Infectious Disease Control Guide for School Staff

1 Randy I. Dorn State Superintendent Office of Superintendent of Public Instruction Old Capitol Building Box 47200 Olympia, WA 98504-7200 Infectious Disease Control Guide for School Staff 2014 Student Support Dan Newell, Assistant Superintendent of Secondary Education and Student Support Prepared by: Gayle Thronson, Former Program Supervisor, Health Services, Office of Superintendent of Public Instruction Gail Park Fast, RN, MN, NCSN, School Nurse Corps Administrator, Educational Service District 105 Lorali Gray, RN, BSN, MEd, NCSN, School Nurse Corps Administrator, Educational Service District 189 Acknowledgements The following agencies and organizations provided comments and revised text for the 2012 revision of the Infectious Disease Control Guide for School Staff .

2 Nancy Bernard, BA, BS, MPH School Environmental Health and Safety Program Manager Washington State Department of Health John Corrales-Diaz, MD Chief of Pediatrics, Harrison Medical Center, Bremerton, WA School Health Liaison Washington Chapter, American Academy of Pediatrics Medical Consultant to South Kitsap School District Charla (Chas) DeBolt, RN, MPH Senior Epidemiologist Washington State Department of Health Laurie Dils, MSW Personal Responsibility Education Program (PREP) Coordinator Washington State Office of Superintendent of Public Instruction Gini Gobeske, RN, MSN Community Health Nurse II, Communicable Disease Program Tacoma Pierce County Health Department Marcia Goldoft, , Washington State Department of Health Communicable Disease Epidemiology Margaret Hansen, BA Coordinated School Health Manager Washington State Department of Health David Heal, MSW, LCSW HIV Service Delivery Coordinator Washington State Department of Health Suzanne Hidde, MS Program Supervisor, HIV and Sexual Health Education Washington State Office of Superintendent of Public Instruction Stacia E.

3 Hollar, BA, JD Director of Policy and Legal Services Washington State School Directors AssociationOSPI Infectious Disease Control Guide for School Staff ii Acknowledgements (continued) Sara Hoover Loss Control Consultant Washington State Risk Management Pool Kathleen H. Johnson, DNP, MN, RN-BC, NCSN Interim Health Services Supervisor Washington State Office of Superintendent of Public Instruction Mary Sue Linville, ARM-P Director Washington State Risk Management Pool Lois Lux, RN, MSN Communicable Diseases Tacoma Pierce County Health Department Alma McNamee, RN, BSN, MSHCA Team Leader, School Nurse Corps Educational Service District 101 School Nurse Organization of Washington Laurie Moyer, RN, MSN Health Services Coordinator Spokane School District Nealeen (Skitch)

4 Stanton, RN, BSN School Nurse Bickleton and Grandview School Districts Jon Stockton, BA HIV Counseling, Testing, and Referral Coordinator Washington State Department of Health Nancy Zaneski, RN, BSN Lead School Nurse Mukilteo School District Lin Watson RN, MSN CDC Sr. Public Health Advisor Washington Department of Health Office of Immunization and Child Profile Gratitude is also expressed to the School nurses, local health jurisdictions, Washington State Department of Health Staff members, licensed health care providers, and others who assisted in the review and updates of this Infectious Disease Control Guide for School Staff iii Table of Contents Acknowledgements .. i Acronyms .. vi Introduction.

5 1 Disease Reporting, Control , and Exclusion .. 3 General Considerations .. 5 Common Indicators of Infectious Diseases in Children .. 6 Athlete s Foot (Tinea Pedis) .. 9 Bed Bugs .. 11 Bites .. 13 Animal Bites .. 13 Human Bites .. 17 Chickenpox (Varicella) .. 19 Clostridium Difficile Infections (C. diffficile, CDI) .. 22 Common Cold .. 25 Conjunctivitis (Pink Eye) .. 27 Cytomegalovirus Infection (CMV) .. 30 Diarrhea .. 32 Diphtheria .. 36 Fifth Disease (Erythema Infectiosum) .. 38 Foodborne Disease .. 41 Hand, Foot, and Mouth Disease (HFMD) .. 45 Hepatitis .. 47 Viral Hepatitis A (HAV) .. 47 Viral Hepatitis B (HBV) .. 50 Viral Hepatitis C (HCV) .. 53 Herpes Simplex Virus, Oral Area (Cold Sores,Gladiatorum).

