(Including
Impetigo and
Scarlet Fever)
Impetigo:
By direct contact
variable, often 7- with infected persons
10 days
and carriers or by
contact with their
respiratory droplets.
Scarlet Fever:
usually 1-3 days,
rarely longer.
Direct skin to skin
lesion contact
Painful blisters; A person is not infectious
before the blisters appear. Once the rash
has developed crusts, the person is no
longer contagious.
Multiple skin lesions usually of exposed
area (e.g., elbows, legs, and knees), but
may involve any area. Lesions vary in
size and shape, and begin as blisters,
which rapidly mature into brown crusts
on a reddened base. Healing from center
outward produces circular areas, which
may resemble ringworm.
Fever, sore throat, exudative tonsillitis
or pharyngitis. Sandpaper-like rash
appears most often on neck, chest, and
skin folds of arms, elbows, groin, and
inner aspect of thighs.
RECOMMENDATIONS
has been completed.
CONTACTS: Observe for signs
and symptoms. School exclusion
not indicated in absence of
infestation.
CLEANING
LETTER
CASE: Keep area covered
CONTACTS;
immunocompromised, pregnancy
avoid physical contact
CLEANING
LETTER
CASE: Exclude from school until
lesions are healed or until 24 hours
of antibiotic treatment has been
completed.
CONTACTS: Exclusion from
school not indicated. Observe
carefully for symptoms.
CLEANING
LETTER
CASE: Observe for S&S.Exclude
from school during acute illness.
Non-communicable after 24 hours
of appropriate drug therapy.
CONTACTS: Exclude on first
BPS COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL
DISEASE
INCUBATION
PEROID
TRANSMISSION
Streptococcal
sore throat:
short, usually 13 days.
Tinea Corporis
(Ringworm of
the Body)
Unknown but
thought to be
from 4-10 days.
Adapted for Boston use.
COMMON SYMPTOMS
Sudden onset of fever, sore throat,
exudative tonsillitis or pharyngitis, and
enlarged lymph nodes. Symptoms may
even be absent in some cases.
By direct or indirect
contact with lesions
of an infected person
or contaminated
environmental
surfaces.
Circular well-demarcated lesion that can
involve face, trunk, or limbs. Itching is
common.
RECOMMENDATIONS
indication of symptoms. Culturing
of school contacts and treatment of
carriers not usually indicated.
CLEANING
LETTER
CASE: Exclude from school until
24 hours of antibiotic treatment
has been completed.
CONTACTS: Exclusion from
school not indicated. Observe
carefully for symptoms.
CLEANING
LETTER
CASE: Exclusion from school not
indicated as long as lesions are
covered or child is receiving
treatment. During treatment,
exclude from wrestling and
swimming pools.
CONTACTS: School exclusion
not indicated.
CLEANING
LETTER