• Communicable Diseases

    In this Chapter

    • Communicable Disease
    • Reportable Diseases List - See Forms Section
    • Chickenpox
    • Fifth Disease (Erythema Infectiosum)  
    • Hand-Foot-and-Mouth Disease
    • Infectious Hepatitis (Hepatitis A)
    • Hepatitis B
    • Impetigo
    • Influenza
    • Measles (Rubella, Red Measles, 10-day Measles, Hard Measles)
    • Meningitis
    • Molluscum Contagiosum
    • Mononucleosis
    • Mumps
    • Pertussis
    • Pink Eye (Conjunctivitis)
    • Pinworms
    • Ringworm
    • Rotavirus
    • RSV
    • Rubella (German Measles, 3-day Measles)
    • Scabies
    • Scarlet Fever
    • Shingles
    • Tuberculosis

     

    COMMUNICABLE DISEASE

    Description:       

    Communicable diseases are those diseases which may be transmitted from person to person. (When a communicable disease is suspected, please keep in mind that this is a confidential matter.) 

    A communicable disease can be transmitted via any of the following routes:

    • Direct contact with infected individuals or body fluids.
    • Contact with contaminated objects such as clothing, bed linen, equipment, or other belongings.
    • Droplet spread by coughing, sneezing, or talking.
    • Airborne dust/particles or moisture in the air
    • Contaminated food and water

    Any of the following signs and symptoms may indicate the beginning of a communicable disease:

    • Fever (over 100.0°)
    • Chills
    • A cough
    • A headache 
    • Jaundice
    • Nausea
    • Pain
    • Rash      
    • Red and/or draining eye(s) 
    • A sore throat 
    • Stiff neck with fever      
    • Vomiting       

    Controlling communicable disease in schools

    Any person who is suspected of having a communicable disease should be excluded from school by the principal.  The student will need to remain in the health room, isolated, if possible, until arrangements are made for him/her to be taken home.  A copy of the “Unidentified Medical Condition” form should be sent home with the student. 

    ALL DISEASES/CONDITIONS LISTED ON THE REPORTABLE DISEASE/CONDITIONS IN FLORIDA, PRACTITIONER GUIDE MUST BE REPORTED IMMEDIATELY TO YOUR SCHOOL NURSE.  If a nurse is unavailable, please call the School Health Office at 941-927-9000, ext. 32101. (See Reportable Diseases/Conditions in Florida, Practitioner Guide, 6/14 in Form Section.)        

    In addition: 

    Whenever there is more than one student in a classroom with an unidentified or a diagnosed medical condition, the school nurse must be notified.  If a nurse is unavailable, call the School Health office941-927-9000, ext. 32101.  The school nurse will contact the Florida Department of Health in Sarasota County Office of Epidemiology and Communicable Disease Control who will confirm the report through health department investigation.  

    When available, the professional judgment of the school nurse shall be used to determine the exclusion/readmission to school, based on established protocols, per standard medical procedures and practice.  A written statement from the student’s licensed health care provider that the person is free from communicable disease is required for readmission to school.  If parent/guardian identifies Chickenpox, no note from a doctor is required but the student may not return to school until all lesions are dried to the crust stage.  

    NOTE: all suspected or diagnosed cases of chickenpox must be reported to your school nurse.    

    Persons at increased risk for complications include:

    • Individuals with immune system disorders
    • Individuals with sickle cell disease
    • Individuals on steroid therapy
    • Individuals on chemotherapy
    • Individuals who are organ transplant recipients
    • Individuals with tracheostomies


    CHICKENPOX (also see Shingles)

    Click here for photos of chickenpox

    Signs and Symptoms: 

    • Young children - fever, headache, tiredness, loss of appetite, about the same time as rash appears.
    • Older children and adults - above signs and symptoms may appear one or two days before onset of rash.

    Rash

    • Rash - A rash may change in appearance rapidly.  The sequence of rash:  (1) flat red spot (2) elevated area containing clear fluid (3) crusted lesions. 
    • All stages of the rash may appear on any area of the body at one time. 
    • The rash most dense on trunk; less dense on arms, legs, and face, including scalp and inside of nose and mouth.

    Cause:

    • Varicella-zoster virus

    Incubation Period 

    • From contact to the development of signs and symptoms: usually 14-16 days. 
    • Maybe as short as ten days or as long as 21 days.

