Communicable Disease Protocol
Notify the Regional Manager in writing and by phone when designated onprotocol if a child is diagnosed with any of the listedconditions (See also communicable disease policy ) If a child is diagnosed with a disease not listed contact theHealth Consultant and Regional Manager for more information:
- Acquired Immune Deficiency Syndrome(AIDS) and Human Immunodeficiency Virus (HIV)
- Campylobacteriosis
- Chicken Pox
- Cryptosporidiosis
- Colds
- E. Coli 0157
- Cytomegalovirus (CMV)
- Diarrhea
- Fifth Disease
- Flu (Influenza)
- German Measles (see Rubella )
- Giardiasis
- Hand, Food, Mouth Disease (Coxsackie A)
- Hepatitis Type A
- Hepatitis Type B
- Herpes Simplex
- Impetigo
- Measles
- Meningitis
- Mononucleosis
- Mumps
- Pink Eye (Conjunctivitis)
- Pinworms
- Roseola Infantum
- Rubella (German Measles, Three DayMeasles, Light Measles)
- Salmonellosis
- Scarlet Fever and Strep Throat(Streptococcal Infections)
- Shigellosis
- Whooping Cough (Pertussis)
- Vomiting
REMEMBER, ALERTS ARE ONLY SENT OUT FOR DISEASES WHICH ARE DIAGNOSEDAND ALSO HAVE NO CONFIDENTIALITY LAWS PERTAINING TO THEM.
Acquired Immune DeficiencySyndrome (AIDS)
Disease Description
A disease caused by the human immunodeficiency virus (HIV) that attacksthe immune system, making the person more susceptible to infections andcancers which would be be a threat to someone with a health immunesystem.People can be infected and have no symptoms. Some people develop thefollowing symptoms, lasting two weeks or more: Fever, fatigue, weightloss, night sweats,diarrhea, swollen glands, dry cough, skin sores, persistent yeastinfections.
Incubation Period
Six months to many years.
Infectious Period
Unknown. AIDS probably starts within several weeks of being infectedand may last for the rest of the person’s life.
Ways to Limit Spread
AIDS is spread by infected blood (e.g., sharing needles), sexualintercourse, and from mother to fetus/child during pregnancy or birth.In a child care setting the main means of potential contact with thevirusis through blood, although this would not be likely to transmit thevirus.
School/Childcare Protocol
Clean up spills of blood promptly. Gloves should be worn when handlingblood (keep some in the first aid kit). Keep cuts or sores covered.HIV is not spread through casual contact such as sharing toilets,shaking hands, eating together, or sharing toys. A child or adult infected withHIV can remain in the child care or school setting as long as:
- Their health allows;
- The child care/school practices good handwashing;
- The child care/school practices appropriate techniques whencleaning up blood or blood-containing body fluids;
- The person keeps any open wounds covered with a clean bandage;
- The illnesses that the other children or teachers have do notthreaten the health of the person infected with HIV.
State law requires that the identity of a child infected with HIVmust not be revealed to anyone except those who care for the child andhave a need to know the diagnosis to be able to provide care.
Notify Regional Manager by telephone immediately .
Regional Manager will notify Health Consultant. Follow strictconfidentiality laws. Only the DST, R.M. and Health Consultant need toknow about this illness.
Campylobacteriosis
Disease Description
Bacterial infection that causes diarrhea, fever, stomach pain,occasionally the person has bloody diarrhea.
Incubation Period
1 to 10 days
Infectious Period
As long as the bacteria are in the stool (usually 2-7 weeks).Antibiotics shorten the contagious period.
Ways to Limit Spread
Spread through stools of infected people or animals, and throughinfected animal products (meats, poultry, milk). Wash hands carefullyafter changing diapers, toileting, after handling animals, and beforepreparing food.Cook meats and poultry thoroughly. Clean and disinfect cutting boardsbetween use, especially when used with raw meat, poultry, and fish.
School/Childcare Protocol
Exclude child or teacher while symptoms are present. Notify otherfamilies of the illness.
