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Guidance on
Communicable Diseases
MARCH 2008
ISSUE 01
1.0
INTRODUCTION
1.1
These guidelines have been produced to assist establishments in dealing
with queries about communicable diseases.
1.2
In most cases the diagnosis will have been made by a doctor, often the
GP. If you have any concerns about a child’s health while they are in
school you should consider contacting the parents with a view to
sending them home. (Many illnesses are infectious before a diagnosis can
be made).
1.4
The Health Protection Agency (HPA) provides details on recommended
exclusion periods for the more common communicable diseases in
Guidance on Infection control in Schools . This information has previously
been distributed to all schools in poster format and should be displayed
within the school.
Further copies are available free from Prolog on telephone number 08701
555 455 or email [email protected]. Quoting item number 50367.
1.5
Factsheets for schools on the following specific conditions have been
produced by the Department of Health and the Health Development
Agency and are available on the HPA website.
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Antibiotic resistance
Athlete's foot
Head lice
Impetigo
Influenza
Measles
Meningococcal infection
Tuberculosis
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2.0
IF A CHILD IS ILL
2.1
The HPA’s Guidance on Infection control in Schools sets out information
on conditions which may mean that a child should not attend school.
2.2
If, after, consulting this, you need further clarification, or the chart does not
include the condition the child is said to be suffering from, contact your
school nurse initially.
2.3
As soon as an outbreak is suspected within the establishment i.e. If you
experience >1 case of the same infectious disease within the same period,
or feel you may be seeing more cases than normal of any illness
contact your school nurse or the Beds & Herts Health Protection Unit
(HPU).
2.4
Certain diseases must be formally notified to the HPU’s Consultant in
Communicable Disease Control (CCDC) under the Public Health (control
of diseases) Act 1984 and Public Health Infectious Disease Regs 1988,
Appendix 1 provides a full list of these notifiable diseases. There is no
statutory requirement for schools to notify the HPU of illness. The
statutory responsibility for notifying infectious diseases lies with the
attending doctor.
3.0
PRACTICAL MANAGEMENT OF DIARRHOEA AND VOMITING
(see also GUIDANCE ON NOROVIRUS IN SCHOOLS)
3.1
In the case of an outbreak of vomiting and diarrhoea immediately contact
the HPU and local Environmental Health Department1 (EHD) and any
specific advice on controlling the outbreak followed.
3.2
Generally with outbreaks of diarrhoea and/or vomiting the priority is the
prevention of the spread of the disease & protection of unaffected pupils
and staff.
3.3
Practically this is likely to involve :
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The exclusion of affected pupils & staff
They should not return to the site for 48 hours from last episode of
diarrhoea or vomiting.
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Enhanced cleaning of the environment and equipment
It is very important that a robust cleaning regime is carried out. This
should occur as directed by EHD / HPU during the outbreak and will
1
Early signs of a viral gastrointestinal outbreak and food poisoning can be very similar and
environmental Health officers may wish to check for any possible food links.
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generally involve the use of a hypochlorite solution e.g. Bleach / Milton on
hard surfaces.
E.g. A concentration of 0.1% hypochlorite solution (1000ppm) will
effectively destroy Norovirus. This can be achieved by the use of a dilute
solution of household bleach ( check label for concentrations) or as a
safer alternative ‘Milton’ fluid (standard strength is 2%, dilute 1 part Milton
in 19 parts water).
For areas of gross contamination a 1% hypochlorite solution (10,000ppm)
should be used.
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Effective hand washing
Hand washing is one of the most important ways of controlling the spread
of infections, especially those that cause diarrhoea and vomiting, and
should be actively encouraged.
It is recommended that hot water and antibacterial liquid soap be used
and that hands are dried using disposable paper towels.
4.0
INFORMATION TO PARENTS
4.1
On occasion, you may judge that information needs to be sent home to
parents. Where serious illnesses are concerned, or if you need further
medical information you should contact the HPU who will be able to
advise you and discuss what medical information should be given to
parents/staff.
5.0
ANIMALS AND COMMUNICABLE DISEASE
5.1
Avoiding Ill Health at Open Farms – Advice to Teachers HSE information
sheet AIS23 (supplement), provides specific advice on controlling the risk
of infections from animals children may contact during the visit.
5.2
Advice on farm visits is also included in the CSF Off Site Visits Manual
Part C ‘ Advice on Specific Activities’.
5.3
Guidance on handling animals in schools is provided in appendix 2 and
should be read in conjunction with CLEAPSS ( Consortium of Local
Education Authorities for the Provision of Science Services) Guidance
Document L56 ‘Small Mammals’.
