Communicable Disease School Nurse Guidance

Breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs -Direct contact with respiratory secretions from an infected person -Touching a contaminated object then touching mouth, nose or eyes

Variable, including runny nose, watery eyes, fatigue, coughing, and sneezing. May or may not have fever

Variable

Variable, often from the day before symptoms begin up to 5 days after onset

No exclusion unless febrile or other symptoms meeting exclusion criteria are present

May depend of etiology/organism

Report unusual illness, clusters of cases above baseline for group and time of year, or increased/unusual severity of illness to the local health department

http://www.cdc.gov/conjunctivitis/index.html

Contact with an infected person’s skin, body fluid or though contact with a contaminated surface and then touching mucus membranes/eyes

Red eyes, usually with some discharge or crusting around eyes; may be itchy, sensitive to light, or watery

Bacterial: may have yellow/greenish discharge; may affect one or both eyes

Allergic and chemical conjunctivitis usually affects both eyes

Bacterial: Unknown

Viral: Varies with etiology

Bacterial: from onset of symptoms until after start of antibiotics, or as long as there is discharge form the eye

Viral: variable, before symptoms appear and while symptoms are present
(Allergic and chemical conjunctivitis is not contagious.)

Bacterial, Viral, or unknown etiology: Exclude if conjunctivitis is accompanied by symptoms of systemic illness or if the child is unable to keep hands away from eye.

Childcare rules: exclude if purulent drainage until after 24 hours of treatment
http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Not required to be reported

May notify local health department of large clusters of cases or cases with unusual severity of illness

http://www.flu.gov/
http://ilga.gov/commission/jcar/admincode/077/077006900D04650R.html
http://ilga.gov/commission/jcar/admincode/077/077006900D04680R.html
http://ilga.gov/commission/jcar/admincode/077/077006900D04690R.html

Person to person by respiratory droplets created by coughing or sneezing, or though contact with a contaminated surface and then touching mucus membranes/eyes The virus can live on surfaces for several hours.

Sudden onset of fever, chills, headache, malaise, body aches, and nonproductive cough

1-4 days

Variable, from 24 hours before onset of symptoms, peaks during first 3 days of illness through 7 days

Until fever-free for 24 hours without using fever-reducing medications and symptoms are improving. Upon return, CDC recommends enhancing hygiene practices and wearing a well-fitted mask for 5 days.

Criteria may differ in pandemic or novel/variant strain influenza situation.

Influenza deaths in persons<18 years of age. ICU admissions are reportable within 24 hours.

Influenza A, variant virus cases are required to be reported immediately within 3 hours by healthcare providers.

Annual influenza vaccine recommended for everyone 6 months and older, improve ventilation, wearing well-fitted masks, enhancing hygiene practices, and testing to inform actions.

https://www.cdc.gov/epstein-barr/about/mononucleosis.html

Person to person, most commonly through bodily fluids, especially saliva.

However, these viruses can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantations.

Extreme fatigue, fever, sore throat, headaches, body aches, swollen lymph nodes in the neck and armpits, swollen liver, or spleen or both, rash. May have mild or no symptoms, especially in young children.

4-6 weeks after exposure, Epstein-Barr Virus (EBV) most common

Illness usually lasts 7 to 10 days but can vary person to person. Infected individuals may remain contagious for up to 6 months.

No contact sports for 4-6 weeks, or until cleared by student’s physician.

Not reportable in Illinois.

Avoid kissing, sharing drinks and food, and using the same personal items that an infected person recently used.

http://www.cdc.gov/mumps/index.html
http://ilga.gov/commission/jcar/admincode/077/077006900D05500R.html

Contact with droplets from eyes or mouth of infected person

Fever with swelling and tenderness of one or both parotid glands located below and in front of the ears Unrecognized mild cases without swelling may occur.

12 to 25 days (usually 16 to 18 days)

Peak infectious time begins 1 to 2 days before swelling to 5 days after, but may range from 7 days before to 9 days after. For the purpose of contact tracing and exclusions, the infectious period is 2 days before to 5 days after parotitis.

