Tài liệu Communicable Diseases Summary: A Guide for School Health Services Personnel, Child Care Providers and Youth Camps doc

Disease IncubationPeriod Symptoms Mode of Transmission Period of Communicability Exclusion Yes or No and Control Measures Other Information BITES, ANIMAL N/A Redness, pain, swelling, dra

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Diseases

Summary

A Guide for School Health Services Personnel,

Child Care Providers and Youth Camps

Revised: November 2011

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If you have questions about anything in this Summary, or other questions about communicable diseases:

Please call your local health department or the Maryland Department of Health and Mental Hygiene,

Office of Infectious Disease Epidemiology and Outbreak Response (IDEOR) at 410-767-6700,

OR

Please check the DHMH website at < http://ideha.dhmh.maryland.gov/SIPOR/ > for additional information.

Acknowledgements: The following contributed to the content, review and production of this document:

 Maryland Department of Health and Mental Hygiene (DHMH), Infectious Disease and Environmental Health Administration (IDEHA), Office of Infectious Disease Epidemiology and Outbreak Response (IDEOR)

 Maryland Department of Health and Mental Hygiene (DHMH), Family Health Administration (FHA), Center for Maternal and Child Health, School Health Services Program

 Maryland State Department of Education (MSDE), Division of Student and School Support, School Health Services Program

 American Academy of Pediatrics (AAP), Maryland Chapter

 Medical and Chirurgical Faculty of Maryland (MedChi), Public Health Committee, Maternal and Child Health Subcommittee

 Medical and Chirurgical Faculty of Maryland (MedChi), Infectious Disease Committee

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Use of this document:

The intent of this document is to provide general guidance to school health services personnel, child care providers, youth camp owners/operators about common communicable diseases It is not intended for use as a diagnostic guide Please consult a health care provider for any situations which require medical attention This guidance is to be used in conjunction with School Health Services (SHS) guidance and local health department (LHD) policies and procedures, and applies to individual or sporadic cases of the communicable diseases described below Outbreaks or unusual situations may require

additional control measures to be instituted/implemented in consultation with your local health department The procedures in this document represent measures specific to school, child care or youth camp settings References to SHS Guidelines are intended for use by schools in programs serving school- aged children.

If a child’s health care provider (HCP) provides exclusion recommendations which conflict with these guidelines, please consult with your local health department If parents have additional questions, they should contact their HCP or local health department.

This document is intended to guide the development of specific local policy and procedures regarding management of communicable diseases in schools, child care, and youth camps These policies and procedures should be implemented in collaboration and in consultation with local health departments, school health services programs, local child care authorities and youth camp regulatory authorities.

Definitions:

Outbreak: In general, an outbreak is defined as an increase in the number of infections that occur close in time and location, in a facility, such as a school,

child care center, or youth camp, over the baseline rate usually found in that facility Many facilities may not have baseline rate information, if you have questions, please contact your local health department about whether a particular situation should be considered an outbreak In some cases, the health department may require longer exclusions than stated in this guide in response to an outbreak.

Reportable disease/condition: Maryland statute, Maryland Code Annotated, Health-General ("Health-General") §18-201 and §18-202, and Maryland

regulation, Code of Maryland Regulations ("COMAR") 10.06.01.04 ”Communicable Diseases” and 10.16.06.25 “Certification for Youth Camps”, require that health care providers, school and child care personnel, masters of vessels or aircraft, medical laboratory personnel, owners/operators of food

establishments, and owners/operators of youth camps, submit a report in writing or notification by telephone of diagnosed or suspected cases of specified diseases to the Commissioner of Health in Baltimore City or the health officer in the county where the provider cares for that person A list of reportable diseases and conditions can be found at http://ideha.dhmh.maryland.gov/reportable-diseases.aspx

Infection control measures: Includes the use of one or of combinations of the following practices The level of use will always depend on the nature of the

anticipated contact:

o Handwashing, the most important infection control method

o Use of protective gloves, latex-free gloves are recommended*

o Masks, eye protection and/or face shield

o Gowns

o Proper handling of soiled equipment and linen

o Proper environmental cleaning

o Proper disposal of sharp equipment (e.g., needles)

o Isolation in a separate area for those who cannot maintain appropriate cleanliness or contain body fluids

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Fever: For the purposes of this guidance, fever is defined as a temperature >100.0◦ F orally; an oral temperature of 100◦ F is approximately equivalent to

101◦ F rectally or temporally (Temporal Artery Forehead scan), or 99.5◦ F axillary (armpit).

