DISEASE

• Unexplained fevers. 

• Failure to grow & develop well.

• Enlarged lymph nodes. 

• Swollen salivary glands. 

• Frequent infections, including  diarrhea, thrush, pneumonia.

Blood and body fluids,  sexual intercourse, sharing  needles.  

Not spread through typical  classroom activities, such as  contact with surfaces   touched by infected   individuals.

Practice Standard  Universal Precautions. 

Wear gloves when  handling any body fluids.

Individual case consideration.

• Itchy bites, often in a straight line,  on areas that are exposed during the night. 

• Bites often have red dot in the  middle of raised red bump. 

• Difficult to distinguish from other  insect bites.

NOT spread from person to  person. 

During the daytime bedbugs  do not remain on the  affected person. 

May hide in belongings. Crawl at speed of ladybug.

Provide enough space  between each child’s  belongings so they do not  touch. 

Limit items that travel  back and forth between  home and school.

NO EXCLUSION.

• Diarrhea. 

• Mild abdominal pain. 

• Low grade fever. 

• More severe symptoms may occur  in immunocompromised children.

Fecal-oral route.

Good hand hygiene, using soap and water.

*Alcohol based sanitizers are not effective in killing C difficile spores.

EXCLUDE UNTIL NO DIARRHEA FOR 24 HOURS WITHOUT MEDICATION.

• Fever, runny nose, cough. 

• Itchy red spots that develop into small blisters over 3-4 days which then scab. 

• May be in stages of red bumps, blisters, and scabs at the same time.

Airborne through   respiratory secretion  droplets and/or infected dust  particles. 

Direct contact with blisters or uncovered Shingles rash.

If high fever or severe  illness, consult a physician. 

Surface sanitation and good hand hygiene.

Immunization is the most  effective method for prevention.

EXCLUDE 6 DAYS FROM  APPEARANCE OF RASH AND UNTIL ALL BLISTERS ARE  CRUSTED OVER OR DRY  (SCAB).

• Can be infected and show no symptoms.  If symptoms are present, they are usually mild.

• Fever/chills, cough, shortness of breath or trouble breathing fatigue, muscle/body aches, headache, new loss of taste or smell, sore throat, nasal congestion or runny nose, nausea/vomiting, diarrhea

Respiratory (droplet) route: droplets form when infected person talks, laughs, coughs/sneezes, or sings.  Droplet route is the most common method of transmission.

Airborne route: breathing small particles of virus floating in air.

Contact route: surfaces become contaminated with respiratory/oral secretions and infection is spread by contact with these surfaces (thought to be the least common mode of transmission)

Follow latest CDC guidance

Good hand hygiene

Prevent contact with respiratory secretions

Reduce crowding as much as possible

Increase outdoor time

EXCLUDE IF TEMPERATURE 100o F OR ABOVE AND UNTIL  FEVER FREE FOR 24 HOURS  WITHOUT MEDICATION.

*Defer to current CDC recommendations and the guidance of state and local health departments.

• Most young children do not exhibit any symptoms of infection

• Older children and adults may have a generalized illness with fever

Person-to-person contact with body fluids/secretions

Virus  may remain in the body  throughout a person’s life  without symptoms. 

Virus may be found in  blood, urine or saliva of infected persons with or  without symptoms.

Good hand washing is the  best way to prevent  infection.  

Practice standard precautions.

Avoid the exchange of saliva.  Do not share cups or eating utensils.

Pregnant women should  wash hands after handling  wet diapers or contact with  saliva or urine. They  should notify their  personal physician about  CMV infection.

EXCLUDE IF TEMPERATURE 100o F OR ABOVE AND UNTIL  FEVER FREE FOR 24 HOURS  WITHOUT MEDICATION.

OR MEETS CONDITIONS REQUIRING TEMPORARY  EXCLUSION.*

• Runny or stuffy nose. 

• Sneezing. 

• Sore or scratchy throat. 

• Cough. 

• Watery eyes. 

• Fever. 

• Chills. 