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6.0
FURTHER ADVICE
6.1
For further information and guidance you can contact:
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Your school nurse
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Consultant in Communicable Disease Control
Bedfordshire and Hertfordshire Health Protection Unit
Charter House, Parkway
Welwyn Garden City
Hertfordshire
AL8 6JL
Tel: 01707 361284
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Education Health and Safety Team
Tel: 01992 556478
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Environmental Health Officer for your district
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APPENDIX 1
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LIST OF NOTIFIABLE DISEASES
Under Public Health (control of Disease) Act 1984, others under Public
Health (Infectious diseases) Regs 1988
Acute Encephalitis
Parathypoid Fever
Acute Poliomyelitis
Plague*
Anthrax
Rabies
Cholera*
Relapsing Fever*
Diphtheria
Rubella
Dysentery
Scarlet Fever
Food poisoning (or suspected food
poisoning)*
Smallpox*
Leprosy
Tetanus
Leptospirosis
Tuberculosis
Malaria
Typoid Fever
Typhus*
Measles
Viral Haemorrhagic fever
Meningitis (viral, bacterial or fungal)
Viral Hepatitis (A,B,C,D,E)
Meningococcal Septicaemia
Whooping cough
Mumps
Ophthalmia neonatoram
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Yellow fever
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APPENDIX 2
HANDLING / KEEPING ANIMALS IN SCHOOLS: HEALTH & SAFETY ISSUES
This summary should be read in conjunction with CLEAPSS guidance document
L56 small mammals.
1.0
HANDLING ANIMALS
1.1
If animals will be handled, the most important issue is the maintenance of
good hygiene. When handling animals:
do not consume food or drink,
cover any open cuts or abrasions on the exposed skin of hands and arms
with waterproof adhesive dressings,
wash your hands with soap and water before and directly after handling
animals.
keep animals away from the face.
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1.2
Careful handling of small mammals is most important; the animals should
be restrained sufficiently so that, they cannot damage themselves or the
handler.
1.3
All mammals should be handled daily if possible (unless breeding or
nursing when they should be disturbed as little as possible). In this way
they will normally become quite tame and accustomed to being handled.
1.4
Gloves should not normally be worn unless it is known that an animal for
one reason or another is likely to bite or scratch. In this situation a pair of
rubber gloves which does not, however, particularly reduce dexterity, is a
sensible precaution.
1.5
Physical injuries
1.5.1 There is always the danger of bites and scratches, and teachers or
technicians should check that animals to be brought in are docile, friendly
and gentle in the presence of children.
1.5.2 Small fingers poked towards the mouths of normally non-aggressive
animals may be interpreted as an offering of food and obligingly bitten.
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1.6
Diseases, parasites and allergies
1.6.1 The likelihood of diseases being passed on to humans from pet animals is
low. However allergic reactions to mammals, birds and a few other
animals cannot be discounted. These might result from handling the
animals or just from being near them and be detected by the development
of skin rashes, irritation to the eyes and nose or breathing difficulties.
1.6.2 Again, washing hands soon after handling animals will help and it is
important to stop children rubbing their eyes before this has been done.
Teachers should watch for the development of allergic reactions in pupils
who come into contact with the animals.
1.6.3 Children known to have allergic reactions to specific animals must, of
course, have restricted access to those that may trigger a response. In
most cases, an allergic reaction will subside once the animal and the
afflicted person are kept apart; in extreme cases, seek medical advice.
1.6.4 Salmonella bacteria may be carried by reptiles; good hygiene is again
required, especially if aquatic reptiles, such as terrapins, are kept.
Good general hygiene and hand washing are essential for risk reduction.
1.6.5 Children under five should not have contact with such reptiles or the
environment in which the reptiles live or exercise.
2.0
2.1
ANIMAL SUPPLIERS
The majority of animals available through reputable suppliers present no
hazards that good hygiene procedures cannot address.
2.2
In order for there to be minimal risk to humans of diseases being
transmitted. from animals kept in schools, it is important that animals are
obtained from accredited or high-quality sources.
Unless these are known to have originated from a reliable source, it will
not be possible to be confident that they are disease-free.
3.0
ANIMAL HEALTH
3.1
If animals are not then kept in scrupulously clean conditions,
or come into contact with other animals from dubious sources, it will no
longer be possible to guarantee that the animals will remain in a diseasefree condition.
3.2
Holiday times, particularly in primary schools, obviously create real
difficulties.
It is much better that the animals remain at school and suitable
arrangements made for their normal feeding, watering and cleaning. If,
however, this is impossible and animals have to be taken out of school at
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holidays, they should not be sent home with pupils or other people unless
all of the following considerations can be satisfied.
It can be guaranteed that the animals will be looked after as well as usual.
Whoever is caring for the animals must have all the necessary
information, equipment, food, skills, etc.
Parents must have been informed and given their consent.
Steps will be taken to ensure that the school's animals will not be able to
come into contact with pet animals (cats, dogs, rodents or other
mammals).
That small mammals cannot come into contact with wild rodents (mice,
rats, etc) while off the school premises.
4.0
4.1
CLEANING AND HYGIENE
This is clearly important, both for the health of the animals and for those
people looking after them. Hands should be washed before and, of
course, after cleaning, rubber or plastic gloves should preferably be worn.
4.2
After removing soiled litter material, the cages should be scrubbed with
hot water and liquid detergent.
4.3
Frequency of cleaning (Small Mammals)
4.3.1 As a general rule, this should be done at least every 10 days. Gerbils
produce very little urine and so require relatively infrequent changes.
Hamsters produce a little more urine; mice, rats, guinea pigs and rabbits
urinate in relatively large amounts. These animals should be cleaned at
least once a week. Your nose is always a good guide - cages which are
even slightly offensive should already have been cleaned! Arrangements
must be made for cages to be cleaned as regularly as normal at holiday
times.
5.0
SOILED LITTER DISPOSAL
5.1
Soiled litter should ideally be incinerated; more conveniently it could be
sealed in strong plastic bags and placed with other waste in dustbins.
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