Diarrhea: Loose or watery stools of increased frequency that is not associated with change in diet.

Vomiting: Two or more episodes of vomiting in a 24 hour period.

General Considerations:

Exclusion: Children may be excluded for medical reasons related to communicable diseases or due to program or staffing requirements In general, children

should be excluded when they are not able to fully participate with the program, or in the case of child care settings, when their level of care needed during

an illness is not able to be met without jeopardizing the health and safety of the other children, or when there is a risk or spread to other children that cannot

be avoided with appropriate environmental or individual management For exclusion, all applicable COMAR regulations should be followed; for youth camps, specifically COMAR 10.16.06.31 “Exclusion for Acute Illness and Communicable Disease”.

Fever: A child may have a fever for many reasons If a child has a fever, all applicable COMAR regulations should be followed In addition, any child

with a fever and behavior changes or other symptoms or signs of an acute illness should be excluded and parents notified Once diagnosed, exclusion due to fever should be based on disease-specific guidelines or other clinical guidance from the child’s health care provider Also, it is important to be sure the appropriate method for measuring temperature is used based on the age or developmental level of the child.

An unexplained fever in any child younger than 3 months requires medical evaluation Fever in an infant the day following an immunization known to cause fever, may be admitted along with health care provider recommendations for fever management and indications for contacting the health care provider Instructions from the health care provider should include: the immunizations given, instructions for administering any fever reducing medication, and

medication authorizations signed by the parent and the health care provider.

Diarrhea: Diarrhea may result in stools that are not able to be contained by a diaper or be controlled/contained by usual toileting practices An infectious

cause of diarrhea may not be known by the school, child care facility, or camp at the time of exclusion or return Documentation of the cause of diarrhea should be sought.

A child with diarrhea should be excluded if:

o Stool is not able to be contained in a diaper or in the toilet, or child is soiling undergarments

o Stool contains blood

o Child is ill or has any signs of acute illness

o Diarrhea is accompanied by fever

o Child shows evidence of dehydration (such as reduced urine or dry mouth)

With appropriate documentation, a child with diarrhea may be readmitted to care, school, or camp when:

o An infectious cause of diarrhea (see chart) has been treated and the child is cleared by a health care provider, in conjunction with the local health department, if necessary

o The diarrhea has been determined by the local health department to not be an infectious risk to others

Vomiting: An infectious cause of vomiting may not be known by the school, child care facility, or camp at the time of exclusion or return Documentation

of the cause of vomiting should be sought Child should be excluded until vomiting resolves or until a health care provider clears for return (is not

contagious).

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Disease Incubation

Period Symptoms

Mode of Transmission

Period of Communicability

Exclusion (Yes or No) and Control Measures Other Information

BITES, ANIMAL N/A Redness, pain,

swelling, drainagearound area bitten

May develop fever,lymph nodeenlargement

Direct contact N/A No, exclusion is not

routinely recommended aslong as student/child doesnot meet any otherexclusion criteria It isstrongly recommended thatthere be medical follow-up

For school age children,

see SHS “Guide for

Emergency Care in Maryland Schools, 2005”.

For preschool age children,contact the child’s healthcare provider

After immediate needs ofbitten victim(s) are takencare of, notify local healthdepartment and

appropriate localauthority (police, sheriff,animal control)

immediately bytelephone

[Also, see section for

“Rabies”.]

BITES, HUMAN N/A Redness, pain,

swelling, drainagearound area bitten

May develop fever,lymph nodeenlargement

Direct contact N/A No, exclusion is not

routinely recommended aslong as student/child doesnot meet any otherexclusion criteria It isstrongly recommended thatthere be medical follow-up

For school age children,

see SHS “Guide for

Emergency Care in Maryland Schools, 2005”.

For preschool age children,contact the child’s healthcare provider

After immediate needs ofbitten victim(s) are takencare of, notify

Responsible authorityand parent/guardian.Assess immunizationstatus of childreninvolved, includingtetanus and Hepatitis Bvaccination

[Also, see SHS

“Bloodborne Pathogens Control And Handling Body Fluids in the School Setting, 2007”.]