Notify Regional Managerby telephone. RegionalManager will notify Health Consultant.
Chicken Pox
Disease Description
Illness caused by virus with sudden fever, tiredness, and skin rash.Rash begins as a small blister and leaves a scab in three to four days.
Incubation Period
11 to 20 days
Infectious Period
Up to five days before rash appears until six days after first blistersappear.
Ways to Limit Spread
Spread through contact with blisters and by sneezing and coughing.Separate ill child from others who have not had the disease.
School/Childcare Protocol
Because Chicken Pox in some people can be quite severe, exclude thechild or teacher from the Head Start Center until all skin blistershave crusted and there is no weeping blisters (about five to seven daysfrom the start of the rash). Notify other families of illness. Do notgive aspirin to child as there appears to be an association betweenaspirin and Reye’s Syndrome (a serious illness which can cause death).Contacts who are pregnant and have not had Chicken Pox should consulttheir health providers.
Notify Regional Managerby telephone. RegionalManager will notify Health Consultant.
Cryptosporidiosis
Disease Description
Disease caused by a protozoan with diarrhea as a symptom.
Incubation Period
Not known for sure. Probably about twenty (20) days.
Infectious Period
For several weeks.
Ways to Limit Spread
Spread through the stool. Good handwashing after diaper changing andtoileting, after handling animals, and before fixing food will decreasethe risk of spread. Careful cleaning of diaper changing area is needed.
School/Childcare Protocol
Exclude child or teacher until diarrhea stops. Notify other families ofillness.
Notify Regional Manager by telephone immediately. RegionalManager will notify Health Consultant.
Colds
Disease Description
Illness caused by virus with cough, watery eyes, chills, sneezing, sorethroat or stuff/running nose, and sometimes fever.
Incubation Period
Usually 12 to 72 hours, but can be up to 6 or 7 days.
Infectious Period
One (1) day before beginning of symptoms and until a week or more aftersymptoms appear.
Ways to Limit Spread
Avoid sharing cups, foods, and tissues. Cover mouth when coughing orsneezing. Wash hands after contact with nose or throat discharge.
School/Childcare Protocol
Exclude or separate child or teacher only if he or she seems too ill tokeep up with the usual activities. Exclusion rarely prevents colds fromspreading.
E. Coli 0157
Disease Description
Bacterial infection which causes diarrhea, especially bloody diarrhea.May cause life threatening blood and kidney problems.
Incubation Period
12 to 72 hours.
Infectious Period
Not known. Maybe several weeks.
Ways to Limit Spread
Spread through the stool. Good handwashing after diaper changing andtoileting, after handling animals, and before fixing food will decreasethe risk of spread.
School/Childcare Protocol
Exclude persons until their diarrhea is gone and when they have anegative stool specimen. Notify other families of illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Cytomegalovirus (CMV)
Disease Description
Viral infection which most often has no symptoms. The most severe formoccurs in fetuses and newly born babies. A very common viral infectionin child care settings.
Incubation Period
Not known for sure. Infections acquired during birth appear three (3)to twelve (12) weeks after delivery.
Infectious Period
As long as virus is present in urine or saliva. May be months or years.
Ways to Limit Spread
The virus is passed in urine, saliva, and breast milk. Wash hands aftercontact with nose and throat secretions and diapers. Recognize thatinfected children may be present in any child care setting. Avoidkissing the children.
School/Childcare Protocol
Thorough handwashing. Staff who wish to become pregnant or who arepregnant should consult a physician for advice.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Diarrhea
Disease Description– An increased number of watery stoolsin a 24 hour period
Incubation Period– Some cases of Diarrhea are contagiousand some are not. If the following symptoms exist the child is morelikely to have a communicable disease;
- Child does not look or act as though they are well.
- Blood in stool that is bright red or coffee colored.