Exclude cases from school, childcare or workplace until 5 days after onset of parotitis.  Note: daycare licensing rules require 9 days exclusion; refer to link below.

http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Susceptible contacts should be excluded from school or the workplace from days 12-25 after last exposure.

Report case to local health department within 24 hours. 

Outbreaks: three or more probable or confirmed cases linked by time and place.

Timely immunization beginning at age 12 months; if outbreak occurs, unimmunized persons should be immunized or excluded for at least 26 days following onset of parotitis in last case.

http://www.cdc.gov/pertussis/
http://www.ilga.gov/commission/jcar/admincode/077/077006900D07500R.html

Contact with droplets from nose, eyes or mouth of infected person

Initially cold-like symptoms, later cough; may have inspiratory whoop, post-tussive vomiting

5 to 21 days (usually 7 to 10 days)

Before cough onset (with onset of runny nose), continuing until child has been on antibiotics for 5 days

If untreated, infectious for 3 weeks after cough begins

School exclusion: Cases must be excluded from school until 5 days of appropriate antibiotic treatment is completed or 21 days after cough onset if no treatment is received.

Susceptible contacts do not need to be excluded unless they become symptomatic.

Report as soon as possible, within 24 hours

Outbreaks: Five or more cases epidemiologically linked

Timely immunization beginning at age 2 months; booster dose of Tdap is recommended at 11 years. All adults caring for children younger than 12 months should receive a booster dose of Tdap. Close contacts that are unimmunized should have pertussis immunization initiated. Chemoprophylaxis is recommended for targeted groups of close contacts regardless of age and immunization status. Contact the local health department for more information.

https://www.cdc.gov/rsv/

https://www.cdc.gov/respiratory-viruses/index.html

Highly contagious; contact with droplets from nose, eyes or mouth of infected person; virus can live on surfaces (toys, tissues, doorknobs) for several hours

Fever, runny nose, cough. May have wheezing

2 to 8 days (4 to 6 days most common)

Variable, from the day before until 3 to 8 days or longer; may last up to 3 to 4 weeks

For 24 hours until both are true: fever-free without using fever-reducing medications and symptoms are improving overall. Upon return and for the next 5 days, CDC recommends enhancing hygiene practices, wearing a well-fitted mask and physical distance from others when indoors as much as possible.

RSV deaths in persons <18 years of age and ICU admissions are reportable within 24 hours.

Avoid sharing linens, toys, and other items

Staying up to date with vaccination for those eligible, improve ventilation, wearing well-fitted masks, enhancing hygiene practices, and testing to inform actions.

https://www.cdc.gov/respiratory-viruses/index.html

Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.

Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.

Touching eyes, nose, or mouth with hands that have the virus on them.

May have no symptoms or can have any of the following: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea, dermatologic manifestations

2-14 days

From 2 days before symptom onset through Day 10 after symptom onset

For 24 hours until both are true: fever-free without using fever-reducing medications and symptoms are improving overall. Upon return and for the next 5 days, CDC recommends enhancing hygiene practices, wearing a well-fitted mask and physical distance from others when indoors as much as possible.

COVID-19 deaths in persons <18 years of age and ICU admissions are reportable within 24 hours.

Outbreaks with hospitalization or deaths related to COVID-19 involving 3 or more in a core group of individuals within a 10-day period or if the school is no longer able to safely operate and provide essential services. 

Staying up to date with vaccination, improve ventilation, wearing well-fitted masks, enhancing hygiene practices, and testing to inform actions.

http://www.cdc.gov/groupastrep/
http://www.ilga.gov/commission/jcar/admincode/077/077006900D06700R.html

Contact with droplets from nose and mouth; close crowded contact, direct contact

Fever, sore throat with pus spots on tonsils, tender swollen glands

Scarlet fever has above symptoms plus a sandpaper-like rash Symptoms may vary.

