Suspicion of any communicable disease requires the student to be sent home. All communicable diseases should be reported to the school nurse within 24 hours by the parents. Generally, the recovery time is as follows, but each case should be cleared by the family physician. Students must be fever free for 24 hours and feeling better before returning to school.
- Chicken Pox
- Fifith Disease
- Streptococcal Throat Infections
- Head Lice
- Lyme Disease
CHICKEN POX (VARICELLA)
This usually mild viral infectious disease, most commonly occurs in early school age children and is characterized by:
General feeling of illness – Headache, muscle ache, malaise, or chills may occur the first day or two.
Low grade fever – Fever may develop as the skin rash develops over the first few days.
Skin Rash – Groups of spots can spread almost anywhere on the body. Spots quickly change to fluid filled pustules, then to crusts. New crops of spots continue to break out so that at the height of the rash, red spots, pustules, and crust can appear in the same area. Because chicken pox can be serious, you should always consult your physician if you suspect it.
The usual incubation period is from 10 to 21 days after exposure. When the final lesions have crusted, the child can no longer transmit the disease. Children should remain home until visible lesions have crusted, usually 5 to 6 days.
Chicken pox is a common childhood disease, which can result in:
Secondary infection – Pustules can become infected as a result of excessive scratching. Consult your physician or pharmacist for ways to minimize scratching (which can cause scarring).
Shingles – Subsequent rash caused by the chicken pox virus that may manifest itself as nerve pain and skin rash.
Varicella is highly contagious from the day before spots appear until no new lesions have appeared for 24 to 48 hours, and all spots are scabbed or crusted over (about six days later). The virus is spread by respiratory droplets, or by direct contact with pustule fluid. Infected persons should be isolated from infants, pregnant women, children taking steroid drugs or who have a chronic disease, and from any immune suppressed persons. These at risk individuals should consult their physician immediately if they are exposed to chickenpox.
Your physician or pharmacist is your best resource for chicken pox treatment information. His or her recommendations may include:
Bathing with natural colloidal oatmeal bath treatments to help ease skin discomfort. For additional itch relief, topical products (anti-itch cream and concentrated lotions) can be used or oral antihistamines may be purchased.
To minimize risk of infection by scratching, trim the child’s fingernails and keep him or her comfortable and occupied. Encourage rest and plenty of fluids.
FIFTH DISEASE (ERYTHEMA INFECTIOSUM)
An acute viral disease characterized by mild constitutional symptoms and a blotchy or maculopapular rash beginning on the cheeks and spreading to the exposed areas of the extremities.
ETIOLOGY AND EPIDEMIOLOGY:
The disease is caused by the recently discovered human parvovirus B19 agent. It occurs most often during the spring months, and localized outbreaks among children and adolescents are common. Parvovirus B19 is now also recognized as the primary cause of aplastic crisis in clients with chronic hemolytic disorders, such as sickle cell disease. Spread is thought to be usually by the respiratory route and inapparent infection can occur.
SYMPTOMS AND SIGNS:
The incubation period is 4 to 12 days. Signs and symptoms can vary among different individuals. In “classic” cases, manifestations are low-grade fever, slight malaise, and an indurated, confluent erythema over the cheeks (“slapped face” appearance). Within 1 to 2 days a symmetric eruption appears that is most prominent on the arms, legs, and trunk, usually sparing the palms and soles. The rash is maculopapular, tending toward confluence, it forms slightly blotchy areas and reticular or lacy patterns, usually most prominent on the exposed areas of the arms. The duration of illness is usually 5 to 10 days, but the eruption may recur for several weeks afterwards, exacerbated by sunlight, exercise, heat, fever, or emotional stress. Mild joint pain and swelling are sometimes observed in adults with this disease.
DIAGNOSIS AND TREATMENT:
The appearance and pattern of spread of the rash are the only diagnostic features, however, such a diagnosis must be made with caution, since rubella and some entero-viruses have been known to mimic this disease. If there is any doubt, rubella infection should be ruled out by serologic testing, therefore, persons with any such concerns should consult their physician immediately.
Only symptomatic treatment is necessary (antihistamine and non-aspirin pain relievers, with use of cool compresses).
Fifth Disease is most contagious prior to the onset of illness and is unlikely to be infectious after onset.
STREPTOCOCCAL THROAT INFECTIONS
An acute bacterial infectious disease spread by direct contact and airborne droplet infections.
Sore throat, fever, red swollen pharynx, and/or tonsillar exudate are typical symptoms. Some patients are asymptomatic, have fever or mild sore throat alone, or have nonspecific symptoms such as headache, malaise, nausea, stomachache, or vomiting. Immediate examination by a physician is necessary to determine the cause of the symptoms.
A positive quick strep test or a positive throat culture incubated for 24 hours.
1. The prescribed antibiotic should be taken for the full number of days as directed by the child’s physician. (Untreated strep infection may cause rheumatic disease or kidney infection.)
2. Symptomatic treatment includes drinking of fluids, warm salt water gargles, use of lozenges, and use of non-aspirin pain relievers.
Student needs to be on the antibiotic for 24 hours and be without a fever for a full 24 hours before returning to school.
