Communicable Illness

Initially: a mild headache, moderate fever, clear runny nose & generalized aching.  A rash appears in stages:

1. Macule (flat, red spot)

2. Vesicle (fluid-filled, elevated lesion)

3. Crusting

The rash usually appears first on the trunk and later on the face, neck, arms, and legs; and is associated with intense itching.

Incubation Period

10-21 days, usually 14-16 days

Mode of Transmission & Communicability

The virus is spread by direct contact with discharges from the infected person's nose, mouth, skin, and mucous membrane.  Children on immunosuppressive drugs have a higher risk of contracting chicken pox.  Communicable 1-2 days before onset of symptoms until all of the vesicles have crusted.  One episode or vaccination usually confers immunity; however, children who have received the varicella vaccine can still develop chickenpox (usually a milder case).

School Action

1. Exclude from school until all vesicles are dry and crusted (Usually 6 days after the rash begins).

2. Treatment consists of frequent cleansing of the skin, over the counter medications for itching and Tylenol for fever and discomfort.

3. Contact your healthcare provider for secondary infection of the lesion or other complications.

4. Ensure all school-aged children have had 2 varicella vaccines.

Symptoms

Fluid-filled blisters usually on the lips, but may occur anywhere on the face or in mucous membranes.  They usually crust and heal within a few days.  (Maybe confused with Impetigo).

Incubation Period

2-14 days

Mode of Transmission & Communicability

The virus is transmitted by direct contact with the sores or saliva of infected persons.  Maybe communicable as long as 7 weeks after the lesions appear.

School Action

1. No restrictions.

Symptoms

Acute Respiratory signs; including watery eyes, sneezing, runny nose, coughing, and a general feeling of illness.

Incubation Period

12 hours- 3 days

Mode of Transmission & Communicability

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons.  Communicable 24 hours before the onset of symptoms and for 5 days after nasal involvement.

School Action

1. No restriction unless the child has a fever or is not able to participate in regular school activities.

2. If the child has a fever, exclude from school until 24 hours after the temperature returns to normal and the child is able to participate in regular school activities.

Symptoms

Low-grade fever, slight generalized body weakness and achiness and a "slapped cheek" appearance 1-2 days before the rash.  The rash is small, flat or slightly raised pink spots, can be blotchy appears on the extremities and trunk.

Incubation Period

4-21 days

Mode of Transmission & Communicability

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons. Most contagious before the beginning of the rash.

School Action

1. Refer for medical diagnosis is the questions remain regarding the cause of the rash.

2. If other rash-causing illnesses are ruled out, there is no need to exclude the child.

Symptoms

Sores occur toward the front of the mouth, on the sides of the tongue, inside the cheeks, and on the gums and may last 7-10 days.  In most cases, sores can be found on the palms of the hands, the fingers, and the soles of the feet.  A low-grade fever may last 1-2 days.

Incubation Period

3-6 days

Mode of Transmission & Communicability

The virus is spread through contact with the nose and throat discharge and stool of infected persons.  Communicable 1-3 weeks after onset of illness.

School Action

1. Exclude until the temperature is normal for 24 hours and the child is well enough to participate in normal activities.

Symptoms

Fluid-filled blisters, rapidly covered with honey-colored crusts, often occurring on the nose, arms, legs or around the mouth.  (Maybe confused with cold sores).

Incubation Period

1-10 days

Mode of Transmission & Communicability

The bacteria is spread by touching the fluid from the sores of infected persons or rarely, by touching objects freshly soiled with discharges from their noses, throats, or lesions.  Communicable until all lesions have healed or the person has been treated with an antibiotic for at least a full 24 hours.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until the child has been treated with an antibiotic for at least a full 24 hours.

3. Cover sores as a barrier to prevent spread until the sores have healed completely.

Symptoms

Infestation of the head hair or other parts of the body with lice and/or nits.  Lice are 1/8 inch long wingless, tan or reddish brown parasites.  Nits are sacs of eggs and are small, plump, and cream-colored when alive and flat and white when dead or empty.  Nits are attached to the hair shaft close to the scalp, usually at the neckline and/or behind the ears, but can be anywhere.  Scratching causes reddened rash-like areas.

Incubation Period

Variable, the eggs hatch 7-10 days after they are laid

Mode of Transmission & Communicability

Lice are spread by direct contact with an infected person's head/hair or with objects that have come in contact with an infected person's head/hair within the past 7-10 days (such as combs, brushes, hair accessories, hats, clothing, bedding, pillows, stuffed animals, etc.)  Live/crawling lice are communicable.  Lice that hatch from live nits (7-10  days after they are laid) are communicable.  Dead lice and dead nits are not communicable.

• "Nix", a cream rinse product available OTC which contains permethrin, a synthetic insecticide
• Many brands of pyrethrin-based shampoo products ("Rid", "R&C", "Triple-X", etc.) which are also available OTC
• "Ovide", a prescription drug containing malathion

If live lice are found, exclude from school until all lice are dead.  The school will check the child's hair on readmittance.