2 to 5 days

Highest during acute infection; no longer contagious within 24 hours after antibiotics

Schools: Exclude until fever free without the use of fever-reducing medications or symptoms improving if fever not present AND on appropriate antibiotics for at least 12 hours. However, during outbreaks or in the setting of recurrent infection, IDPH recommends individuals stay home for at least 24 hours after on effective antibiotics AND fever free or symptoms improving if fever not present.

Child Care: rules: Exclude until 24 hours after treatment has been initiated and until the child has been without fever for 24 hours;
http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Clusters of 10 epidemiologically linked cases of strep throat/scarlet fever within a 10 day period are reportable to the local health department.

Invasive disease from streptococcal bacteria is reportable.

Avoid kissing, sharing drinks or utensils; exclude infected adults from food handling; symptomatic contacts of documented cases should be tested, and if results are positive, should be treated.

http://www.cdc.gov/TB/
http://www.ilga.gov/commission/jcar/admincode/077/07700696sections.html

Airborne inhalation of droplets from nose and mouth of diseased person (children usually contract TB from close contact with a diseased adult)

Fever, fatigue, weight loss, cough (lasting 3+ weeks), night sweats, loss of appetite

2 to 10 weeks to years; risk of developing disease is highest 6 months to 2 years after infection

Individuals with infection but without active disease (latent TB) are not infectious. 

Individuals with active disease are infectious until treatment.

For active disease: after therapy started, adherence documented, symptoms diminished, and determined to be non-infectious; consult with public health officials; no exclusion for latent infection

Report suspect or confirmed TB cases to local health department within 7 days

Routine TB skin testing is not recommended at this time for children; however, it is recommended that all adults who have contact with children in a child care setting are screened for TB; local health department personnel should be informed for contact investigation.

https://www.cdc.gov/campylobacter/about/index.html
https://www.ilga.gov/commission/jcar/admincode/077/077006900D03350R.html

Ingestion of undercooked meat, contaminated food or water, or raw milk

Diarrhea (may be bloody), abdominal pain, malaise, fever

1-10 days, usually 2-5 days

Throughout illness (usually 1-2 weeks, but up to 7 weeks without treatment)

Exclude until diarrhea has ceased for at least 24 hours; additional restrictions may apply.

Cases of campylobacteriosis are reportable to the local health department within 7 days.

http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.html

Person-to-person through inadequate handwashing or on contaminated objects or surfaces, and ingestion of spores

Diarrhea, may have fever, nausea, abdominal cramping

Unknown, likely less than 7 days

During active infection (while symptomatic); can continue to shed spores when asymptomatic

Exclude while symptomatic and until diarrhea has ceased for 24-48 hours

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Alcohol-based hand hygiene products do not inactivate C. difficile spores; soap and water must be used. Sporicidal or bleach-based products are recommended for cleaning and disinfection.

https://www.cdc.gov/ecoli/about/index.html
https://www.ilga.gov/commission/jcar/admincode/077/077006900D04000R.html

Fecal-oral: person-to person, from contaminated food or liquids, contact with infected animals

Profuse, watery diarrhea, sometimes with blood and/or mucus, abdominal pain, fever, vomiting

Variable, usually 2-10 days; for E. coli O157:H7 commonly 3-4 days

Typically, one week or less in adults or up to 3 weeks in children

School: Exclude until diarrhea, vomiting, and fever have ceased for at least 24 hours; additional restrictions may apply. Release specimens shall be required for food handlers, health care workers, and sensitive occupations.

Daycare: If below the age of 5 or incontinent of school, exclude until two consecutive negative release specimens are obtained.

Report cases as soon as possible within 24 hours.

https://www.cdc.gov/salmonella/index.html
https://www.ilga.gov/commission/jcar/admincode/077/077006900D06300R.html

Fecal-oral: person-to person, contact with infected animals or via contaminated food

Abdominal pain, diarrhea (possibly bloody), fever, nausea, vomiting, dehydration

Average 12-36hrs (range: 6hrs-72 hours)

During active illness and until organism is no longer detected in feces

Exclude until diarrhea, vomiting, and fever have ceased for at least 24 hours; additional restrictions may apply. Release specimens shall be required for food handlers, health care workers, and sensitive occupation.