- Pus in stool
- Fever
- Weight loss or failure to gain weight
- Signs of Dehydration-this symptom is life threatening and mayinclude the following:
-no urination for several hours
-tongue, lips and inside of mouth dry
-no tears when child cries
-excessive thirst
-dry and possibly hot skin
-sunken eyes and soft spots on heads of infants
-child/infant lacks energy and responsiveness to surroundings
-child may complain of sudden headache
Ways to Limit Spread–Handwashing aftertoileting/diapering and exclusion from center until stools are solid.
School/Childcare Protocol
Exclude if child or teacher has two to three runny bowel movementswithin last 24 hours and instruct parent to keep child home until bowelmovements become solid for twenty four (24) hours and if signs of acommunicable disease are present the parent must bring a note fromtheir provider indicating that their child does not have a communicabledisease or is no longer contagious. Other families and staff should benotified if it is determined that the child or teacher had acommunicable disease.
Notify Regional Manager by telephone if two ormore children are affected. Regional Manager will notify HealthConsultant.
Fifth Disease
Disease Description
A common, mild viral illness causing a skin rash that is bright red onthe cheeks and may spread to the arms, legs, and chest. Sometimes rashmay get brighter if the body is warm. Usually no fever. Sometimescauses achy joints.
Incubation Period
Estimated to be four (4) to fourteen (14) days.
Infectious Period
Unknown.
Ways to Limit Spread
Probably spread through drainage from nose and throat. Take sameprecautions as given under colds . Thoroughhandwashing helpful.
School/Childcare Protocol
No exclusion is necessary. Notify other families of illness. Pregnantchild care staff and parents should consult with their health careproviders.
Flu (Influenza)
Disease Description
Mild to severe infection caused by virus with sudden fever, chills,cough, sore throat, and aching muscles. Also, may have headache, runnynose, and feel tired.
Incubation Period
Twenty four (24) to seventy two (72) hours.
Infectious Period
Three (3) days.
Ways to Limit Spread
Please see colds .
School/Childcare Protocol
Since flu can be a serious illness, exclude child or teacher from HeadStart Center until they are well (fever, congestion cough is gone orminimal) to prevent complications.
Giardiasis
Disease Description
Disease caused by a protozoan with diarrhea as symptom.
Incubation Period
One (1) to four (4) weeks.
Infectious Period
As long as protozoan is in stool.
Ways to Limit Spread
Spread through the stool or through fecal contaminated water. Goodhandwashing after diaper changing and toileting as well as beforefixing food will decrease risk of spread. Do not drink water fromstreams, lakes, or pools. Care cleaning of diaper changing area isneeded. (In child care centers, food handlers should probably not workin infant changing room changing diapers.
School/Childcare Protocol
Exclude child or teacher until diarrhea stops to prevent the diseasefrom spreading. Notify other families of illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Hand, Foot, and MouthDisease (Coxsackie A)
Disease Description
Viral illness causing fever, sore throat, sore inside the mouth, and arash that may appear on the hands, feet, buttocks, or face. This is notadisease that affects cattle.
Incubation Period
Two (2) to five (5) days.
Infectious Period
During the symptoms and for several weeks afterward.
Ways to Limit Spread
Spread through contact with nose and throat secretions (includingsneezing and coughing) and stool. Wash hands after handling bodysecretions. Encourage people to cover nose and mouth when sneezing.
School/Childcare Protocol
Only exclude the person from child care or school if s/he is too sickto participate in normal child care activities AND if open sores cannotbe covered. Open sores that cannot be covered must be crusted overbeforereturning to school. This is generally not a serious illness; exclusionrarely prevents the disease from spreading. Notify other families ofillness.Most, but not all, adults are probably immune.
Hepatitis Type A
Disease Description
Caused by virus, inflammation of the liver with fatigue, loss ofappetite, low fever, nausea, stomach pain, and sometimes yellowcoloring of the skin and eyes (jaundice).
Incubation Period
Fifteen (15) to fifty (50) days (usually one (1) month).
Infectious Period
For several days before first stomach symptoms occur until one weekafter jaundice occurs.
Ways to Limit Spread
Spread from stool to mouth by hands. Careful handwashing afterdiapering and toileting and cleaning diaper changing areas and beforehandling food will decrease spread.