• Headache. 

• Earache.

Respiratory (droplet) route: contact with droplets formed when child talks, coughs, or sneezes

Contact with respiratory secretions from children or objects contaminated by children who carry respiratory viruses

Sanitize/disinfect all surfaces touched by hands frequently.

Good hand washing. 

Prevent contact with  respiratory secretions.

EXCLUDE IF TEMPERATURE 100o F OR ABOVE AND UNTIL  FEVER FREE FOR 24 HOURS  WITHOUT MEDICATION.

• Barky cough (like a seal)

• Hoarse or whispery voice 

• noisy breathing on inspiration (stridor) 

• Runny nose 

• Possible Fever 

• Can lead to respiratory distress which is a medical emergency

Respiratory (droplet) route: contact with droplets formed when child talks, coughs, or sneezes

Contact with respiratory secretions from children or objects contaminated by children who carry respiratory viruses

Good hand hygiene.

Prevent contact with respiratory secretions.

NO EXCLUSION. 

UNLESS  MEETS CONDITIONS REQUIRING TEMPORARY  EXCLUSION.*

CALL 911 IF RESPIRATORY DISTRESS DEVELOPS

• Frequent loose, watery stools. 

• Abdominal cramps and/or  tenderness. 

• Fever. 

• Not feeling well.

Varies with causative agent  or disease.

GOOD PERSONAL  

HYGIENE AND HAND WASHING.

EXCLUDE UNTIL NO  DIARRHEA AND/OR FEVER  FOR 24 HOURS WITHOUT  MEDICATION.

• Pain inside ear 

• Pain when moving earlobe

• Fever. 

• Ear drainage

Ear infections are not contagious and are a complication of a respiratory infection.

Refer to pediatric health professional.

NO EXCLUSION. 

UNLESS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• Temperature 100o F or above taken from any site (axillary, oral, temporal/forehead, tympanic, or rectal) with an appropriate thermometer.

Varies with cause of fever.

Temperature below 100o F, children may stay in  school.

EXCLUDE IF TEMPERATURE  IS 100o F OR ABOVE. 

CHILD MAY RETURN TO  SCHOOL WHEN HE/SHE HAS  BEEN FEVER FREE FOR 24  HOURS WITHOUT  MEDICATION.

Primary Infection:

• Fever. 

• Irritability. 

• Tender, swollen lymph nodes.  

• Blisters on or inside the mouth and  on the gums and lips.  

• Blisters weep clear fluid, bleed and  are slow to scab over.

Subsequent infections occur with presence of blisters and absence of other symptoms.

Direct contact with   contaminated saliva and open sores.

Good hand hygiene. 

Do not touch sores.

Do not share food/drinks.

NO EXCLUSION. 

UNLESS  MEETS CONDITIONS REQUIRING TEMPORARY  EXCLUSION.*

• Fever. 

• Headache. 

• Tired, muscle aches. 

• Red "slapped cheek" appearance. 

• Lace-like rash which spreads from the trunk to the  rest of the body. The rash comes and goes with exposure to heat and can persist for weeks.

Respiratory (droplet) route: Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing.

Contagious 4-14 days before the rash appears.  NO LONGER  CONTAGIOUS ONCE  RASH APPEARS. 

Practice good hand hygiene.

Pregnant employees  should check with their physician if an outbreak occurs at school.

ONLY EXCLUDE FOR FEVER  100o F OR ABOVE, COUGH OR  SORE THROAT. 

OR MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• Sudden onset of fever. 

• Chills. 

• Headache. 

• Muscle or body aches. 

• Sore throat. 

• Nasal congestion. 

• Cough. 

• Croup/bronchiolitis/pneumonia. • Mild pink eye. 

• Abdominal pain. 

• Nausea/Vomiting

Respiratory (droplet) route: Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing. 

Contact with objects   contaminated with   respiratory secretions.

Annual immunization is the most effective method for prevention.  

Good hand hygiene.

Prevent contact with respiratory secretions.

