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«Communicable Disease Investigation Reference Manual ACKNOWLEDGEMENTS REVIEWER LIST Bureau of Environmental Health Services Bureau of HIV, STD, & ...»

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A Guide for School Administrators, Nurses, Teachers,

Child Care Providers, and Parents or Guardians

A Guide for School Administrators, Nurses, Teachers,

Child Care Providers, and Parents or Guardians

FOREWORD

Communicable Disease Investigation Reference Manual

ACKNOWLEDGEMENTS

REVIEWER LIST

Bureau of Environmental Health Services Bureau of HIV, STD, & Hepatitis Office of Veterinary and Public Health Section for Child Care Regulation Section of Epidemiology for Public Health Practices Center for Emergency Response and Terrorism (CERT) Bureau of Communicable Disease Control and Prevention Bureau of Immunization Assessment and Assurance Bureau of Genetics and Healthy Childhood Bureau of WIC and Nutrition Services Section for Disease Control and Environmental Epidemiology Office of Public Information

INTRODUCTION

Please note that on the PROVIDER fact sheets, for any diseases labeled "REPORTABLE", the provider MUST consult with the LOCAL or STATE HEALTH DEPARTMENT.

PARENT/GUARDIAN

This document replaces all previous versions of the “Prevention and Control of Communicable Diseases, A Guide for School Administrators, Nurses, Teachers, and Child Care Providers”.

DISCLAIMER -

TABLE OF CONTENTS

SECTION 1 GUIDELINES: STAFF AND CHILDREN

SECTION 2 GUIDELINES: ENVIRONMENT

SECTION 3 GUIDELINES: PREVENTION AND CONTROL

SECTION 4 COMMUNICABLE DISEASE REPORTING

SECTION 4 (CONTINUED)

SECTION 5 COMMUNICABLE DISEASE CONTROL AND MANAGEMENT

SECTION 6 COMMUNICABLE DISEASE FACT SHEETS

Parent Fact Sheet 80 Parent Fact Sheet 83 Parent Fact Sheet 86 Parent Fact Sheet 89 Parent Fact Sheet 91 Parent Fact Sheet 94 Parent Fact Sheet 96 Parent Fact Sheet 99 Parent Fact Sheet 101 104 Parent Fact Sheet SECTION 6 Parent Fact Sheet 107 (CONTINUED) Parent Fact Sheet 110 Parent Fact Sheet 112 Parent Fact Sheet 117-118 Parent Fact Sheet 121 Parent Fact Sheet 128 Parent Fact Sheet 130

–  –  –

SECTION 8 MISSOURI LAWS RELATED TO CHILDCARE/SCHOOLS

SECTION 9 EMERGENCY PREPAREDNESS

SECTION 10 GLOSSARY SECTION 11 REFERENCES

GENERAL EXCLUSION GUIDELINES FOR ILL CHILDREN/STAFF

Exclude children with any of the following:

Illness

–  –  –

Signs/Symptoms of Possible Severe Illness Diarrhea

GENERAL EXCLUSION GUIDELINES FOR ILL CHILDREN/STAFF

Vomiting Mouth Sores with Drooling Rash with Fever or Behavior Change Eye Drainage Unusual Color of Skin, Eyes, Stool, or Urine

SPECIFIC DISEASE EXCLUSION FOR CHILDCARE

Acute Bronchitis (Chest Cold)/Bronchiolitis

–  –  –

Hand, Foot, and Mouth Disease Head Lice Hepatitis A Hepatitis B Hepatitis C Herpes, Oral HIV/AIDS Impetigo Influenza Measles Meningococcal Disease Methicillin-Resistant Staphylococcus aureus (MRSA) Molluscum Contagiosum Mononucleosis Mosquito-Borne Mumps Norovirus Parapertussis Pertussis (Whooping Cough) Pinworms Pneumococcal Infection Pneumonia Respiratory Infection (Viral) Respiratory Syncytial Virus (RSV) Infection Ringworm Roseola Rotaviral Infection Rubella (German Measles)

–  –  –

.