School/Childcare Protocol
The Health Department may recommend that child care staff and childrenget a preventive injection. Exclude ill child until Health Departmentgive permission to return. Regional Manager will contact HealthConsultant for more information.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Hepatitis Type B
Disease Description
Caused by virus, inflammation of the liver with fatigue, loss ofappetite, low fever, nausea, stomach pain, and sometimes yellowcoloring of the skin and eyes (jaundice).
Incubation Period
Forty-five (45) to ninety (90) days.
Infectious Period
Several weeks before the first symptoms appear and until the blood testshow that the person is no longer infectious. About five percent (5%)toten percent (10%) of the people infected with Hepatitis B become longtermcarriers.
Ways to Limit Spread
Hepatitis B is a disease spread by blood, sharing needles, sexualcontact, and from mother to child during pregnancy or birth. In a childcare setting the main means of contact with the virus is through blood.Clean up spills of blood promptly. Gloves should be worn when handlingblood (keep somein the first aid kit). Keep cuts or sores covered. Hepatitis B is notspread through casual contact such as sharing toilets, shaking hands,eating together, or sharing toys.
School/Childcare Protocol
People infected with Hepatitis B virus can remain in the child caresetting as long as:
- The center consistently practices good handwashing and cleaningtechniques;
- The person does not have a bleeding wound or sore;
The identity of the person with Hepatitis B need not be revealed toanyone except those who care for a child who has Hepatitis B.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Follow strict confidentiality laws, only the DST, R.M. andHealthConsultant need to know about this illness.
Herpes Simplex
Disease Description
Viral infection that causes cold sores or fever blister and is prone torecurrence. Usually occurs before the fifth year of life. Sorescommonlylast seven (7) to ten (10) days.
Incubation Period
Two (2) to twelve (12) days.
Infectious Period
As long as the virus is present in body secretions. Very commonlypresent in body secretions.
Ways to Limit Spread
Spread by direct contact with secretions from the nose, throat, andsores. Wash hands thoroughly after handling body secretions. Discouragepeople from sharing items that they have put in or around their mouths.
School/Childcare Protocol
People with active Herpes simplex sores should stay away from newbornbabies, children with skin problems or burns, and people with impairedimmunity to prevent serious infections from occurring.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Impetigo
Disease Description
Bacterial skin infection with honey-crusted sores around mouth, nose,arms, or legs.
Incubation Period
Usually one (1) to five (5) days, but may be more than five (5) days.
Infectious Period
Until sores are completely healed or child has been treated withantibiotics for twenty four (24) hours.
Ways to Limit Spread
Spread by direct contact with sores. Good handwashing will decreasespread.
School/Childcare Protocol
Report to parent so child can get medical care. Exclude child ortreatment a minimum of twenty four (24) hours after antibiotictreatment is started to allow it enough time to get rid of thebacteria. Notify other families of illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Measles (Redmeasles, rubeola, hard measles, 8-10 day measles)
Disease Description
Serious disease that starts with cold-like symptoms. After about threedays, small white spots appear in the mouth. Then a red, raise rashbegins, usually on the race and spreads quickly over the upper body,then to the back and legs. Symptoms include high fever and cough, eyeswhich are red, itching, and sensitivity to light.
Incubation Period
Seven (7) to fourteen (14) days.
Infectious Period
Up to seven (7) days before and usually four (4) days after the rashbegins.
Ways to Limit Spread
Spread by coughing and sneezing and contact with nose and throatdischarge. Avoid sharing cups and tissues. Use good handwashingpractices.
School/Childcare Protocol
Exclude child or teacher until seven (7) days after rash develops toprevent the spread of this serious illness. Notify other families ofillness. Review teachers’ and students’ immunization records forprotection against measles.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Meningitis
Disease Description
Inflammation of the lining of the brain and spinal cord often caused bybacteria or viruses. Symptoms include high fever and chills, stiffneck,headache, vomiting, and sometimes coma, seizures, and a rash.
Incubation Period
One (1) to seven (7) days.