EXCLUDE UNTIL FEVER  FREE FOR 24 HOURS  WITHOUT MEDICATION. 

OR  AS LONG AS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• Signs and symptoms of common  cold. 

• Fever, sore throat, runny nose,  cough. 

• Small sores or blisters in mouth, on  hands, and feet. 

• May be confused with chicken pox in early stages

Respiratory (droplet) route: Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing. 

Contact with objects   contaminated with  respiratory secretions. 

Fecal-oral route.

Practice good hand  hygiene. 

Prevent contact with  respiratory secretions.

NO EXCLUSION. 

UNLESS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• Fever. 

• Loss of appetite. 

• Nausea and/or vomiting. 

• Abdominal discomfort. 

• Fatigue. 

• Dark brown urine. 

• Jaundice (yellowing of the skin  and white of eyes).

Person to person, usually by  fecal-oral route.  

Direct contact, diaper  changing, or food prepared  by infected food handlers.

Consult physician.  

Most contagious 1-2 weeks  before onset of symptoms. 

GOOD HAND HYGIENE.

Clean and disinfect surfaces. 

Immunization is the most effective method for prevention. 

Report to Health  Department.

EXCLUDE. 

PHYSICIAN’S RELEASE  

NECESSARY FOR RETURN TO  SCHOOL.

• Jaundice

• Nausea/vomiting 

• Muscle aches 

• Loss of appetite 

• Fatigue

• Joint pain

Contamination from blood or body fluids of an infected person.  

Sexual contact with an  infected person.  

Often by contaminated   needles and syringes.

Consult physician.  

Immunization is the most effective method for prevention.  

Utilize Standard Precautions

Report to Health  Department.

EXCLUDE IF WEEPING SORES CANNOT BE COVERED

OR 

MEETS CONDITIONS REQUIRING TEMPORARY  EXCLUSION.*

•Small red pimples or blister like sores that develop into yellow crusting skin lesions.  

• Usually around the mouth, nostrils,  hands, elbows, and knees.

Contact with sores of an infected person or contact with contaminated surfaces.

Contagious until treated  with antibiotics or all  lesions are gone. 

LESIONS MUST BE  COVERED.

EXCLUDE UNTIL MEDICAL  TREATMENT IS STARTED.  

PHYSICIAN’S RELEASE  NECESSARY FOR RETURN TO  SCHOOL.

• Adult lice found in hair. 

• Nits (eggs) attached to hair- most easily seen behind ears and at or near nape of the neck. 

• Can affect scalp, body, pubic  areas. 

• Intense itching, irritation,  secondary infections may occur  with scratching.

Direct head to head contact  with infected individuals. 

Less commonly, by contact  with infected articles of  clothing, headgear,   furniture, or bedding.

TREAT WITH A  PEDICULICIDE   SHAMPOO, FOLLOW PRODUCT INSTRUCTIONS- INCLUDING

RETREATMENT AT APPROPRIATE INTERVALS

If initial treatment is unsuccessful, an alternative chemical should be tried.

Discourage activity that causes head-to-head contact.  Avoid sharing clothing/headgear.

Head lice are a nuisance,  not a health hazard.

NO EXCLUSION.

Students should not be sent home for head lice.  Students should be allowed to return to school as soon as over the counter treatment is started.  No doctor’s note should be required.

Education is available through each site nurse.

• Fever. 

• Cough. 

• Runny Nose. 

• Red, watery eye.s 

• Rash at hairline spreading over the  body.

Complications may be serious.

Airborne through   respiratory secretion   droplets and/or infected dust  particles.

Immunization is the most effective method for prevention.

Good hand hygiene.

*A single case of Measles anywhere in the US is considered a reportable outbreak.

EXCLUDE IMMEDIATELY. 

PHYSICIAN’S RELEASE  NECESSARY FOR RETURN TO  SCHOOL. 

Consult with local public health  authorities regarding exclusion of unimmunized/inadequately immunized individuals if case of measles is  documented in the school  population.