    Transmission: 

    • A person is infectious to others 1-2 days before the eruption of rash and until ALL lesions are dry and crusted (approximately 5-6 days).
    • Transmission directly from lesions or droplet, coughing, etc. or indirectly from clothing freshly soiled by discharge from vesicles or mucous membranes of an infected person.  

    Treatment:  

    • Itching may be minimized by soaking in water with baking soda or oatmeal.  
    • Physicians will sometimes prescribe antihistamines if a child is uncomfortable or irritable.  
    • Body temperature control may be necessary with some children.  
    • Do not give aspirin or Pepto Bismol.   

    Complications 

    • Uncommon  
    • Reye's Syndrome has been associated with chickenpox.
    • Immuno-compromised children are at higher risk for complications.  They may experience a prolonged eruption of lesions and high fever and are contagious throughout this period.   

    Immunization:

    • Varicella Zoster vaccine (Varivax) is available through private pediatricians and the Florida Department of Health in Sarasota County. 
    • Immunization after exposure can lessen the severity of the disease.
    • Clinical illness after re-exposure is rare but may occur particularly in immuno-compromised persons.

    School Action:

    • Encourage parent/guardian to report cases to the school office.
    • The student is excluded from school until all lesions are dried to the crust stage.  Contact the school nurse if you have any questions.

    All suspected or diagnosed cases must be reported to the school nurse and the School Health office (941-927-9000, ext.32101).

                 

    FIFTH DISEASE (Erythema Infectiosum)

    Click here for photos of Fifth Disease

    Signs and Symptoms:

    • First signs and symptoms are low-grade fever, malaise, and a rash on the cheeks that gives a flushed appearance (sometimes referred to as a "slapped face" look).  
    • Within two or three days the “lacy look,” a slightly raised rash, will spread to the arms, legs, and trunk, usually not appearing on the palms or soles.  
    • The duration of the illness is normally 5 to 10 days. 
    • The rash will sometimes recur for several weeks, particularly when the individual is exposed to sunlight or heat, exercise, or stress. 

    Cause:

    • Parvovirus B19 

    Incubation Period:

    • Time from contact to the development of signs and symptoms ranges from 4 to 20 days. 

    Transmission: 

    • Transmitted primarily through contact with infected respiratory secretions.  
    • May be transmitted from mother to unborn child.

    Treatment:   

    • Parent/guardian should be urged to take children with the above symptoms to a physician to be diagnosed.  

    Complications: 

    • Exposed pregnant women should notify their obstetrician. 

    School Action: 

    • For re-entry to school: If the rash is present, a physician statement of diagnosis and "not contagious” must accompany the student.
    • The student should not be in school if they have a fever.
    • References indicate the disease is most contagious before the onset of the rash.

    Whenever there is more than one student in a classroom diagnosed with Fifth Disease, notify the school nurse and the School Health office; 927-9000, ext. 32101.

             

    HAND-FOOT-AND-MOUTH DISEASE

    Click here for a photo of Hand-Foot--And-Mouth Disease

    Signs and Symptoms:

    • Fever 
    • Sores in mouth
    • Rash on hands and feet.   

    NOTE:  The fever is usually gone in 3 or 4 days. The mouth ulcers usually resolve in 7 days, but the rash on the hands and feet can last up to 10 days.  This disease mainly occurs in children six months to 4 years of age.    

    Cause: 

    • Enterovirus, especially Coxsackie A 16.   

    Incubation Period: 

    • The time from contact to the development of signs and symptoms ranges from 3-6 days. 

    Transmission: 

    • The illness is transmitted through respiratory droplets or direct contact with nasal or throat secretions of infected persons or fecal-oral route.  

    Treatment: 

    • Parent/guardian should be advised to take a child with the above symptoms to a physician to be diagnosed. 

    Prevention:

    • Hand washing, as always, is important to prevent the spread of the virus with emphasis on hand washing after toileting.  
    • Proper cough etiquette should also be emphasized. 

    Complications: 

    • The most frequent complication is dehydration from refusing fluids due to mouth ulcers.  

    School Action: 

    • For re-entry to school: If the rash is present, a physician statement of diagnosis and "not contagious” must accompany the student.
    • A student is to remain at home until at least 24 hours after there is no longer a fever (without the use of fever-reducing medicine).