Infectious Period
Until the organism is not found in nose and mouth discharges (withtwenty four (24) hours after treatment started).
Ways to Limit Spread
Spread by contact with nose and mouth discharge or by coughing andsneezing. Avoid sharing cups and tissues. Use good handwashingpractices.
School/Childcare Protocol
Exclude child or teacher until doctor gives permission to return tochild care. Observe other children for signs of illness and notifytheir families.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Mononucleosis
Disease Description
A viral infection that causes fatigue, fever, swollen glands, andsometimes causes the liver or spleen to become inflamed.
Incubation Period
Thirty (30) to fifty (50) days.
Infectious Period
Several weeks to months.
Ways to Limit Spread
Spread person-to-person by items that may have saliva or nasaldischarge on them.
School/Childcare Protocol
Avoid mouth kissing. Avoid sharing dishes, toothbrushes, food, drink,toys. Promptly dispose of soiled tissues or towels. Notify otherfamiliesof illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Mumps
Disease Description
Caused by virus with painful swelling of glands in front of ear(parotid glands), fever, headache, and cold symptoms.
Incubation Period
14 to 21 days; average 18 days.
Infectious Period
From six (6) days before to nine (9) days after swelling begins.
Ways to Limit Spread
Spread by coughing and sneezing or contact with saliva. Use goodhandwashing practices and avoid sharing cups and tissues.
School/Childcare Protocol
Exclude child or teacher until swelling and other symptoms gone (aboutnine (9) days after swelling begins). Review teachers’ and students’immunization records for protection against mumps. Notify other parentsof illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Pink Eye (Conjunctivitis)
Disease Description
Common infection caused by bacteria or virus with irritated, wateryeyes, swollen lids and a clear or yellow discharge that makes eyelashessticky. One or both eyes may be affected.
Incubation Period
Twenty four (24) to seventy two (72) hours.
Infectious Period
During active infection.
Ways to Limit Spread
Spread through contact with eye discharge. Avoid touching the eyes anduse good handwashing practices.
School/Childcare Protocol
If the pink eye is though to be caused by a bacterium, exclude thechild or teacher for twenty four (24) hours after antibiotic treatmentis started. Symptoms should subside rapidly. If they don’t it is mostlikely that the pink eye is being caused by a virus, therefore, thechild should be excluded until there is no drainage, in order toprevent the spread of this illness. Notify other families of theillness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Pinworms
Disease Description
Caused by small roundworm in intestines. Signs include rectal (bottom)itching, especially at night.
Incubation Period
Four (4) to six (6) weeks.
Infectious Period
As long as pinworm eggs are present.
Ways to Limit Spread
Pinworm eggs are spread from stool to mouth by hand or from clothingand bedding. Handwashing after diapering and toileting may decreasespread.
School/Childcare Protocol
Child may return to center once treatment is started. Observe othersfor signs of illness. Notify other families of the illness.
Roseola Infantum
Disease Description
A common viral rash of young children, especially those less than twoyears of age. The illness starts with a high fever and cold symptoms.Asthe fever goes away, the rash appears. The red rash lasts one (1) tothree(3) days.
Incubation Period
Estimated to be five (5) to fifteen (15) days.
Infectious Period
Unknown.
Ways to Limit Spread
Unknown. Outbreaks of several cases at once are uncommon.
School/Childcare Protocol
Exclude the child or teacher from center until able to participate innormal activities. Notify other families of illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Rubella (German Measles, Three DayMeasles, Light Measles)
Disease Description
Mild illness caused by virus. First sign may be swollen, tender neckglands and low fever. Then pink toned spots appear on the face andspread quickly to the rest of the body. Mild itching may occur.
Incubation Period
Fourteen (14) to twenty-one (21) days.
Infectious Period
From seven (7) days before to five (5) days after rash begins.
Ways to Limit Spread
Spread by contact with nose and throat discharge. Wash hands carefullyand avoid sharing cups and tissues to decrease spread. Pregnant womenmust avoid contact with child with rubella.