Parent Action

1. Parents to institute treatment and remove all lice and nits from the child's head and objects the child has been in contact with. 

Symptoms

Early symptoms include an expanding rash (> 2 inches) which resembles a bullseye, occurring first at the site of the bite and may occur elsewhere on the body.  Symptoms such as fever, malaise, fatigue, headache, stiff neck or muscle aches may be present.  Later symptoms can affect the joints, nervous system, and heart.

Incubation Period

7-14 days, from the time a person is exposed until early symptoms develop

Mode of Transmission & Communicability

The Lyme disease bacteria is spread through the bite of an infected deer tick.  The tick must be attached and feeding for at least one or two days before transmission can occur.  Not all deer ticks carry the bacteria.  Lyme disease is not contagious.

School Action

1. Check tick is removed.  The deer tick is brown and red in color and slightly smaller than a sesame seed.  They are 1/2 the size of a wood tick.

2. Refer for medical evaluation and treatment if symptoms of Lyme disease are present.

3. Report to the local health department (required by law).

Symptoms

Fever, watery eyes, runny nose, and cough.  A red blotchy rash appears on the third to seventh day, beginning on the face, spreading down the trunk and down the arms and legs.  The rash usually lasts 4-7 days.

Incubation Period

4 days before to 4 days after the rash begins

Mode of Transmission & Communicability

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons.  Communicable 24 hours before the onset of symptoms and for 5 days after nasal involvement.

School Action

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons. Communicable 3-4 days before the rash appears and until 4 days after the appearance of the rash.

Symptoms

Bacteremia- sudden onset of fever, chills, tiredness, sometimes a rash.

Meningitis- fever, vomiting, headache, stiff neck, extreme sleepiness, confusion, irritability, lack of appetite, sometimes a rash or seizures.

Incubation Period

1-10 days, usually 3-4 days

Mode of Transmission & Communicability

The bacteria is spread through direct contact with secretions of the nose and mouth of an infected person; more common in households, childcare settings, or schools where there is close prolonged physical contact (e.g., through kissing, sharing food, beverages or toothbrushes).  Antibiotics to prevent meningitis are recommended for: Household contacts of the person with meningitis. overnight visitors, or people who had contact with the secretions of the infected person through kissing, by sharing food, beverages, chapstick or toothbrushes.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until 24 hours after treatment is initiated, the child is without fever for 24 hours and is clinically well.

3. Report to the local health department (required by law).

Symptoms

A headache, fever, sore throat, tiredness, swollen lymph glands in the neck and generalized body weakness, achiness and sometimes a rash.  Young adults may jaundice (yellowing of the skin or eyes) and an enlarged spleen.

Incubation Period

30-50 days in most cases

Mode of Transmission & Communicability

The virus is spread by contact with an infected person's oropharynx (such as kissing).  Communicable from many weeks to a year or more.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until 24 hours after temperature returns to normal.

3. If the spleen is enlarged, students should avoid contact sports for 6 weeks or until the healthcare provider has given approval for the student to continue with the sport(s).

Symptoms

Initially; chills, headache, lack of appetite, low to moderate grade fever and generalized body weakness and achiness. 12-24 hours later; swelling of the parotid (salivary) gland located just below and in front of the ear, and sometimes nearby glands and tissue, and high fever.

Incubation Period

12-25 days, usually about 16-18 days

Mode of Transmission & Communicability

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons. Communicable 7 days before swelling of the parotid gland and until the swelling resolves (usually 9 days).

School Action

1. Exclude from school until 5 days after the swelling begins.

2. Report the case to the local health department (required by law).

3. Ensure all school-aged children have had 2 mumps vaccines.

Symptoms

Initially symptoms like those of common cold.  After 1-2 weeks, persistent cough in explosive bursts, sometimes ending with a high pitched whoop and vomiting.

Incubation Period

7-10 days

Mode of Transmission & Communicability

The bacteria is spread by droplets expelled from sneezing or coughing of infected persons.  Communicable until 3 weeks after a cough begins without antibiotic treatment and for 5 days with antibiotic treatment.

School Action

1. Exclude from school until on antibiotics for 5 days.

2. Report the case to the health department (required by law).

3. Ensure all children have completed their primary series of pertussis immunization. (DPT)

Symptoms

May include redness, itching, pain, and eye discharge depending on the cause.  Bacterial conjunctivitis can sometimes be distinguished from other forms of conjunctivitis by more purulent (white or yellow) eye discharge (pus).

Incubation Period

1-12 days, usually 1-3 days

Mode of Transmission & Communicability

Viruses and bacteria are spread with secretions from the eyes, nose, and mouth of infected persons.  Spread can also occur by sharing towels, washcloths, eye makeup, contact lens solution, etc.  Communicability depends on the agent.

School Action

1. If no pus, eye pain, or eye-lid redness; monitor.  no treatment recommended or restrictions.

2. If fever, pus, eye pain, or eye-lid redness present; refer for medical evaluation and treatment.

3. Children may return to school once treatment has started unless they are unable to keep their hands away from their eyes.