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Period Symptoms

CHLAMYDIA

(Chlamydia

trachomatis)

Usually 7-14days; up to

30 days

May beasymptomatic; genitalinfection can include:

purulent discharge,painful urination,lower abdominal pain

Symptoms ofconjunctival infectioninclude painful,swollen eyelids

Sexual contact:

genital, oral, anal

Conjunctivitis: frominfected mother toinfant

Variable, but can be

a long time, if nottreated

No, exclusion is notroutinely recommended

A case or outbreak must

be reported to the localhealth department Allcases should be referred

to a health care providerfor assessment (includingpotential for gonorrhealco-infection) and possibletreatment This infection

in a young child maypossibly be an indicator

of sexual abuse

COMAR 10.16.06.35requires camp operator toreport child abuse

[Also, see SHS “Guide for Emergency Care in Maryland Schools, 2005” section for “Child Abuse and Neglect”.]

Through mucosalcontact withinfected secretions

or excretions (such

as urine, saliva,feces, blood andblood products,breast milk, semen,cervical

secretions)

Variable, may bemany months orepisodic for severalyears

Control measures:

Emphasize washing handsoften, especially aftertoileting and after diaperingand handling any childrenless than 2 years old

A pregnant woman or awoman who is

considering pregnancyshould talk to her doctor ifshe cares for infants oryoung children, orhandles urine or saliva inany home or occupationalsetting Pregnant women

do not necessarily need

to be excluded from suchsituations

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Period Symptoms

COMMON COLD 12 hours to 5

days; usually

2 days

Runny nose, wateryeyes, sneezing, chills,sore throat, cough,and general bodydiscomfort lasting 2-7days May also have

a low-grade fever

Direct contact with

an ill person orrespiratorydroplets; also bycontact with hands

or articlescontaminated withnose or throatsecretions

Variable, depending

on cause; average

24 hrs before to 5days after

symptoms havestarted

No, unless child meetsother exclusion criteria

Do not exclude solely onthe presence of runny noseregardless of the color orconsistency of the nasaldischarge, or presence ofcough

Control measures:

Emphasize covering noseand mouth when

coughing/sneezing; usingfacial tissue to dispose ofnose or throat secretions;

washing hands often andnot sharing eating utensils

Many different virusescan cause the commoncold

White or yellowdischarge,accompanied by pink

or red conjunctivae,redness and swelling

of the lids, andmatted, sticky lids

Direct contact orthrough

contaminatedhands followed bycontact with eyes;

contaminatedswimming poolsare rarely a source

of infectious pinkeye

Variable, depending

on cause, fromseveral days toweeks

Yes, until cleared for returnwith documentation from ahealth care provider, aftertaking antibiotics for 24hours, or until symptomshave resolved

Control measures:

Emphasize hand hygiene

Refer any newborn withconjunctivitis to a healthcare provider

NOTE: Exclusion notnecessary for allergicconjunctivitis (watery eyedischarge, without fever,pain, red lids, and with orwithout pink eye orinjected conjunctivae) ifevaluated and

documented by a healthcare provider

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Period Symptoms

DIARRHEAL

ILLNESS:

UNKNOWN CAUSE

Variesaccording tocausativeagent

Varies according tocausative agent

Symptoms mayinclude

nausea, vomiting,diarrhea, stomachcramps, headache,blood

and/or mucus instool, fever

Usually spread fromperson-to-person byfecal-oral route; fromingesting

contaminated food orwater

Duration of clinicalsymptoms or untilcausative agent is

no longer present instool

Exclude until diarrhea hasresolved and child isdiarrhea-free for at least 24hours; or until cleared bymedical provider

Control measures:

Emphasize hand hygiene;

observe exclusion periodespecially for those inactivities at high risk fortransmission: child careattendees, food serviceworkers, those who care forthe very young or elderly,health care workers, etc

Report individualcases according

to state healthdepartment “List ofReportable Diseases andConditions" An outbreakmust be reported to thelocal health department

DIARRHEAL

ILLNESS:

CAMPYLOBACTER

Usually 2-5days; range1-10 days

Diarrhea with orwithout blood,abdominal pain,fever, cramps,malaise, nauseaand/or vomiting

Spread from to-person by fecalcontact, contact withinfected pets, or fromingesting

person-contaminated foodssuch as raw orundercooked meats,unpasteurized milk, oruntreated water

be reported to the localhealth department

DIARRHEAL

ILLNESS: E COLI

O157:H7 and other

STEC (Shiga

Toxin-producing E coli)