Staph Skin Infection STEC (Shiga toxinproducing Escherichia coli) Infection Streptococcal Infection (Strep Throat/Scarlet Fever) Tick-Borne Tuberculosis (TB) Viral Meningitis Warts Yeast Infection (Candidiasis) Other communicable diseases

–  –  –

Hand, Foot, and Mouth Disease Head Lice Hepatitis A Hepatitis B Hepatitis C Herpes Gladiatorum Herpes, Oral HIV/AIDS Impetigo Influenza Measles Meningococcal Disease Methicillin-Resistant Staphylococcus aureus (MRSA) Molluscum Contagiosum Mononucleosis Mosquito-Borne Mumps Norovirus Parapertussis Pertussis (Whooping Cough) Pinworms Pneumococcal Infection Pneumonia Respiratory Infection (Viral) Ringworm Rotaviral Infection Rubella (German Measles) Salmonellosis

–  –  –

Streptococcal Infection (Strep Throat/Scarlet Fever) Tick-Borne Tuberculosis Viral Meningitis Warts Yeast Infection (Candidiasis) Other communicable diseases Consult your local or state health department when there is more than one case of a reportable disease or if there is increased absenteeism.

COMMUNICABLE DISEASE CONCERNS FOR PREGNANT WOMEN

CYTOMEGALOVIRUS (CMV) AND PREGNANCY

What is CMV?

What illness does it cause?

Is this illness serious?

I’ve recently been exposed to someone with CMV. How will this exposure affect my pregnancy?

CYTOMEGALOVIRUS (CMV) INFECTION AND PREGNANCY

I have had a blood test for CMV. What do the results of the blood test show?

If I develop CMV, what do I need to do about my pregnancy?





Is there any way I can keep from being infected with CMV?

practice good personal hygiene

Information on the Web:

FIFTH DISEASE (PARVOVIRUS B19) AND PREGNANCY

What is parvovirus B19?

What illnesses do parvovirus B19 infection cause?

Are these illnesses serious?

I’ve recently been exposed to someone with fifth disease. How will this exposure affect my pregnancy?

FIFTH DISEASE (PARVOVIRUS B19) AND PREGNANCY

What should I do about this exposure?

I have had a blood test for parvovirus B19. What do the results show?

If I’m infected, what do I need to do about my pregnancy?

Is there a way I can keep from being infected with parvovirus B19 during my pregnancy?

Information on the Web:

HAND, FOOT, AND MOUTH DISEASE AND PREGNANCY

What causes hand, foot, and mouth disease (HFMD)?

What illness does it cause?

Is HFMD illness serious?

I’ve recently been exposed to someone with enteroviruses. How will this exposure affect my pregnancy?

HAND, FOOT & MOUTH DISEASE AND PREGNANCY

If I develop HFMD, what do I need to do about my pregnancy?

Is there any way I can keep from being infected with HFMD?

So throughout the pregnancy, practice good personal hygiene to reduce the risk of exposure to

enteroviruses:

Information on the Web:

HEPATITIS B VIRUS AND PREGNANCY

What is hepatitis B and what illness does this cause?

Is hepatitis B serious?

If I've been exposed to someone infected with the hepatitis B virus, what should I do?

How will this exposure affect my pregnancy?

HEPATITIS B VIRUS AND PREGNANCY

Can anything be done to protect my baby?

–  –  –

I have had a blood test for hepatitis B. What do the results of the blood test show?

Is there a way I can keep from being infected with hepatitis B during my pregnancy?

Information on the Web:

HUMAN IMMUNODEFICIENCY VIRUS (HIV) AND PREGNANCY

What is HIV?

I’ve recently been exposed to HIV. What should I do?

How will this exposure affect my pregnancy?

All pregnant women should be tested for HIV early in their pregnancy.

Women who are infected with HIV should not breastfeed their babies; the retrovirus is present in the breast milk.

How can I tell if I'm infected with HIV?

HUMAN IMMUNODEFICIENCY VIRUS (HIV) AND PREGNANCY

What are the HIV/AIDS symptoms?

Early symptoms Late symptoms I have had a blood test for HIV. What do the results of the blood test show?

Is there a way I can keep from being infected with HIV during my pregnancy?

Information on the Web:

RUBELLA (GERMAN MEASLES) AND PREGNANCY

What is rubella?

What illness does rubella infection cause? Is this illness serious?

I’ve been exposed to someone with rubella. How will this exposure affect my pregnancy?

What should I do about this exposure?

I have had a blood test for rubella. What do the results of the blood test show?

RUBELLA (GERMAN MEASLES) AND PREGNANCY

If I'm infected or have been exposed, what do I need to do about my pregnancy?