Symptoms

Sudden onset of violent vomiting, mental confusion, extreme sleepiness, very fatigued, twitching or jerking movements, hostility, and coma.

Incubation Period

1-7 days following viral infection (cold, flu, chicken pox)

Mode of Transmission & Communicability

Usually follows a viral infection.  It is not contagious.  The cause is unknown.  There is no prevention.  It requires immediate attention at the onset of symptoms.  It is most common in young children.

School Action

1. If one or more symptoms appear, call a doctor immediately (child should be evaluated in the emergency room).

2. Do not give aspirin.

3. Exclude from school until clinically well and released by a physician.

Symptoms

Flat, spreading, ring-shaped or irregular lesions on the skin.  May have fluid-filled blisters and/or scaly borders.  Maybe clear in the center and may become inflamed and crusted.

Incubation Period

7-21 days

Mode of Transmission & Communicability

The fungus is spread by contact with lesions of infected persons, animals, or contaminated objects.  Communicable as long as the infected lesions are present.  Communicability is greatly reduced once treatment has begun.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until treatment has been started.

3. If the lesions cannot be fully covered; no PE, swimming or other close contact activity until 72 hours after treatment has begun.

Symptoms

Fever, headache, runny nose, swollen lymph glands of the neck and generalized body weakness and achiness 1-5 days before the appearance of the rash.  The rash is fine, pink, flat spots that pinpoint on the second day.

Incubation Period

7 days before to 7 days after the rash begins

Mode of Transmission & Communicability

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons. Communicable from 1 week before until 6 days after the appearance of the rash.

School Action

1. Exclude from school until 7 days after the rash appears.

2. Report the case to the local health department (required by law).

3. Ensure all school-aged children have had 2 rubella vaccines.

Symptoms

Itching, scratch marks, or burrow marks.  Common sites are thighs, beltline, wrists, elbow, and webs of fingers.  Scratching may cause secondary infections or rash.

Incubation Period

2- 6 weeks

Mode of Transmission & Communicability

The mite is transferred by prolonged direct contact with an infected person, and to a limited extent, undergarments or soiled sheets, freshly contaminated by an infected person.  Communicable from the time a person acquires the mites (before the rash appears) until 24 hours after treatment begins.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until 24 hours after initiation of treatment.

Symptoms

Strep throat plus high fever diffuse pinkish- red rash and red tongue.

Incubation Period

3- 5 days

Mode of Transmission & Communicability

The bacteria are spread by direct contact with infected persons or with objects freshly soiled with discharges from noses, throats or lesions. Contagious until all lesions have healed or the person has been treated with an antibiotic for at least a full 24 hours.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until at least 12 hours after antibiotic treatment begins, the child is without fever and the child is clinically well.

Symptoms

Severe pain, itching, and numbness along certain nerve pathways, commonly around the midline or on the face.  About 1-3 days later a red rash appears.  Soon after, clusters of blisters appear in crops, usually on one side of the body and closer together than chicken pox.  Shingles usually occur in older adults but can occur in children, especially if the child had the chicken pox disease before 1 year of age.

Incubation Period

None (After a person has chickenpox, the virus can remain inactive in the body and later cause shingles)

Mode of Transmission & Communicability

The virus is spread by contact with fluid from the blisters.  Communicable until 1 week after the blisters appear.  When people who have not had the chicken pox are exposed to the shingles virus, they can develop chicken pox.  Shingles do not spread from person to person.

School Action

1. If the sores can be completely covered by clothing or a bandage, no exclusion is needed.  If the sores cannot be covered, exclude the child until the sores have crusted.

2. Ensure all school-aged children have had 2 varicella vaccines.

Symptoms

Fever, sore throat, swollen glands, headache, nausea, and vomiting.

Incubation Period

2-5 days

Mode of Transmission & Communicability

The virus is spread directly by droplets from coughing and sneezing and indirectly through hands or objects contaminated with nose or throat discharges of infected persons. Communicable 24 hours before the onset of symptoms and for 5 days after nasal involvement.24-48 hours after the treatment is started.

School Action

1. Refer for medical diagnosis and treatment.

2. Exclude from school until at least 12 hours after antibiotic treatment begins, the child is without fever and the child is clinically well.

3. For negative quick strep tests, recommend children remain out of school until the 24-hour throat culture results are available.

Symptoms

Tiredness, weight loss, fever, and night sweats.  When TB is in the lungs; cough, chest pain. and possibly coughing up blood.

Incubation Period

12-12 weeks

Mode of Transmission & Communicability

The bacteria is spread by droplets expelled by coughing or sneezing of infected persons.  Only TB of the lung is communicable; from the onset of symptoms until adequate treatment, usually 1-3 weeks after treatment started.

School Action

1. Exclude children with TB of the lung until a physician states the child is no longer communicable.

2. Children with positive Mantoux tests, but without symptoms, refer for medical evaluation, do not exclude.

3. Report the case to the local health department. (Required by law)