    INFECTIOUS HEPATITIS (Hepatitis A)

    Signs and Symptoms: 

    • Fever
    • Loss of appetite
    • Vomiting
    • Abdominal discomfort
    • An indefinite feeling of being ill 
    • Dark urine (coffee color) with light stools may be noticed 
    • Yellow (jaundice) color of the skin and the whites of the eyes follow this in a few days. 

    NOTE:  Severity increases with age. Children are more apt to have mild cases, frequently without jaundice. 

    Cause: 

    • Hepatitis virus, Type A 

    Incubation Period:

    • Time from contact until the development of signs and symptoms 15-50 days, an average of 28-30 days.  

    Transmission: 

    • The virus is present in intestinal contents of infected persons and is passed in bowel movements
    • Where sanitation is poor, the virus can be transferred from sewage to drinking water, milk, vegetables, and seafood
    • Close person-to-person contact  
    • Use of contaminated articles 
    • Failing to wash hands thoroughly after handling the contaminated object.     

    NOTE:  Person becomes infectious to others approximately two weeks before jaundice appears and remains infectious for about one week following evidence of jaundice.

    Treatment: 

    • A physician should see all cases of suspected hepatitis. The severity of cases can vary from illness of 1 to 2 weeks to an occasionally disabling disease of several months. 
    • Bed rest and careful observation are recommended until signs and symptoms have subsided.  

    Complications: 

    • Severity tends to increase with age, but complete recovery is the rule.  

    Immunization: 

    • There is a vaccine against Type A Hepatitis. 
    • Close contacts of confirmed hepatitis cases such as household members, persons exposed in day care centers or other group living situations, or persons known to be exposed to contaminated food or water should receive immune globulin as soon after exposure as possible. 
    • Immune globulin protects for about two months. 

    Prevention:

    It is better to avoid this disease by:

    • Good personal and household hygiene 
    • Sanitary disposal of body wastes 
    • Training children in good toilet habits 
    • HANDWASHING 

    School Action: 

    • All known or suspected cases should be reported immediately to the school nurse and the School Health office; 941-927-9000, ext. 32101.
    • Emphasize good personal hygiene, particularly hand washing, to all students and staff members.

    HEPATITIS B

    Signs and Symptoms: 

    • Gradually developing loss of appetite
    • Abdominal discomfort
    • Nausea
    • Vomiting 
    • Sometimes joint pain and rash  
    • Often jaundice (yellowish tint of eyes and skin) appears later
    • Fever may or may not be present
    • The seriousness of illness varies 

    Cause: 

    • Hepatitis B virus (HBV)

    Incubation Period: 

    • Usually 45-180 days, average 60-90 days. 

    Transmission:    

    • The virus is passed either directly from those who are already infected or indirectly from their body fluids. 
    • The virus can live on a surface for up to 30 days. 

    The most common ways of getting the disease are: 

    • Through needle stick or needle sharing
    • Through breaks in the skin by way of cuts or scrapes and exposure to blood or other body fluids
    • Through exposure to blood or other body fluids via the eyes or mouth
    • Through sexual contact
    • Through body piercing or tattooing    

    Treatment: 

    • Studies with antiviral drugs are in progress 

    Complications:    

    • Acute hepatic necrosis (liver tissue death) 
    • Cirrhosis of the liver
    • Liver cancer
    • Chronic hepatitis, with or without symptoms
    • Death 

    Immunization:    

    • Hepatitis B vaccine is routine for infants and adolescents and is also indicated for persons with high risk of exposure to hepatitis. 
    • Immunoglobulin (IG or HBIG) is used to immunize known contacts of persons with hepatitis.   

    School Action:

    • Utilize standard precautions in handling body fluids and items contaminated with body fluids.
    • All known or suspected cases should be reported immediately to the school nurse and the School Health office; 941-927-9000, ext. 32101.
    • Emphasize good personal hygiene, particularly hand washing, to all students and staff members.

    IMPETIGO

    Click here for a photo of Impetigo

    Signs and Symptoms: 

    • Lesions - Yellow to red, weeping and crusted or pustular, especially around the nose, mouth, and cheeks, or on the extremities  
    • Early lesions are raised and contain fluid, later they contain pus, and finally become crusted 

    Cause: 

    • Staphylococcal and streptococcal organisms (bacteria) 

    Incubation Period: 

    • Variable and indefinite.  Commonly 4-10 days. 

