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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