Report cases as soon as possible within 7 days

https://www.cdc.gov/shigella/about/index.html
https://ilga.gov/commission/jcar/admincode/077/077006900D06400R.html

Fecal-oral: frequently person-to-person; also via contaminated food or water

Abdominal pain, diarrhea (possibly bloody), fever, nausea, vomiting, dehydration

Average 1-3 days (range 12-96hrs)

During active illness and until no longer detected; treatment can shorten duration

Medical clearance required; exclude until diarrhea has ceased for at least 24 hours; additional restrictions may apply.  Release specimens may be required.

Report cases as soon as possible within 7 days

http://www.cdc.gov/norovirus/

Contact with food, water or surfaces contaminated with vomit or feces, person-to-person, aerosolized vomit

Nausea, vomiting, watery diarrhea, abdominal pain, possibly low-grade fever, chills, headache

Duration of symptoms usually 12-72 hours

Average 24-48hrs (range: 12-72hrs)

Usually from onset until 2-3 days after recovery; typically, virus is no longer shed after 10 days

Exclude until diarrhea, vomiting, and fever have ceased for 24 hours

Exclude from food handling for 48 hours after recovery

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Norovirus is highly infectious and is frequent cause of outbreaks.  Staff cleaning vomitus/stool spills should wear mask as aerosolization of virus can occur; cleaning and disinfection with product with EPA label for norovirus or use bleach solution.  Contact local health department for guidelines.

http://www.cdc.gov/rotavirus/

By the fecal-oral route through direct contact or contact with contaminated hands, objects, food, or water

Diarrhea, nausea, vomiting, fever, abdominal pain; may have loss of appetite and dehydration

Average: 2 days

Usually from onset until 3 days after recovery

Exclude until diarrhea, vomiting, and fever have ceased for 24 hours

Exclude from food handling for 48 hours after recovery

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

Spreads easily; good handwashing helps prevent spread. Vaccination is available for infants.

http://www.cdc.gov/hepatitis/
http://ilga.gov/commission/jcar/admincode/077/077006900D04500R.html

By the fecal-oral route through direct contact, person to person, or ingestion of contaminated food or water

Fever, loss of appetite, nausea, abdominal discomfort and weakness followed by jaundice.

Many unrecognized mild cases without jaundice occur, especially in children

From 15-50 days, average 28-30 days

Communicability greatest in 2 weeks before onset of illness, and through 7 days after onset of jaundice

Exclude from school and daycare for 7 days after onset of jaundice or for two weeks after onset of symptoms if no jaundice present

Exclude food handlers, healthcare workers, or workers in sensitive occupations for 7 days after onset of jaundice, or two weeks after onset of initial symptoms, if jaundice is not present

Report cases as soon as possible within 24 hours.

Outbreaks: Two or more cases linked by time and place.

Timely immunization at 12 months of age; consider hepatitis A vaccine for caregivers; infected caregivers should not prepare meals for others. Contact local health department for guidance.

http://www.cdc.gov/parasites/giardia/

By the fecal-oral route, ingestion of contaminated food or water, person-to-person transmission of cysts from infected feces; contaminated water (e.g. water play tables)

Nausea, bloating, pain, and foul-smelling watery diarrhea, excessive flatulence, nausea and stomach cramps; symptoms can recur several times over a period of weeks. May be asymptomatic.

Average 7-10 days (range 3-25+ days)

Highly variable but most infectious during diarrhea phase.

Exclude until diarrhea has ceased for at least 24 hours; may be relapsing; additional restrictions may apply

Individual cases do not have to be reported.

Clusters of cases should be reported to the local health department.

http://www.cdc.gov/parasites/crypto/
http://ilga.gov/commission/jcar/admincode/077/077006900D03650R.html
http://www.cdc.gov/parasites/crypto/childcare/prevent.html

By the fecal-oral route, ingestion of fecally contaminated food or water, contact with infected animals, consumption of contaminated unpasteurized food and drinks

Diarrhea, which can be profuse and watery, preceded by loss of appetite, vomiting, abdominal pain; asymptomatic cases can spread the infection to others; symptoms can come and go for up to 30 days

Range 1-12 days

Commonly 7 days

As long as the oocysts are being shed, typically days to weeks. Shedding may persist after symptoms resolve.