    Transmission: 

    • Impetigo is extremely contagious and is usually transmitted by contaminated hands, particularly where there are open draining areas. 
    • Easily transmitted by direct contact with infected persons.  
    • The hands are the most important instrument for transmitting infection. Good hand washing is vital. 

    Treatment: 

    • Application of an antibiotic ointment, after soaking crusts in mild, soapy water. 
    • If an infection is widespread, physicians will sometimes prescribe oral antibiotics. 

    Possible Complication: 

    • Seldom scarring. 
    • Occasionally enlarged lymph nodes, which may indicate extensive infection or accompanying infection. 

    School Action: 

    • Emphasize good hygiene, particularly hand washing.
    • A student with suspected impetigo should be excluded from school until; 
      • a diagnosis in writing by a physician indicates a non-contagious skin ailment; or
      • a student is being treated, and lesions are satisfactorily covered; or
      • lesions are dry.

    INFLUENZA

    Signs and Symptoms:

    • Fever or feeling feverish/chills
    • A cough
    • Runny or stuffy nose
    • A headache
    • Muscle Aches and Pains
    • A sore Throat
    • Fatigue (tiredness)

    Cause:

    • A group of respiratory viruses 

    Incubation Period:

    • 1-4 days    

    Transmission: 

    • Respiratory route

    Treatment: 

    • No cure. Symptoms can be treated and annual immunization recommended.    

    School Action:

    • There is no exclusion unless the child is unable to participate or meets other exclusion criteria.

    MEASLES (RUBELLA, RED MEASLES, 10-DAY MEASLES)

    Click here for a photo of Measles

    Signs and Symptoms:

    • Fever, general malaise, conjunctivitis, runny nose, and a cough start three to four days before the rash appears and continue for approximately ten days.
    • Rash
      • The rash appears first on face and neck and progresses down to involve trunk, arms, and legs. 
      • On the fifth day after the rash appears, it begins to fade. 
      • Some scaling of the skin on the trunk may occur.   

    Cause: 

    • Measles-Rubella virus 

    Incubation Period:   

    • Time from contact to development of the disease is 7-18 days.

    Transmission: 

    • Airborne droplet or direct contact with nasal or throat secretions of infected persons.  A child is infectious from first signs of illness until 5 or 6 days after the rash appears.

    Treatment:       

    • Physician or health department should be contacted so diagnosis can be confirmed. 
    • Parent/guardian should seek assistance from a physician in dealing with a child's signs and symptoms.  

    Complications:

    • Most serious: encephalitis. 
    • Others: deafness, otitis media, croup, pneumonia, diarrhea.

    Immunization: 

    • Available.  Should be administered after 12 months of age and again between 4-6 years of age.  Usually given with rubella and mump vaccines like MMR.  

    School Action: 

    • All known or suspected cases should be reported immediately to the school nurse and the School Health office; 941-927-9000, ext. 32101.
    • Emphasize good personal hygiene, particularly hand washing, to all students and staff members.

           

    MENINGITIS

    Signs and Symptoms:

    • Fever
    • A headache
    • Nausea
    • Loss of appetite
    • Stiff neck
    • Irritability
    • Photophobia
    • Confusion
    • Drowsiness
    • Seizures
    • Coma
    • Rash (if bacterial)  

    Cause: 

    • Respiratory route 

    Incubation Period: 

    • Viral (not bacterial) 1-10 days 

    Transmission:

    • Contact with respiratory secretions
    • Fecal-oral route

    Treatment:     

    • Bacterial Meningitis - immunize per recommendations, vaccinate unimmunized or under-immunized children per recommendations.
    • Viral Meningitis - most cases resolve without antibiotic treatment or complications. 

    School Action:

    • Exclusion as soon as expected 
    • All known or suspected Meningococcal disease should be reported immediately to the Health Department, the school nurse, and the School Health office; 941-927-9000, ext. 32101.

           

    MOLLUSCUM CONTAGIOSUM 

    Click here for a photo

    Signs and Symptoms:

    • Small, flesh-colored bumps on the skin.
    • The bumps are:
      • Small
      • May have a small indentation
      • Are filled with white, waxy pus that contains the virus
      • Can appear as a single bump, in groups, clusters or rows
      • Most commonly found on the chest, stomach, arms, legs, groin, genital area and face

    Cause:  

    • Molluscum contagiosum virus (MCV) which is a member of the poxvirus group

    Incubation Period:

    • Incubation period: bumps usually appear 2-8 weeks after exposure.