School/Childcare Protocol
Exclude child or teacher while symptoms are present and until five (5)days after rash begin to prevent spread. Review immunization records.Exclude other children who develop rash or fever until seen by healthcare provider. Notify parents and staff of illness. Pregnant womenwho have been exposed should contact their health care provider.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Salmonellosis
Disease Description
Caused by bacteria. May have blood or pus in diarrhea stools, fever,stomach pain, nausea, vomiting.
Incubation Period
Six (6) to seventy-two (72) hours (usually 12 to 36 hours).
Infectious Period
As long as bacteria is in stool (usually one (1) to four (4) weeks)
Ways to Limit Spread
Spread through stool, animals, contaminated food, or water. Goodhandwashing after changing diapers, toileting, before fixing food, andcareful cleaning of diaper changing area will decrease spread. In childcare centers, food handlers should probably not work in infant roomchanging diapers.
School/Childcare Protocol
Exclude child or teacher until there are two (2) negative stoolspecimens collected twenty-four (24) hours apart or when permitted bythe healthdepartment. Review handwashing, diaper changing, and food handlingprocedureswith staff. Notify other families of the illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Scarlet Fever andStrep Throat (Streptococcal infections)
Disease Description
Caused by bacteria. Infection with sore throat, fever, and sometimes arash.
Incubation Period
One (1) to three (3) days.
Infectious Period
Ten (10) to twenty one (21) days.
Ways to Limit Spread
Spread by contact with nose and mouth discharge. Use good handwashingpractices and avoid sharing cups and tissues.
School/Childcare Protocol
Exclude child or teacher until twenty-four (24) hours after startingantibiotic treatment to allow enough time to get rid of the bacteria.Inform other families of illness and encourage them to seek care ifsymptoms occur.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Shigellosis
Disease Description
Caused by bacteria with symptoms of diarrhea which may contain blood orpus, fever, vomiting, cramps.
Incubation Period
One (1) to seven (7) days (usually two (2) to seven (7) days).
Infectious Period
As long as bacteria are in stool (usually one (1) to four (4) weeks).
Ways to Limit Spread
Spread through stool. Good handwashing after changing diaper,toileting, before fixing food, and careful cleaning of diaper changingarea will decrease spread. In child care centers, food handlers shouldprobably not work ininfant room changing diapers.
School/Childcare Protocol
Exclude child or teacher until there are two (2) negative stoolspecimens collected twenty-four (24) hours apart. Review handwashing,diaper changing, and food handling procedures with staff. Notify otherfamilies of the illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Whooping Cough (Pertussis)
Disease Description
Highly contagious respiratory infection caused by bacteria. Begins withcold-like symptoms and cough which get worse within one (1) to two (2)weeks. The cough is followed by a “whooping” sound, sweating,exhaustion, vomiting, and thick mucous. The cough persists for one (1)to two (2) months.
Incubation Period
Usually seven (7) to ten (10) days, but can be as long as twenty one(21) days.
Infectious Period
Most contagious during cold-like stage; seldom contagious after thefifth week of disease.
Ways to Limit Spread
Spread with direct contact with or coughing from person with illness.Use good handwashing practices and avoid sharing cups and tissues.
School/Childcare Protocol
Exclude child or teacher for the first seven (7) days of antibiotictreatment to allow enough time to get rid of the bacteria. Observechildren who have been exposed. If signs of cold-like illness develop,separate the child until it can be determined if child has whoopingcough. Review child’s immunization records for protection againstPertussis. Notify other families of illness.
Notify Regional Manager by telephone. RegionalManager will notify Health Consultant.
Vomiting
School/Childcare Protocol
Exclude if child or teacher vomits more than two (2) times and askparent to keep the child home until free of vomiting for a full twentyfour (24) hours and if signs of a communicable disease are present askfamily take child to health provider.
This policy complies with HeadStart Performance Standard 45 CFR Section 1304.22 .
It was approved by Policy Council on October 17, 1997
Updated November 14, 2001. January 15, 2004
© 1995-2004. Head Start of Lane County. All rights reserved.