Severe abdominalpain, diarrhea with

or without bloodand vomiting

Spread from to-person by fecal-oral route or ingestingunder-cooked beef,un-pasteurized milk

person-or juices, raw fruits person-orvegetables, orcontaminated water

Usually 1-3 weeks Yes, if symptomatic until

cleared by local healthdepartment Contact localhealth department forguidance

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Period Symptoms

DIARRHEAL

ILLNESS: GIARDIA

Usually 7-10days; range

3 days to 4weeks

Acute waterydiarrhea withabdominal pain,bloating, frequentloose and palegreasy stools,fatigue and weightloss

Spread fromperson-to-person

by fecal-oral route

or ingestion ofcontaminatedrecreational/

drinking water

Entire period ofinfection, oftenmonths

Yes, until treated If nottreated, contact local healthdepartment for guidanceabout exclusion criteria

Control measures:

Hand hygiene by staff andchildren should be

emphasized, especiallyafter toilet use or handling

of soiled diapers; dispose

of feces in a closedcontainer; disinfection offeces-soiled articles

Nausea, vomiting,abdominal cramps,diarrhea, fever,headache

by fecal contact orfrom ingestingcontaminatedfoods Commonlyfrom contaminatedsurfaces, objects

Possibletransmission viaaerosolizedparticles

At least 48 hoursafter symptomsresolve Sometimeslonger

Yes, until 48 hours afterresolution of symptoms

Control measures:

Emphasize handwashingafter use of bathroom orchanging diapers andthorough environmentalcleaning

An outbreak must bereported to the localhealth department

DIARRHEAL

ILLNESS:

ROTAVIRUS

Rangeapprox 1-3days

Vomiting, fever andwatery diarrhea

by fecal-oral route

Possible airbornetransmission

At least 48 hoursafter symptomsresolve

Sometimes longer

in persons withweakened immunesystems

Yes, until 48 hours afterresolution of symptoms

Control measures:

Vaccine-preventable

Emphasize handwashingafter use of bathroom orchanging diapers andthorough environmentalcleaning

An outbreak must bereported to the localhealth department.NOTE: Vaccine available

as of 2007

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Period Symptoms

Diarrhea, fever,abdominal cramps,nausea, vomiting,headache

Ingestion ofcontaminatedfoods, includingpoultry, beef, fish,eggs, dairyproducts or water;

also contact withinfected reptiles

Throughout thecourse of infection;

extremely variable,usually severaldays to severalweeks

Yes, for children in childcare if not toilet trained,whether symptomatic ornot Asymptomatic schoolage children generally donot need to be excluded

Contact local healthdepartment for guidance

DIARRHEAL

ILLNESS:

SHIGELLA

Abdominal cramps,fever, diarrhea withblood and mucous;

also waterydiarrhea

Sometimes nausea

or vomiting

Direct or indirectfecal-oraltransmission from asymptomaticpatient orasymptomaticcarrier; ingestion ofcontaminatedwater or food

During acuteinfection and up to

4 weeks afterillness

Yes, for those who aresymptomatic until cleared

by local health departmentafter further testing

DIPHTHERIA

(Corynebacterium

diphtheriae)

Patches of grayishmembrane withsurroundingredness of throat,tonsils, nose,and/or mucousmembranes Mayinclude nasaldischarge, sorethroat, low gradefever, hoarseness,barking cough

Less common sites

of infection: skin,eyes, ears, andvagina

by contact withrespiratorysecretions or skinlesions Rarely,transmission mayoccur from articlessoiled with

discharges fromlesions of infectedpersons

Variable; usually

2-4 weeks or until 5days after antibiotictherapy has beenstarted

Yes, until cleared by localhealth department

Contact the local healthdepartment for furtherguidance

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Period Symptoms

be asymptomatic

Spread fromperson-to person

by respiratorysecretions; bycontaminatedblood or bloodproducts; frommother to fetus

Most infectiousbefore the onset ofrash in most cases

No, exclusion is usually notnecessary Contact healthcare provider and/or localhealth department aboutspecial recommendationsfor infected persons withchronic anemia at risk forhemolytic complications(such as sickle celldisease), weakenedimmune systems, or forpregnant women

Control measures:

Encourage hand washingand disinfection ofsurfaces, high-contactitems, such as doorknobs,and items shared amongchildren

An outbreak must bereported to the localhealth department.Pregnant womenexposed to a case ofFifth disease shouldconsult with their healthcare provider