    Transmission:

    • Most commonly spread via direct skin to skin contact.
    • Touching objects that have a virus on them (toys, clothing, towels, and bedding)
    • Maybe spread from scratching or rubbing bumps and touching other parts of the body. (Most often Molluscum Contagiosum bumps are spread to other areas of the affected child’s body, rather than to other children.)

    Treatment:

    • In many cases, Molluscum Contagiosum resolves without treatment
    • Can be scraped, frozen (cryotherapy) or use of laser therapy by a physician
    • Administration of oral medication. 

    Complications:

    • Molluscum Contagiosum generally cause no long-term problems.  

    School Action: 

    • Exclusion from school until confirmed by a Physician.
    • Bumps need to be covered. 

    Prevention: 

    • Wash hands 
    • Avoid touching bumps
    • Cover bumps
    • Don't share personal items

    MONONUCLEOSIS (Mono)  

    Signs and Symptoms: 

    • A sore throat
    • Malaise
    • Swollen lymph nodes
    • Fever 

    NOTE:  In young children, the disease is generally mild and more difficult to recognize.  Most commonly recognized in high school and college students. 

    Cause:  

    • Epstein-Barr virus 

    Incubation Period:   

    • Time from contact to the development of signs and symptoms - 4 to 6 weeks. 

    Transmission: 

    • The virus is transmitted from person to person through saliva either directly. or indirectly from contact with eating utensils, drinking glasses or beverage containers.

    Treatment:

    • In the early stages of mononucleosis, the primary management strategy is rest.  Many physicians feel that physical exertion and stress may prolong the course of symptoms or precipitate relapse.  This appears to be more of a problem in adolescents or young adults, many of whom complain of fatigue, with or without exertion, weeks or months after the onset of symptoms. 

    Complications:

    • Uncommon 

    Immunization: 

    • None available 

    School Action:

    • Students with infectious mononucleosis can re-enter school as soon as symptoms subside and they are feeling well.
    • They should present a note from a physician stating the limitations of physical activity when returning to school.
    • Most young children do not require restriction of activities.

    MUMPS

    Click here for a photo

    Signs and Symptoms:  

    • Fever
    • Swelling and tenderness of one or more of the salivary glands 

    Cause:

    • Virus Paramyxovirus    

    Incubation Period: 

    • Time from contact until the development of signs and symptoms - 14-21 days 

    Transmission: 

    • By droplet (coughing, sneezing, etc.)  
    • Direct contact with the saliva of an infected person 
    • Most infectious 24-48 hours before illness begins and can continue as long as nine days after swelling is first observed.  

    Treatment: 

    • Parent/guardian should seek assistance from physicians in dealing with signs and symptoms. 
    • Bed rest with the observation of signs and symptoms is recommended.

    Complications:

    • Hearing impairment (rare) 

    Immunization: 

    • Available.  Should be administered after 12 months of age.  Usually given with measles and rubella vaccines like MMR. 

    School Action: 

    • All known or suspected cases should be reported immediately to the school nurse and the School Health office; 941-927-9000, ext. 32101.
    • Emphasize good personal hygiene, particularly hand washing, to all students and staff members.

    PERTUSSIS (Whooping Cough)

    Signs and Symptoms:

    • Begins with cold-like symptoms
    • Coughing which may progress to severe coughing
    • Whooping (high pitch sound)
    • A cough persists from weeks to months
    • Fever may or may not be present 

    Cause: 

    • Respiratory droplet  

    Incubation Period:

    • 5-21 days (typically 7-10 days)
    • Contagious from the beginning of symptoms until two weeks after a cough begins

    Transmission:

    • Respiratory route 

    Treatment:

    • Seek medical advice
    • Possible antibiotic therapy
    • Good hand hygiene
    • Vaccine-preventable.  

    School Action:

    • All known or suspected cases should be reported immediately to the Health Department, the school nurse and the School Health office; 941-927-9000, ext. 32101.
    • Emphasize good personal hygiene, particularly hand washing, to all students and staff members.
    • Inform all adults that have had contact with the child.
    • Ensure children who have had contact with the child have been immunized.