HEAD LICE (PEDICULOSIS)
The head louse is a small wingless, brownish-gray insect approximately 1-2 mm long. The average life span of the louse is one month. Lice eggs or nits, are silvery-white, tear shaped spheres each: “glued” to an individual hair strand. The nymph hatches in 8-10 days and matures in about three weeks. Lice feed on human blood, and require body warmth to live. They will lay eggs only on a human host. Dogs and cats do not harbor lice.
MODE OF TRANSMISSION:
a. Direct head to head contact with infected person(s).
b. Contact with common articles, which may be harboring lice, looking for a new host, (combs, brushes, hats, scarves, coats, sports headgear, towels, bed linens, etc.).
SIGNS AND SYMPTOMS:
A. Unusual scratching of the head accompanied by redness around the nape of the
neck and ears.
B. Secondary infections occur from scratching wounds
C. Identification of lice or nits on the head.
D. Identification of viable nits found within ¼ inch of the scalp. These may resemble
dandruff but are oval and firmly attached to the hair shafts.
PREVENTION AND CONTROL:
Prompt treatment of infested individuals with a recommended pediculicide used according to label directions. Your physician may be consulted for an over the counter shampoo(pediculicide). Shampoo treatment should be followed by combing of the hair with a fine tooth comb to remove the remaining nits. Pediculicides now on the market are effective in killing lice and most of the eggs. Over treatment should be guarded against. One shampoo washing, followed by another may be recommended in eight days to insure adequate treatment of any remaining viable eggs.
CARE OF CONTAMINATED ARTICLES:
A. Machine-wash all clothing and linens in hot water and detergent. Dry at hottest temperatures for 20 minutes.
B. Change all linen (e.g. sheets, pillowcases, etc.) and vacuum mattresses, pillows can be put in a hot dryer for half an hour, vacuum upholstered surfaces, carpets, car and throw pillows. Dispose of vacuum bags. Dry clean non-washables. Articles may also be sealed in plastic bags for 2 weeks. Pediculicide sprays are also available. Also hot wash and dry the drawer before returning these clothes to the same drawer.
C. Wash combs and brushes with a pediculicide or cook in hot water on the stove for 5 to 10 minutes at 150 degrees. Hair clips headbands and small headwear can be placed in a plastic bag and left in a freezer for three days. Use new combs and brushes, or microwave old ones, which do not have metal clips, for two minutes.
D. Either place stuffed animals in a hot dryer for half an hour or put them in a plastic bag, sealed for one month.
Parents/Guardians are requested to send a written note to the School Nurse documenting the date of the shampoo treatments and the name of the shampoo utilized when the child returns to school following the initial shampoo treatment.
Lyme Disease is an illness caused by the Borrelia Burgdorferi Spirockete bacteria, and transmitted to humans through the bite of a deer tick. The tiny deer tick clings to vegetation and mammals in grasslands and wooded areas in order to feed on the host’s blood. In the Northeast, the deer tick is most active from April through October. Personal protection strategies should be followed carefully during the late Spring, Summer and early Fall.
A. Stage I:
In over 50% of cases, a characteristic “bull’s eye” rash appears around the bite two days to two weeks after the tick bite, though rashes do occur on other body areas as well. Other symptoms include, fever, chills, headache, muscle aches, swollen glands, and fatigue.
IF YOU HAVE ANY OF THESE SYMPTOMS, CALL YOUR PHYSICIAN IMMEDIATELY.
B. Stage II:
Untreated Lyme Disease may cause heart problems (palpitations and mild shortness of breath) and nervous system problems (headaches, difficulty concentrating, memory loss, muscle weakness, and painful joints).
C. Stage III:
Chronic severe arthritis and chronic nervous system disabilities.
DIAGNOSIS AND TREATMENT:
· When in tick infested areas, you should wear light colored clothing so that you can see a tick more easily.
· Wear long sleeve shirt with a collar and snug cuffs.
· Tuck long pants into socks.
· Wear closed toe shoes.
· Wear a hat.
· Apply insect repellant on clothes.
· Carefully use repellants containing DEET on exposed skin.
· Inspect the body thoroughly and carefully remove any attached tick.
· Check all pets for ticks. Consult your Veterinarian if you suspect infection in an animal.
CONSULT WITH YOUR PHYSICIAN IMMEDIATELY IF YOU HAVE ANY ATTACHED TICKS OR HAVE ANY SYMPTOMS OF LYME DISEASE.
A skin infection caused by the staph or strep bacteria. These bacteria can live on the skin and can cause an infection if they invade a cut, rash, bite, chicken pox or other break in the skin.
The area can begin as a reddish circle. Spots change to fluid filled pustules, then form honey colored crusts. New sores and swollen glands develop nearby. Itching is common and scratching may spread the infection.
DIAGNOSIS AND TREATMENT:
Diagnosis is usually based on clinical findings.
- Treatment includes washing with an antibacterial soap three times a day, followed by the application of an antibacterial ointment.
- An oral antibiotic may be prescribed by your pediatrician.
- Keep fingernails short to reduce the risk of spreading the infection to other parts of the body and to other people.
- The child can return to school when the lesions are dry and scabbed over.