Exclude until diarrhea has ceased for at least 24 hrs; exclude from food handling and working in sensitive occupations for 48 hrs after recovery; exclude from swimming in public pools (or any recreational water venue) while symptomatic and for 2 weeks after symptoms resolve

Report cases as soon as possible within 7 days

For people with weakened immune systems, symptoms can be severe and could lead to severe or life-threatening illness. Alcohol-based hand sanitizers are not effective against Crypto. Contact local health department for guidelines.

http://www.cdc.gov/parasites/pinworm/

Pinworms lay microscopic eggs near rectum, causing itching; infection spreads through ingestion of pinworm eggs, after contamination of hands by scratching

Often asymptomatic, but itching around the anus is a common symptom

1 to 2 months or longer

Eggs may survive up to 2 weeks after appropriate therapy and resolution of rectal itching; re-infection is common

None

Not reportable

Frequent, good handwashing, particularly by infected child and any caregivers assisting with toileting; keep fingernails clean and short; prevent fingers in mouth; bed linen and underclothing of infected children should be handled carefully, not shaken and laundered promptly

http://www.cdc.gov/meningitis/bacterial.html

Contact with droplets from nose, eyes or mouth of infected person

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Hib: Unknown (usually 1 to 10 days)

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

H. influenza, Invasive disease and meningitis, Reportable as soon as possible, within 24 hours

If meningitis is suspected, follow up with a healthcare provider should occur as soon as possible.

http://www.cdc.gov/hi-disease/about/causes-transmission.html
http://ilga.gov/commission/jcar/admincode/077/077006900D04410R.html

Contact with droplets from nose, eyes or mouth of infected person

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Unknown (usually 1 to 10 days)

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

H. influenza, Invasive disease and meningitis, Reportable as soon as possible, within 24 hours

Vaccination is recommended for children <age 5 years and for certain at-risk groups. Exposures may need antibiotic prophylaxis.

http://ilga.gov/commission/jcar/admincode/077/077006900D05550R.html

Contact with droplets from nose, eyes or mouth of infected person

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

1 to 10 days (usually less than 4 days)

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

Reportable as soon as possible, within 24 hours

Contacts with saliva contact/exposure should receive antibiotic prophylaxis. Vaccination is recommended for children and teens, and certain at-risk groups.

http://ilga.gov/commission/jcar/admincode/077/077006900D06780R.html

Contact with droplets from nose, eyes or mouth of infected person

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck

May have petechial rash with Neisseria meningitidis

Can have behavioral changes including altered mental status

May have invasive disease with bacteremia or pneumonia

Variable (usually less than 4 days)

Unknown; communicable for as long as the organisms are present in the nasopharynx.

No longer communicable after 24 hours of antibiotic therapy

Exclude until after at least 24 hours of antibiotic treatment received, including antibiotics to eliminate carrier state

Exclusion of contacts not indicated.

Reportable when invasive disease is present in children less than 5 years of age within 7 days

Treatment of contacts is not recommended. Vaccination is recommended for children and certain at-risk groups.

http://www.cdc.gov/meningitis/viral.html

Contact with droplets from nose, eyes or mouth of infected person or fecal material, often from healthy people

Sudden onset, severe headache, fever, nausea, vomiting, stiff neck, behavioral changes

3 to 6 days

Viral shedding can occur from the day before illness until up to 2 weeks after onset.

Exclude until fever resolved for at least 24 hours without the use of fever-reducing medication.

Individual cases are not reportable. 

Clusters of cases are reported to local health department.