           

    PINK EYE (Acute Contagious Conjunctivitis)

    Click here for a photo

    Signs and Symptoms: 

    • Tearing
    • Irritation
    • Inflammation (redness) of the conjunctiva (lining of eyelids and covering of the eye)
    • Swollen eyelids
    • Crusting or discharge in one or both eyes 

    Causes: 

    • Acute bacterial, viral, allergic or chemical 

    Incubation Period: 

    • Bacterial is usually 24 to 72 hours. 

    Transmission: 

    • Contact with discharges from eyes and upper respiratory tract of infected persons and contaminated fingers, clothing, or other articles. 
    • It is presumed contagious until symptoms have resolved.
    • Chemical transmission usually appears shortly after contact with an irritating substance. 

    Treatment: 

    • Bacterial - antibiotic ointments or drops prescribed by a physician.
    • Viral - will clear up with no specific antiviral treatment.   

    Complications:

    • Unusual, if treated. 
      • Eye pain
      • Impaired vision
      • Photophobia 

    School Action:

    • Students with suspected pink eye should be excluded from school until:
      • (a) a diagnosis in writing made by a physician indicates a non-contagious eye ailment; or
      • (b) signs and symptoms have disappeared (usually within 48 hours after treatment begins).
    • The spread of infection is minimized by careful hand washing.

             

    PINWORMS

    Click here for a photo

    Signs and Symptoms: 

    • Perianal itching
    • Disturbed sleep 
    • Irritability and local irritation with secondary infection as a result of scratching the skin 

    NOTE:  Worms usually come out of rectum at night and are most likely to be seen in the anal region immediately after waking in the morning.  

    Cause: 

    • Intestinal parasite (nematode)  

    Incubation Period: 

    • Life cycle of parasite is 2 to 6 weeks. 
    • Signs and symptoms may not be evident for months. 

    Transmission: 

    • Direct transfer of infective eggs by hands from anus to mouth of the same or another person.
    • Indirectly through clothing, bedding, food, or other articles contaminated with eggs of the parasite.   

    Treatment: 

    • Suspected cases should be seen by a physician for confirmation and treatment. 
    • One dosage treatment is now available. 
    • Bed linens and underwear should be changed daily. 

    Complications: 

    • Uncommon

    Prevention: 

    • Good hygiene, particularly hand-washing 

    School Action:

    • Suspected cases should be referred to a parent/guardian. 
    • If signs and symptoms persist or if the parent/guardian is unresponsive, refer to the school nurse.
    • Unless symptoms are severe, exclusion is not necessary.
    • Stress good hygiene, particularly hand-washing and change of underwear daily.

               

    RINGWORM

    Click here for a photo

    Signs and Symptoms:

    • Ringworm of the Scalp -
      • Small raised area spreads leaving scaly patches of temporary baldness
      • Infected hairs become brittle and break off easily 
      • Occasionally, raised and draining areas develop
    • Ringworm of the Body 
      • Flat, spreading, ring-shaped lesions
      • The outer edge is usually reddish and may contain clear fluid or pus.
      •  In later stages, outer edges will become scaly or crusted, and the central area will appear like normal skin
    • Ringworm of the Foot - Athlete's Foot 
      • Scaling or cracking of skin, especially between toes
      • Blisters containing watery fluid.

    Cause: 

    • Fungi 

    Incubation Period:  

    • Scalp - 10 to 14 days 
    • Body - 4 to 10 days 
    • Foot – unknown      

    Transmission: 

    • Direct or indirect contact with skin lesions of infected persons
    • Contaminated articles and areas used by infected persons
    • Hair from infected persons and animals 

    Treatment: 

    • Usually, topical antifungal to be applied as directed by label  
    • For more serious cases, an oral antifungal medication may be prescribed  

    School Action: 

    • A student with suspected ringworm of scalp or body should be excluded until:
      • A diagnosis in writing made by a physician indicates a non-contagious skin ailment; or
      • The student is being treated, and the lesions are satisfactorily covered.
    • All equipment and articles which an infected student comes in contact with should be disinfected when ringworm infestation has been identified.
    • Personal hygiene should be stressed.