Is there a way I can keep from being infected with rubella during my pregnancy?

–  –  –

Information on the Web:

VARICELLA-ZOSTER VIRUS (CHICKENPOX AND SHINGLES)

What is varicella-zoster?

Varicella-zoster is a herpes virus that causes chickenpox, a common childhood illness. It is highly contagious. If an adult develops chickenpox, the illness may be more severe. After a person has had chickenpox, the varicella-zoster virus can remain inactive in the body for many years. Herpes zoster (shingles) occurs when the virus becomes active again.

What illnesses does varicella-zoster cause?

Chickenpox first occurs as a blister-like skin rash and fever. It takes from 10-21 days after exposure for someone to develop chickenpox. The sores commonly occur in batches with different stages (bumps, blisters, and sores) present at the same time. The blisters usually scab over in 5 days. A person with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs. Children with weakened immune systems may have blisters occurring for a prolonged time period. Adults can develop severe pneumonia and other serious complications.

Shingles occurs when the virus, which has been inactive for some time, becomes active again. Severe pain and numbness along nerve pathways, commonly on the trunk or on the face, are present. Clusters of blisters appear 1 to 5 days later.

The blisters are usually on one side of the body and closer together than in chickenpox. Shingles does not spread as shingles from one person to another. If people who have never had chickenpox have contact with the fluid from the shingles blisters, they can develop chickenpox.

Can you get chickenpox if you've been vaccinated?

Yes. About 15%–20% of people who have received one dose of varicella (chickenpox) vaccine do still get chickenpox if they are exposed, but their disease is usually mild. Vaccinated persons who get chickenpox generally have fewer than 50 spots or bumps, which may resemble bug bites more than typical, fluid-filled chickenpox blisters. In 2006, the Advisory Committee on Immunization Practices (ACIP) voted to recommend routine two-dose varicella vaccination for children. In one study, children who received two doses of varicella vaccine were three times less likely to get chickenpox than individuals who have had only one dose.

Are chickenpox and shingles serious illnesses?

The symptoms may be more severe in newborns, persons with weakened immune systems, and adults. Serious problems can occur and may include pneumonia (bacterial and viral), brain infection (encephalitis), and kidney problems. Many people are not aware that before a vaccine was available, approximately 10,600 persons were hospitalized, and 100 to 150 died, as a result of chickenpox in the U.S. every year.

What should I do about an exposure to varicella?

If you have been in contact with someone with chickenpox or shingles, or if you have a rash-associated illness that might be chickenpox or shingles, discuss your situation with your healthcare provider. Blood tests may be done to see if you have become infected with the virus or have had the disease in the past. If you are pregnant and not immune and have been exposed to chickenpox or shingles, call your healthcare provider immediately. Your provider may choose to treat you with a medication called varicella-zoster immune globulin (VZIG), but in order for this medication to be most helpful, it needs to be given as soon as possible after your exposure to varicella.

I'm pregnant and have recently been exposed to someone with chickenpox. How will this exposure affect me or my pregnancy?

Susceptible pregnant women are at risk for associated complications when they contract varicella. Varicella infection causes severe illness in pregnant women, and 10%-20% of those infected develop varicella pneumonia, with mortality (death) reported as high as 40%.

Because of these risks, pregnant women without evidence of immunity to varicella who have been exposed to the virus may be given varicella-zoster immune globulin (VZIG) to reduce their risk of disease complications.

July 2011 31

If you are pregnant and have never had chickenpox, and you get chickenpox during the:

First half (about 20 weeks) of your pregnancy, there is a very slight risk (0.4% to 2%) for birth defects or miscarriage.

Second half of your pregnancy, the baby may have infection without having any symptoms and then get shingles (zoster) later in life.

Newborns whose mothers develop varicella rash from 5 days before to 2 days after delivery are at risk for neonatal varicella, associated with mortality as high as 30%. These infants should receive preventive treatment with varicella-zoster immune globulin (VZIG).

I’m pregnant and have had a blood test for chickenpox. What do the results of this test show?

The blood test can show that you:

Are immune (have already had varicella disease or varicella vaccine) and have no sign of recent infection. You have nothing further to be concerned about.

Are not immune and have not yet been infected. You should avoid anyone with chickenpox during your pregnancy.

Have or recently had an infection. You should discuss what the risks are for your stage of pregnancy with your healthcare provider.

Is there a way I can keep from being infected with chickenpox?



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