• Abrupt onset of fever. 

• Blood red rash. 

• Intense headache. 

• Nausea and/or vomiting. 

• Loss of appetite.  

• Sometimes a stiff neck. 

• Irritability/behavioral changes.  • Sensitivity to bright light. 

• Confusion. 

• Drowsiness.  

• Seizures. 

• Coma.

Respiratory secretions from  children who carry germs  that cause meningitis. 

Contact with objects   contaminated with  respiratory secretions from children who carry germs  that cause meningitis. 

Fecal-oral route.

Consult physician  immediately.  

Can develop over several  hours or take 1-2 days. 

Immunization is the most  effective method for prevention. 

GOOD HAND HYGIENE. PROPER CLEANING OF CONTAMINATED  SURFACES, SUCH AS  HANDLES AND  DOORKNOBS.

EXCLUDE IMMEDIATELY.  

PHYSICIAN’S RELEASE  NECESSARY FOR RETURN TO  SCHOOL.

• Small, flesh colored, dome shaped  bumps on the skin, often with a tiny, hard, indented, seedlike center

Direct person-to-person contact or contact with shared items, such as  clothing, towels, and  washcloths.

Consult physician.  

Contagious period is  unknown. 

GOOD HAND HYGIENE.

Mildly contagious and more commonly spreads to other areas of the affected child’s body

NO EXCLUSION.  

KEEP LESIONS  COVERED AS WELL AS POSSIBLE, ESPECIALLY IN EVENT OF CLOSE SKIN-TO-SKIN CONTACT OR WATER ACTIVITIES.

• Symptoms may be mild or not at  all in younger children. 

• Fever. 

• Sore throat. 

• Swollen lymph glands. 

• Fatigue. 

• Occasional rash. 

• Enlarged liver and spleen.

Close person to person  contact via saliva, i.e. saliva  on hands/toys, or kissing on  the mouth.

Consult Physician. 

Avoid transfer or contact  with saliva. 

Practice good hand hygiene.

NO EXCLUSION. 

UNLESS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• Most cases, swollen glands below  and in front of ears, under jawline.

• Fever. 

• Headache. 

• Earache. 

• Painful swelling of testicles may  occur in teenage males. 

• Abdominal pain due to swelling of  ovaries may occur in teenage  females.

Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing.

Contact with respiratory secretions or objects contaminated with respiratory secretions from infected person.

Immunization is the most  effective method for prevention.

EXCLUDE IMMEDIATELY. 

PHYSICIAN’S RELEASE  NECESSARY FOR RETURN TO  SCHOOL. 

Consult with local public health  authorities regarding exclusion of unimmunized/inadequately immunized individuals if case of measles is  documented in the school  population.

• Red or pink, tearing, swelling,  burning, itching of eye(s).  

• More than a tiny amount of thick  yellow/green discharge from  eye(s).  

• Affected eye(s) may be crusted  shut in the morning. 

• Sensitivity to light. 

• May affect one or both eyes.

Varies with causative agent.

Direct or indirect contact  with eye drainage.

Consult Physician. 

Good handwashing. 

Sanitation of objects  commonly touched. 

Readily communicable in  the classroom.

NO EXCLUSION. 

UNLESS  MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• May have no signs or symptoms.

• Itching and irritation around anal  or vaginal area.

Fecal-oral route.

Shared toys, bedding, clothing, toilet seats.

Consult Physician. 

Good handwashing.

NO EXCLUSION.

• Red rash within a few days of contact

• bumps, red patches or streaking, or weeping blisters (NOTE: fluids in blisters will not cause blisters to spread on affected person or to others.)

• Itching

• Swelling

Direct contact with  plants or oils. 

Indirect contact through contaminated objects.

Inhalation of particles containing oils from burning plants.

Refer to physician if  reaction is severe, or if rash is on face or genitals. 

Reaction may begin in a  few hours to 4 days after  exposure. 

*CALL 911 if person is having severe allergic reactions such as swelling or difficulty breathing

NO EXCLUSION. 