       

    ROTAVIRUS

    Signs and Symptoms:

    • Non-bloody diarrhea
    • Nausea
    • Vomiting
    • Dehydration
    • May last 3-8 days 

    Incubation Period:

    • 1-3 days

    Cause:

    • Fecal-oral route

    Treatment:

    • Vaccine-preventable
    • Hand hygiene
    • Surface disinfection 

    School Action:

    • Exclusion if the stool is not contained in a diapered child
    • Stool frequency is exceeding 2 or more stools above normal

     

    RSV

    Signs and Symptoms:

    • Cold like symptoms
    • Irritability
    • Lethargy
    • Wheezing 

    Cause:

    • A virus that causes the common cold. (Most common in winter and early spring.) 

    Incubation Period:

    • 2-8 days

    Transmission:

    • Respiratory droplet. (This virus can live on surfaces for many hours and 30 minutes on hands.) 

    Treatment: 

    • Treat symptoms
    • Good hand hygiene
    • Sanitize commonly touched surfaces

    School Action:

    • No exclusion unless the child cannot participate or child meets other exclusion criteria.

    RUBELLA (German measles or Three Day Measles)

    Click here for a photo

    Signs and Symptoms:

    • A young child may have no signs and symptoms until the rash appears; then low-grade fever and tiredness. 
    • Older children and adults usually have symptoms one to five days before rash, along with joint pain and swollen lymph nodes. 
    • Swollen lymph glands behind the ears and at the top of the back of head appear 5-10 days before the rash. 
    • The rash is pink in color and begins on face and neck and progresses downward to trunk, arms, and legs. 
    • Lesions are usually discrete and begin to fade within 48 hours. 

    Cause: 

    • Rubella virus 

    Incubation Period: 

    • Time from contact to development of signs and symptoms 14 - 21 days. 

    Transmission: 

    • Transmission is by droplet spread (sneezing, coughing, etc.) or contact with infected persons 
    • Period of infectiousness is from about one week before the appearance of rash to about five days after it appears  
    • Highly communicable 

    Treatment: 

    • A physician or public health department should be contacted so diagnosis can be confirmed. 
    • Possible contacts with pregnant women should be identified and their immunity status determined. 
    • Children with rubella should be treated according to symptoms.

    Complications: 

    • There are seldom complications in young children. 
    • Rubella can cause birth defects in the offspring of women who acquire the disease during pregnancy (especially if acquired during the first trimester).

    Immunization: 

    • Available.  Should be administered after 12 months of age.  (Usually given with measles and mumps vaccines as MMR.)

    School Action: 

    • All known or suspected cases should be reported immediately to the school nurse and the School Health office; 941-927-9000, ext. 32101.
    • Emphasize good personal hygiene, particularly hand washing, to all students and staff members.

    SCABIES

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    Signs and Symptoms: 

    • Small raised areas or tiny raised burrows containing mites and eggs. 
    • Lesions are most around finger webs, inside surface of wrists, elbows, and folds underarms, and around the waist. 
    • The rash may appear generalized and secondary infection may occur due to scratching. 
    • Itching is intense, particularly at night.  

    Cause: 

    • Mite (Sarcoptes scabiei) 

    Incubation Period: 

    • Two to six weeks after exposure until itching begins in persons with previous exposure. 
    • Persons previously infected may develop symptoms 1-4 days after re-exposure. 

    Transmission: 

    • Transfer of mite by direct skin-to-skin contact and to a limited extent by contaminated garments and bed linens. 
    • Communicable until mites and eggs have been destroyed, ordinarily after one or two treatments a week apart.  

    Treatment: 

    • Parents/guardian should contact their licensed health care provider regarding diagnosis and treatment. 
    • Treatment requires a prescription specifically for scabies.  

    School Action: 

    • A student with suspected scabies should be excluded from school until a diagnosis in writing by a physician indicates a non-contagious skin ailment; or upon completion of treatment. 
    • The student should be watched for re-infestation (appearance of new lesions or continued itching) for 7-10 days after initial treatment.
    • Persons with skin to skin contact with infected persons may need to be treated.  
    • Launder or disinfect any articles used by infected persons.

    SCARLET FEVER (Streptococcal Diseases)

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    Signs and Symptoms: 

    • Fever, headache, chills, general malaise, rash; a sore throat and vomiting within 12 hours of onset of rash.
    • Rash - Small, flat red dots. 
      • Red areas become white when pressure is applied. 
      • The rash develops most often on the neck, chest, axial, elbow, inner thighs, and groin. 
      • Scaling of skin on the feet and hands may occur.  