No specific treatment, no treatment for contacts recommended; teach importance of basic hygiene, hand hygiene, covering mouth and nose when coughing and sneezing, proper disposal of used Kleenex/tissues.

http://www.cdc.gov/chickenpox/
http://ilga.gov/commission/jcar/admincode/077/077006900D03500R.html

Contact with the chickenpox rash or breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs

Fever and generalized rash.

There are usually two or three crops of new blisters that scab over then heal, sometimes leaving scars.

Disease in vaccinated children can be mild or absent of fever with few lesions, which might not be blister-like.

Range 10-21 days

Commonly 14-17 days

Until lesions have crusted

Exclude until all lesions have crusted (and at least 5 days)

For vaccinated children with atypical rash: exclude until afebrile and no new lesions have developed for at least 24 hours

Day Care licensing requirements: exclude at least 6 days after rash onset  http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

No exclusion of susceptible contacts unless in a healthcare facility/setting.

Cases are reportable as soon as possible but within 24 hours.

Outbreaks are defined as 3 or more cases that are epidemiologically linked.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

Vaccination recommended prior to school entry; susceptible contacts: families should be notified of risk of chicken pox and monitor for symptoms.

http://www.cdc.gov/parvovirusB19/fifth-disease.html

By breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs

Redness of the cheeks and body, "slapped cheek” rash.

May have mild fever, runny nose, headache

Rash may come and go for weeks

Range 4-20 days

Until rash appears

In immunosuppressed persons, communicability may last months-years

No exclusion unless febrile or other symptoms meeting illness exclusion criteria are present

Not reportable

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/rubella/
http://ilga.gov/commission/jcar/admincode/077/077006900D06200R.html

Contact with droplets from nose, eyes or mouth of infected person; may be transmitted to fetus across the placenta

Red or pink rash appearing on face then spreading down the body; sore throat;  swollen glands behind ears; low grade fever; may have joint pain

14 to 23 days (usually 16 to 18 days)

From 7 days before until 7 days after the rash appears

Infants with congenital rubella can shed the virus for months.

Exclude cases for 7 days after the onset of the rash.

Exclude susceptible contacts from school or the workplace from days 7-23 following rash onset after last exposure.

Reportable as soon as possible, within 24 hours

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/hand-foot-mouth/index.html

By breathing in respiratory droplets containing the pathogen after an infected person exhales, sneezes, or coughs -Touching feces or objects contaminated with feces, then touching mouth

Rash in mouth, hands (palms and fingers), and feet (soles); fever; loss of appetite; may be asymptomatic.

Range 3-5 days

Most commonly during the first week of illness.  Can persist days to weeks after symptoms resolve.

Exclude with febrile illness or other symptoms meeting illness exclusion criteria. 

Exclude if child cannot maintain hygiene (e.g. excessive drooling) or avoid contact with others.

Individual cases are not reportable.

Clusters of 10 epidemiologically linked suspect or confirmed cases within a 10 day period should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/parasites/lice/

Direct close person to person contact; less commonly through contact with contaminated objects 

Itching and scratching of scalp; presence of live lice or pinpoint-sized white eggs (nits) that will not flick off the hair shaft

Commonly 7-10 days

While live lice are present

Childcare rules: exclude until the morning after the first treatment

http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

CDC advises that students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun.

Not reportable

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

Direct person to person contact with lesions, secretions form lesions, or saliva 

Primary infections may have no symptoms; may have fever or malaise; may or may not have rash, vesicular lesions, or ulcers at site, “fever blister”/cold sore

HSV 1 and HSV2 lesions can appear on other parts of the body.

2-12 days

Most infectious while vesicular lesions are present. 

May be present with no symptoms

Exclude from wrestling or contact sports (including practices) if lesions are present on the body (outside the genital area)

If large areas of lesions cannot be covered or if exposure to infectious lesions by other students cannot be avoided, the student should be excluded until lesions are dried and crusted.