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Period Symptoms

Males: Cloudy orcreamy dischargefrom penis, painwith urination

Females: usually

no symptoms, butmay have vaginaldischarge, urinaryfrequency,abdominal pain

Both genders:

throat andanorectal infections(although

uncommon) mayproduce discharge,localized pain

(Gonococcalinfection caninfrequently causeachy, swollenjoints; a skin rash;

fever; and othersymptoms

by genital, oral oranal sexualcontact

Variable, but can

be a long time, ifnot treated

Cases should contact ahealth care provider, andreferred to the local healthdepartment for follow-up

be reported to the localhealth department Allcases should be referred

to a health care providerfor assessment (includingpotential for chlamydialco-infection) and possibletreatment This infection

in a young child maypossibly be an indicator

of sexual abuse

COMAR 10.16.06.35requires camp operator

to report child abuse

[Also, see SHS “Guide for Emergency Care in Maryland Schools, 2005” section for “Child Abuse and Neglect”.]

Various, depending

on site of infection:

ear, eye, skin,lungs, joints, orspinal fluid spaces

Airborne dropletsproduced bycoughing orsneezing or contactwith nose or throatdischarges of an illperson or carrier;

or by direct to-person contact

person-Non-communicable24-48 hours afterthe start ofappropriateantibiotic treatment

Contact local healthdepartment forguidance

Yes, exclude for 24 hoursafter the initiation ofantibiotic therapy

depart-unvaccinated, or administerprophylaxis to contacts

be reported to the localhealth departmentimmediately bytelephone

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Period Symptoms

HAND, FOOT AND

MOUTH DISEASE

(various

Coxsackie-viruses)

Usually 3-5days

Lesions maypersist from7-10 days

Fever, coldsymptoms, rash onpalms, fingers andsoles, sores inmouth

Occasionallyappear on thebuttocks

Spread throughdirect person toperson contact withnose, and throatdischarges, andfeces of an infectedperson

Highly contagiousduring the acutephase Shedding instool may continuefor several weeks

No, unless meets otherexclusion criteria, “hand tomouth” behavior

uncontrollable, not able tocontain secretions, ordraining sores cannot becovered

Control measures:

Avoid person-to-personcontact with ill person

Emphasize washing handsoften and not sharingeating utensils, also forcaretaker of ill infants anddiapered children Wash ordiscard items of clothingcontaminated with nose orthroat discharges or withfecal material

HEPATITIS A Usually 28

days afterexposure;

range 15-50days

Early symptoms:

fatigue, loss ofappetite, stomachpain, diarrhea,nausea, vomiting,fever, dark urine

Later symptom:

jaundice (yellowskin and eyes)

Some cases aremild Children may

be asymptomatic

by fecal contact; orfrom ingesting food

or water containingthe virus

Usually a 3-weekperiod: from 1week before onset

of early symptoms

to 1 week afteronset of jaundice

Prolonged viralexcretion (up to 6months) has beendocumented ininfants andchildren

Yes, for at least 2 weeksafter the onset of earlysymptoms or 1 week afteronset of jaundice

Control measures:

Vaccine-preventable

Emphasis on hand-washingafter use of bathroom orchanging diapers and (ifnecessary) improveddisinfection Food handlers

or servers should refrainfrom preparing or servingfood for 2 weeks afteronset of early symptoms

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Period Symptoms

HEPATITIS B Usually

60-90 days;

range 45-180days

Dark urine, fatigue,loss of appetite,nausea, vomiting,often followed byjaundice Jointpain may bepresent Somecases are mild

Children may beasymptomatic

Spread byexposure toinfected blood;

injection drug use;

from mother toinfant duringpregnancy or birth;

sexual contact; andthrough other bodyfluids

Several weeksbefore onset ofsymptoms andduring course ofacute disease

Persons with apositive hepatitis Bsurface antigen(HBsAg) test areconsideredcommunicable,even years afterinitial infection

No, exclusion is notroutinely recommendedunless the individual is notable to resume activities

However, exclusion could

be considered in cases inwhich a child’s medicalcondition (oozing sores orrash, bleeding) or behavior(scratching, biting)

increases likelihood ofexposing others Contactlocal health department forfurther guidance

Control measures:

Vaccine-preventable

Vaccination is the keypreventive measure

be reported to the localhealth department.Pregnant women who areHBsAg positive should bereferred to their healthcare provider