UNLESS MEETS CONDITIONS REQUIRING TEMPORARY  EXCLUSION.*

• Skin of body or feet: Red circular  patches with raised edges and  central clearing, cracking and  peeling of skin between toes. 

• Scalp: Redness and scaling of  infected areas with broken hairs or  patches of hair loss.

Contact with infected  humans/animals or  contaminated surfaces or  objects, such as combs,  brushes, towels, clothing, or  bedding.

Once medication has been  started, the student is no  longer considered  infectious.

EXCLUDE UNTIL TREATMENT IS STARTED.

MUST KEEP COVERED.

• Fever. 

• Severe headache. 

• Nausea/vomiting. 

• Muscle aches. 

• A fine, bumpy, red rash often appears on the extremities including the palms of the hands and soles of the feet, before spreading to other parts of the body.

Transmitted to humans by  the bite of a tick.

Use tick repellant according to directions.

Care should be used in tick  removal. If possible, save  tick. 

Report to Health  Department.

EXCLUDE UNTIL FEVER  FREE FOR 24 HOURS  WITHOUT MEDICATION. 

IF FEVER FREE, NO  EXCLUSION, SINCE DISEASE  IS TRANSMITTED BY TICK  BITE.

• Most commonly occurs in children ages 6-24 months

• High fever (above 103o F) which  lasts 3-7 days, followed by red  rash lasting from hours to days. 

• Seizure may occur due to fever.

• After infection, virus is present in saliva on and off for rest of person’s life.

Respiratory (droplet) route: Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing. 

Saliva from 75% of adults without symptoms contains the infectious virus.

Good Handwashing.

NO EXCLUSION. 

UNLESS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

• Runny nose, congestion, cough 

• Bronchiolitis (wheezing from narrowed airways) 

• Pneumonia

• May lead to asthma attacks in children with asthma diagnoses

Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing.

Contact with respiratory secretions or objects contaminated with respiratory secretions from infected person.

Good hand hygiene.

Prevent contact with respiratory secretions.

Sanitize commonly touched surfaces more frequently during winter and early spring when outbreaks can be expected.

NO EXCLUSION. 

UNLESS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

CALL 911 IF STUDENT IS EXPERIENCING RESPIRATORY DISTRESS OR CYANOSIS

• Slight fever. 

• Red or pink rash appearing first on face then spreading downward. 

• Joint aches. 

• Swollen glands behind ears.

Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing.

Contact with respiratory secretions or objects contaminated with respiratory secretions from infected person.

Consult physician.  

Report to Health  Department.

Immunization is the most  effective method for prevention.

EXCLUDE IMMEDIATELY UNTIL 7 DAYS AFTER APPEARANCE OF RASH. 

PHYSICIAN’S RELEASE  NECESSARY FOR RETURN TO  SCHOOL.

Consult with local public health  authorities regarding exclusion of unimmunized/inadequately immunized individuals if case of measles is  documented in the school  population.

• Intense itching, especially at night. 

• Rash: raised bumps or small  blisters

• Commonly found between the  fingers, toes, around wrists, waistline, elbows, under arms,  underneath the bra line.

Prolonged and close person-to-person contact.

Consult physician. 

Itching may last several weeks after effective treatment.

Launder bedding and clothing worn next to skin during the 3 days prior to the start of treatment in hot water and dry on hot.

Items that cannot be laundered should be placed in plastic bags for at least 4 days.

EXCLUDE UNTIL TREATMENT IS STARTED. 

PHYSICIAN’S RELEASE  NECESSARY FOR RETURN TO  SCHOOL.

• Often asymptomatic in both males  and females.  

• GONORRHEA: May have  burning on urination, yellowish  discharge.  

• SYPHILIS: May include painless  sore or sores at site where organism  entered body.  

• HERPES (HSV): Very  painful sores on or around  genitalia.

All forms by direct personal contact. 

Sexual intercourse.

Consult physician or  

Health Department. 

Communicable for weeks  to years if untreated.