Individual cases are not reportable.  Clusters of 2 or more suspect or confirmed cases within a 5 day period that are epidemiologically linked should be reported to the local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/groupAstrep/index.html
http://www.cdc.gov/mrsa/community/schools/index.html

Direct skin contact (especially through contaminated hands) or nasal discharge or contaminated surfaces

Small red pimples or fluid filled blisters with crusted yellow scabs; most often found on face but may be anywhere on body

7 to 10 days

Until active crusting lesions are gone or after 24 hours on antibiotics

Sores should be covered and child excluded at the end of the day, to return 24 hours after treatment is started.

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/measles/hcp/index.html
http://ilga.gov/commission/jcar/admincode/077/077006900D05200R.html

Airborne or direct contact with droplets from nose, eyes or mouth of infected person

Cough, runny nose, conjunctivitis, fever, rash that starts at head and spreads down and out on body; sore throat; may have Koplik’s spots

7 to 21 days (usually 8 to 12 days)

From 4 days before until 4 days after rash onset.

Extremely contagious!

Exclude for at least 4 days after start of rash.

Susceptible contacts: Those who do not receive vaccine within 72 hours of exposure shall be excluded for 21 days after onset of last case.

As soon as possible, within 3 hours.

Vaccination is recommended prior to school entry.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

Vaccination is recommended prior to school entry.

Direct skin contact with infected persons rash, scabs or body fluids, touching objects, fabrics (clothing, towels, bedding) and surfaces that have been used by someone with MPV or contact with respiratory secretions.

Fever, headache, muscle aches/backache, swollen lymph nodes, chills, exhaustion, respiratory symptoms (sore throat, nasal congestion, or cough), and a rash that may be located on or rear the genitals or anus but can be located other places like the hands, feet, chest, face and mouth. The rash might look like pimples or blisters and may be painful or itchy.

Roughly 1 to 2 weeks. If flu-like symptoms develop, they usually develop a rash 1 to 4 days later.

From onset of prodrome until the rash has healed, all scabs have fallen off and a fresh layer of skin has formed. This illness typically lasts 2 to 4 weeks.

Prodrome of fever, malaise, headache sometimes sore throat and cough, and lymphadenopathy usually occurs 1-2 days before rash onset.

Exclude until the rash has healed, all scabs have fallen off and a fresh layer of skin has formed. 

As soon as possible, within 24 hours.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/mrsa/index.html
http://www.cdc.gov/mrsa/community/schools/index.html
http://www.cdc.gov/mrsa/community/team-hc-providers/index.html
http://ilga.gov/commission/jcar/admincode/077/077006900D06580R.html

Direct skin contact with infected person, wound drainage or contaminated surfaces; increase risk in crowded conditions; occasional transmission by droplet over short distances

Skin lesions such as furuncles (abscessed hair follicles or “boils”), carbuncles (coalesced masses of furuncles), and abscesses; may have purulence (pus), yellow/white central point, redness

Variable, usually 4-10 days and up to months; at times initially mistaken as spider bite

Duration of acute illness if wound drainage present Draining wounds are very contagious and should be covered at all times.

Exclude if wound drainage cannot be well contained under a dressing

Exclude from high-risk activities such as contact team sports if wound cannot be completely covered with a secure bandage that will remain intact throughout sport activity, until completely healed

Exclude from use of pools/whirlpools, etc. until wounds are healed

Individual cases are not reportable. 

Clusters of 2 or more cases with infections in a 14-day period and with an epidemiological link should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

Keep skin lesions covered.  Environmental cleaning and disinfection as recommended.

http://www.cdc.gov/poxvirus/molluscum-contagiosum/

Person to person close contact;  through sharing of objects such as towels

Small flesh colored bumps on the skin that may have a tiny indented center

2 to 7 weeks, as long as 6 months

When lesions are present; otherwise unknown

No exclusion. 

Provide education on importance of hand hygiene and avoiding scratching areas.

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/fungal/diseases/ringworm/index.html

Direct skin contact with infected person or animal, or contact with surfaces or objects contaminated with fungal spores

Skin: red circular patches with raised edges and central clear area; cracked peeling skin between toes;

Scalp: redness, patchy scaly areas with/without hair loss

Can occur in multiple sites on the body

Typically 4 to 14 days after exposure

From onset of lesions until treatment begins and lesion begins to shrink

If lesion can be kept covered, exclusion are not required.