HEPATITIS C Ranges from

2 weeks to 6months;

commonly

6-9 weeks

Loss of appetite(weight loss),nausea, vomiting,jaundice, darkurine, fatigue, &

vague abdominaldiscomfort mayoccur However,may be

asymptomatic

Exposure toinfected blood:

primarilyparenterally(through injectiondrug use,

accidentalcontaminatedsharps exposure)

Sexual andperinataltransmissionappear rare

Rarely throughother body fluids

One or more weeksbefore the onset ofsymptoms; somepersons becomecarriers and remaininfected indefinitely

No, exclusion is notroutinely recommendedunless the individual is notable to resume activities

However, exclusion could

be considered in cases inwhich a child’s medicalcondition (oozing sores orrash, bleeding) or behavior(scratching, biting)

increases likelihood ofexposing others Contactlocal health department forfurther guidance

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Period Symptoms

Oral herpes: sores

or blisters on thelips or mouth

Genital herpes:

painful sores orblisters in thegenital area

Herpesgladiatorum: Sores

on exposed areas

of skin

by direct contactwith saliva, sores,

or blisters, such astouching, kissing,

or having sex;

perinatally

Virus can berecovered fromlesions 2-7 weeksafter primaryinfections and up to

5 days inreactivation lesions

Oral herpes: No, unlesschild with oral herpes isdrooling and can notcontain secretions or meetsother exclusion criteria

Genital herpes: No, unlessmeets other exclusioncriteria

Herpes gladiatorum: Yes,exclusion from contactsport participation thatrequires skin-skin contact

Control measures:

Handwashing and avoidtouching lesions Coverlesions if possible

Disinfection of sportingequipment after use Avoidsharing sports equipmentthat comes in contact withskin

Pregnant women withherpes should consult ahealth care provider.Stress handwashing andnot touching lesions

Medianincubation ininfectedinfants isshorter thanadults

May beasymptomatic formany years

Symptoms in laterstages of HIVinfection arevariable

Spread fromperson-to-personthrough sexualcontact; exposure

to HIV-infectedblood or body fluids(e.g., dirty

needles); frommother to infantduring pregnancy,

or birth

Soon after onset ofinfection andpersists throughoutlife Infectivity ishigh during firstmonths; increaseswith viral load;

worsening ofclinical status; andpresence of othersexually transmittedinfections

Treatment mayreduce

communicability

No, unless meets otherexclusion criteria, hasweeping and oozing soresthat can not be covered,bleeding condition whereblood can not be contained;

if so, consult local healthdepartment

Control measures:

Responsible sexualbehavior (abstinence orcondom use) Avoidance

of blood and sharpsexposures

Staff who routinelyprovide acute careshould wear gloves anduse good handwashingtechnique Standardprecautions should befollowed by all healthcare personnel

[Also, see SHS

“Bloodborne Pathogens Control And Handling Body Fluids in the School Setting, 2007”.]

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Period Symptoms

INFLUENZA

(Seasonal)

Usually 1-3days

Cough, fever,headache, muscleaches, runny nose,sore throat Lessfrequently, GIsymptoms

Person to person

by droplets ordirect contact withinfected articles

24 hours before theonset of symptomsand up to 7 days inyoung children

Yes, until without fever for

24 hours, or if meets otherexclusion criteria Followlocal health departmentrecommendations

Control measures:

Vaccine-preventable

Emphasize respiratoryetiquette and frequenthandwashing

An outbreak must bereported to the localhealth department Donot use salicylates (such

as aspirin) during illness

Blister-like skinlesions, which laterdevelop intocrusted sores with

an irregular outline

Direct contact withdraining sores or

by touching articlescontaminated withblister fluid

Usually notcontagious after 24hours of treatment

No, if lesion can becovered

Yes, if lesion cannot becovered If antibiotictherapy indicated, excludeuntil 24 hours of antibiotictherapy has been

completed, or otherwisecleared by HCP (in somecases, antibiotic use maynot be indicated fortreatment) If no antibioticsindicated, exclude untillesion is healed

For contact sports: Yes, iflesion cannot be covered,regardless of whetherantibiotics started, untillesion is healed

Control measures:

Avoid touching lesions

Emphasize frequent washing Conduct routineenvironmental cleaning

hand-Cases with lesionsshould avoid contact withnewborns

[See also sections for

“Staphylococcal Infection” and

“Streptococcal Infection.”]