NO EXCLUSION UNLESS  MEDICALLY  RECOMMENDED.

• Loose, watery stools with blood or  mucus. 

• Fever. 

• Headache. 

• Convulsions. 

• Abdominal pain.

Fecal-oral route.

Good hand hygiene. 

Report to Health  Department.

Proper surface disinfection.

EXCLUDE UNTIL RELEASED  BY PHYSICIAN.

• Clusters of red bumps and/or blisters  which may be painful or itchy. 

• Typically in a narrow area along  one side of the body.

Direct by person to person  contact.

Caused by the varicella-zoster (chickenpox) virus.

Good Handwashing. 

Contagious until blisters  are crusted/scabbed over.

NO EXCLUSION. 

UNLESS MEETS CONDITIONS  REQUIRING TEMPORARY  EXCLUSION.*

RASH MUST BE KEPT  COVERED WHILE AT  SCHOOL.

• Skin infection may be red, swollen, painful, warm to touch, full of pus or  

drainage, accompanied by a fever.

• Symptoms depend on the site of infection.

• Carriers have no signs or symptoms.

Skin to skin contact and  contact with surfaces that  have come into contact with  someone else’s infection.

Good Handwashing

Avoid sharing personal items such as dress up clothing.

Cover open sores.

EXCLUDE IF WOUND  

DRAINAGE (PUS) CANNOT BE COVERED WITH A CLEAN  DRY BANDAGE.

Symptoms include some or all of the  following: 

• Fever. 

• Headache. 

• Sore throat. 

• Stomachache. 

• Swollen lymph nodes in neck. • Decreased appetite.  

Diagnosis of strep throat is less likely if  the following occur: 

• Runny nose. 

• Cough. 

• Congestion.

Scarlet fever = A fine red rash caused by a toxin produced by a strep infection. Rash is prominent in armpits and groin area.  Children with scarlet fever are generally not any sicker than those with Strep Throat.

Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing.

Contact with respiratory secretions or objects contaminated with respiratory secretions from infected person.

Good Handwashing. 

Consult physician.

EXCLUDE UNTIL AT LEAST 12 HOURS OF TREATMENT HAS BEEN GIVEN.

• Fatigue. 

• Weight loss. 

• Fever. 

• Night sweats. 

• Chronic cough. 

• Chest pain, and/or coughing up  blood. 

• Growth delay.

Airborne route: Spread by inhalation of  small particles containing bacteria floating in air.

Infection in children is nearly always the results of close contact with an adult who has  active TB.

Consult physician. 

Report to Health  Department.

EXCLUDE THOSE WITH ACTIVE (INFECTIOUS) TB UNTIL RELEASED  BY PHYSICIAN/LOCAL HEALTH OFFICIAL.

CONSULT HEALTH DEPARTMENT REGARDING NEED FOR TESTING OF CLOSE CONTACTS.

• Nausea. 

• Abdominal pain. 

• Diarrhea. 

• Fever.

• Can lead to dehydration

Varies with causative agent  or disease.

Good hand hygiene.

Use Standard Precautions.

EXCLUDE UNTIL NO  VOMITING FOR 24 HOURS  WITHOUT MEDICATION.

• Cold like symptoms.  

• Severe coughing leading to: 

✓ Vomiting while coughing. 

✓ Loss of breath, difficulty  

catching breath. 

✓ Cyanosis (bluish color).  

• High pitched crowing/whooping  sound when breathing in after  

coughing episode. 

• Coughing episodes last for weeks  to months. 

• Fever usually absent or minimal

Respiratory (droplet) route: Contact with respiratory  droplets formed through  talking, sneezing and/or  coughing.

Consult physician. May need preventative antibiotics if exposed.

Good hand hygiene.

Immunization is the most effective method for prevention. 

Report to Health  Department.

EXCLUDE  UNTIL STUDENT ON  ANTIBIOTICS FOR 5 DAYS OR  21 DAYS FROM ONSET IF NOT TREATED WITH ANTIBIOTICS.