If lesions can NOT be kept covered, exclude from school until 24 hours after treatment begins.

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://www.cdc.gov/parasites/scabies/

Prolonged skin-to-skin contact with infested individual; contact with bedding or clothes of infested person

Red bumps commonly found in skin folds; burrows appear as tiny whitish or gray lines on skin surface; intense itching, especially at night

4 to 6 weeks, 1 to 4 days after re-exposure

From up to 8 weeks before skin rash appears until it has been treated with a scabicide

Exclude from school and other extracurricular activities until the morning after treatment recommended by the child’s healthcare provider has been started.

Childcare rules: exclude until the morning after the first treatment. http://www.ilga.gov/commission/jcar/admincode/089/089004070G03100R.html

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

https://www.cdc.gov/shingles/

Direct contact with the rash during blister phase

Painful rash that develops typically on one side of the body; may have fever, headache, chills, nausea

None.

Anyone with history of chicken pox can develop shingles.

Shingles cannot be passed from one person to another, but during the blister phase of rash, direct contact with blister fluid of shingles rash can cause chicken pox in non-immune persons.  When crusted over, rash is no longer infectious.

Exclude if rash cannot be covered, or if child cannot comply with keeping rash covered until crusted over.

Exclude if febrile or other symptoms meeting illness exclusion criteria are present 

Individual cases are not reportable.  Clusters of cases should be reported to local health department.

Good handwashing and hygiene practices; proper disposal of soiled tissues; avoid sharing linens, hair supplies, or clothing items; proper disinfection of surfaces and toys; avoid scratching skin and lesions; avoid direct contact with skin lesions; keep skin lesions covered where possible; recommend nails be kept short and trimmed when itchy lesions are present. Standard precautions.

http://ilga.gov/commission/jcar/admincode/077/077006900D06000R.html

http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1704

Day Care Rules: Animals
http://www.ilga.gov/commission/jcar/admincode/089/089004070F03000R.html

Contact with an infected animal’s saliva through a bite or scratch in the skin, or through mucous membrane exposure (e.g. eyes, nose, mouth); contact with an infected animal’s brain tissue or cerebrospinal fluid

In animals, behavior changes may occur, including seeing nocturnal animals during daylight hours, or wild animals allowing humans to approach.  Animal may have excessive salivation, difficulty walking, or a stunned appearance.  A domestic animal may be unusually aggressive or overly docile.  Bats may be on the ground due to difficulty flying. 

In humans, the person may be apprehension. Symptoms include headache, fever, malaise, and subtle changes in personality or cognition.

Humans: symptom onset usually from 1 to 8 weeks but can appear days to years following exposure

Bites to head and neck usually have sooner onset of symptoms. Once symptoms appear, rabies is almost always fatal.

Animals:  weeks to months

When the virus reaches the saliva of the infected animal

Virus excretion may be intermittent. Animal may or may not show symptoms.

No exclusion.

If a bite or scratch occurs, notify parents and refer individual for medical treatment by or under the direction of a physician.

Report potential human exposure to rabies as soon as possible, within 24 hours

Report animal bites or contact with a bat to the local public health department as soon as possible

Bat exposures and animal bites occasionally occur on school grounds or while students are in route to school. 

Educate students to avoid any domestic or wild animal that is acting strangely, is sick, or is unfamiliar to them 

Teach students to report any contact with a wild animal or an unfamiliar domestic animal, and to report any bites or scratches from any animal 

If a bite or scratch occurs:

1. Provide first aid to the child; flush the wound with lots of water; clean the wound with soap and water, then rinse it well; refer for medical treatment by or under the direction of a physician
2. If you can, confine the animal; if not, note the size, appearance, and any distinguishing characteristics of the animal.  If available, write down the name, phone number and address of the owner and the events surrounding the bite. If the animal escapes, it is particularly important to get as much information as possible
   
3. Report the bite to the local health department and animal control