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Period Symptoms

LICE, BODY

(Pediculus

corporis)

6-10 daysfrom laying ofeggs tohatching ofnymphs

Intense itching,worse at night

Lice live in seams

of clothing and may

or may not bevisible

Direct contact with

an infested person

or contact withobjects used by aninfested person,especially clothing

As long as lice arealive on infestedperson or object

Eggs viable onclothing 1 month

Adult lice viableaway from host up

to 10 days

Yes, at the end of theprogram/activity/schoolday Skin may needtreatment with pediculicide if one is used, exclude for

24 hours after firsttreatment is completed

Control measures:

Bathe with soap and water

Wash clothing and bedding

in hot water and dry onhigh heat or dust clothingwith a pediculicide

An outbreak must bereported to the localhealth department Bodylice may transmit seriousinfections

MEASLES

(Rubeola)

Usually 8-12days fromexposure toonset ofsymptoms

Averageintervalbetweenappearance

of rash afterexposure is

14 days;

range 7-18days

Sudden onset ofchills followed bysneezing, runnynose, conjunctivitis,photophobia, fever,cough Rashusually appearsfirst behind theears or onforehead/ face;

blotchy, unusuallydusky red rashover face, trunk,and limbs Smallwhite spots(Koplik’s spots)inside mouth

Direct contact withinfectious droplets

or, less commonly,

by airborne spread

Highly contagiousamong

unvaccinatedchildren in school,child care or campsettings

1-2 days beforeonset of symptoms(3-5 days beforerash) to 4 days afterappearance of therash Immuno-compromisedchildren can becontagious for theduration of theillness

Yes, until 4 days after theonset of rash in otherwisehealthy children and for theduration of illness inimmunocompromisedchildren Contact localhealth department forfurther guidance onmanagement of cases andcontacts

Control measures:

Vaccine-preventable

Vaccination is the keypreventive measure

be reported to the localhealth departmentimmediately bytelephone Pregnantwomen exposed to acase should see a healthcare provider for

evaluation

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Period Symptoms

on specificviral agent

Usuallywithin 3-10days later

Fever, severeheadache, stiffneck, bright lightshurting the eyes,drowsiness orconfusion, andnausea andvomiting mayoccur Meningitissymptoms are anemergency thatshould beassessedimmediately be ahealth careprovider

Varies depending

on specific viralagent Mostcommon cause:

Enteroviruses,most often spreadthrough directcontact withrespiratorysecretions

Depends on theviral agent causingillness, but usually(Enteroviruses) 3days after infecteduntil about 10 daysafter developingsymptoms

Yes, until cleared for return

by health care provider orlocal health department

Contacts of cases generally

do not need to be seen by

a health care provider orgiven preventive

medications

Control measures:

Emphasize handwashingafter use of bathroom,changing diapers, andbefore handling or eatingfood or drink

be reported to the localhealth department Mostviral infections do notrequire treatment;however, some mayrequire specific antiviraltherapy

on specificbacterialagent, butusually 2-10days,commonly 3-

4 days

Fever, stiff neck,headache,vomiting, and rashmay occur

Meningitissymptoms are anemergency thatshould beassessedimmediately be ahealth careprovider

Direct contact,includingrespiratory dropletsfrom nose andthroat of infectedpeople, but it variesdepending on thebacterial agentcausing illness

Depends on thebacterial agentcausing illness

Yes, until cleared by healthcare provider in conjunctionwith local health

department Contact localhealth department forguidance Some agentsmay require antimicrobialtherapy Some contacts ofcases may need preventiveantibiotics

Control measures:

Vaccine-preventable forsome types of bacteria thatcan cause meningitis

(Haemophilus influenzae,

Neisseria meningitidis, Streptococcus

pneumoniae) Vaccination

is the key preventivemeasure

Tiêu đề	Communicable Diseases Summary: A Guide For School Health Services Personnel, Child Care Providers And Youth Camps
Tác giả	Maryland Department Of Health And Mental Hygiene, Maryland State Department Of Education, American Academy Of Pediatrics, Medical And Chirurgical Faculty Of Maryland
Trường học	University Of Maryland
Chuyên ngành	Public Health
Thể loại	Guide
Năm xuất bản	2011
Thành phố	Maryland

Định dạng
Số trang	36
Dung lượng	230,71 KB