    Cause:

    • Group A beta-hemolytic streptococci  (Streptococci can be cultured from the throat.) 

    Incubation Period: 

    • Time from contact to the development of signs and symptoms: 2-5 days after close contact with an infected person. 
    • Incidence is highest among small children and during cold weather. 

    Transmission: 

    • Usually by direct contact. 
    • By indirect contact through objects or hands (rare). 
    • Occasionally by food contaminated through coughing and sneezing. 

    NOTE:  Treated cases usually do not transmit infection after 48 hours.  Untreated cases can transmit infection as long as 21 days. 

    Treatment: 

    • A physician should see all suspected cases. 
    • Administration of an antibiotic is the usual treatment of choice.

    Possible Complications: 

    • Otitis media (ear infection)
    • Abscesses extending around the tonsils
    • Sinusitis
    • In extreme cases - heart and kidney problems.    

    Immunization: 

    • None 

    School Action:

    • A student with Scarlet Fever may be readmitted to school 24 hours after antibiotic treatment, with a note from the doctor.
    • All known or suspected cases should be reported immediately to the school nurse and the School Health office; 941-927-9000, ext. 32101.

    SHINGLES (also see Chickenpox)

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    Signs and Symptoms:

    • First symptoms may be:
      • A headache
      • Sensitivity to light
      • Flu-like symptoms without a fever. 
    • Later symptoms there may be:
      • Itching 
      • Tingling
      • Pain in a narrow area on one side of the body. 
    • That is often followed in a few days by a rash that becomes a cluster of fluid-filled blisters, similar to chickenpox, in this same area on one side of the body. Over the next 2-4 weeks, these blisters crust over and heal. Once all the blisters have crusted, the person is no longer considered contagious.  Occasionally, no rash develops.
    • Some people feel dizzy or weak while they have shingles.
    • The pain from shingles may range from mild to severe and may continue after the blisters heal. 

    Cause:

    • Varicella-zoster virus.  Shingles occur when the virus that causes chickenpox starts up again in your body.  After you get better from chickenpox, the virus “sleeps” (is dormant) in your nerve roots. Sometimes the virus stays dormant forever, but in some cases, it “wakes up” when disease, stress, or aging weakens the immune system and then it causes shingles.   

    Transmission: 

    • A person with shingles cannot give another person shingles, but the virus that causes shingles can be passed along to immune-vulnerable individuals, usually children or the elderly, who have never had chickenpox. These individuals would then develop chickenpox when exposed to the virus, not shingles.

    Treatment: 

    • There is no cure for shingles, but treatment may help you get well sooner and prevent other problems. The sooner you start treatment, the better it works.
    • The treatment is oral medication from the doctor. 

    Complications: 

    • Occasionally someone will develop postherpetic neuralgia or pain in the area where the rash was that continues for weeks to months after the rash is gone.  Taking oral medication may prevent this from occurring. 

    Immunization:

    • There is a shingles vaccine available for anyone older than 60-year old that may prevent shingles or make it less painful if you do get it.  

    School Action:

    • Persons with shingles should keep the rash covered and not touch or scratch the rash.
    • As long as the area of the rash can be covered and any fluid from the blisters contained, the person can be in school. 
    • Hand washing, as always, is important to prevent the spread of the virus.

    TUBERCULOSIS 

    Description:

    • TB Infection is diagnosed by a positive tuberculin skin test or a special TB blood test.  A chest x-ray is needed to determine the extent of infection and the course of treatment. 

    Signs and Symptoms:

    • A chronic cough
    • Weight loss
    • Fever
    • Growth delay
    • Night Sweats
    • Chills

    Cause:

    • A disease caused by an infection with Mycobacterium tuberculosis that typically affects the lungs  

    Transmission:

    • Airborne route
    • Infection in children is nearly always the result of close contact with an adult that has TB

    Treatment:

    • Antibiotic therapy
    • Assessment of high-risk individuals
    • Tuberculin skin testing of children at risk 

    School Action:

    • Exclusion if there is an active TB infection.
    • All known or suspected cases should be reported immediately to the Health Department, the school nurse and the School Health office; 941-927-9000, ext. 32101.