6 56 Herpes Zoster (Shingles) .. 59 Human Immunodeficiency Virus (HIV) .. 61 Impetigo .. 64 Infectious Mononucleosis (Mono) .. 66 Influenza (Flu) .. 68 Lice (Pediculosis) .. 71 OSPI Infectious Disease Control Guide for School Staff iv Table of Contents (cont.) Body Lice (Pediculosis humanus corporis) .. 71 Crab Lice (Pediculosis humanus pubis) .. 73 Head Lice (Pediculosis humanus capitus) .. 75 Measles .. 79 Meningitis .. 82 Methicillin Resistant Staphylococcus Aureous (MRSA) .. 85 Molluscum Contagiosum .. 89 Mosquito-borne Illness .. 92 Mumps .. 94 Norovirus (Norwalk-like Viruses) .. 96 Pertussis (Whooping Cough) .. 99 Pinworms .. 102 Poliomyelitis (Polio) .. 104 Ringworm (Tinea) .. 106 Rubella (Three-Day Measles).

7 108 Scabies .. 110 Sexually Transmitted Infections (STI) .. 113 Chlamydia .. 114 Gonorrhea (Clap, Strain, Dose) .. 116 Herpes Simplex Virus, Genital Area .. 118 Human Papillomavirus (HPV, Genital Warts) .. 120 Non-Gonococcal Urethritis (NGU) .. 122 Syphilis .. 124 Trichomoniasis ( Trich ) .. 126 Vaginitis .. 128 Smallpox .. 130 Streptococcal (Sore Throat, Scarlet Fever, Necrotizing Fasciitis) .. 133 Tetanus (Lockjaw) .. 136 Ticks .. 138 Tuberculosis (TB) .. 141 Warts (Verrucae) .. 144 APPENDIX I .. 146 Index .. 224 OSPI Infectious Disease Control Guide for School Staff v Acronyms CDC Centers for Disease Control and Prevention CDI Clostridium Difficile Infections CMV Cytomegalovirus Infection DOH Washington State Department of Health DOSH Division of Occupational Safety and Health DT Diphtheria/Tetanus DTaP Diphtheria/Tetanus/Acellular Pertussis vaccine DTP Diphtheria/Tetanus/Pertussis vaccine ESD Educational Service District HAV Hepatitis A Virus HBIG Hepatitis B Immune Globulin HBV Hepatitis B Virus HCV Hepatitis C Virus HFMD Hand.

8 Foot and Mouth Disease HIV Human Immunodeficiency Virus HSV Herpes Simplex Virus HPV Human Papilloma Virus ICP Infection Control Program IDRH Infectious Disease and Reproductive Health LHJ Local Health Jurisdiction MMR Measles, Mumps, and Rubella Vaccine MRSA Methicillin Resistant Staphylococcus Aureous NGU Non-Gonococcal Urethritis OSPI Office of Superintendent of Public Instruction OSPI Infectious Disease Control Guide for School Staff vi PPE Personal Protective Equipment RCW Revised Code of Washington STI Sexually Transmitted Infection TB Tuberculosis Td Tetanus/Diphtheria Tdap Tetanus/ Diphtheria/Acellular Pertussis vaccine VZIG Varicella-Zoster Immune Globulin WAC Washington Administrative Code OSPI Infectious Disease Control Guide for School Staff vii Introduction This material is provided to schools in the state of Washington to assist district Staff members in their efforts to

9 Preserve and protect the health of both students and employees. Infectious diseases are very common in the School -age child. Because several of the diseases addressed in this manual are vaccine-preventable, it is expected that their incidence in the state will be reduced with the continued implementation of the Washington State immunization law (RCW , see Appendix I) School districts should always refer to the most updated version of the specific law or regulation on the Department of Health (DOH) Web site. The following pages contain guidelines for the Control and reporting of diseases in the School -age population and among Staff members of schools in the state of Washington. Because the authority for Control of diseases of public health significance lies with local health jurisdictions, schools should consult with their local health jurisdiction for guidance regarding specific measures to be used in handling individual cases or outbreaks of Disease .

10 A number of diseases, although contagious, are not covered in this Guide because they are not often seen in School or in people of School age. For some conditions, we have included information on the effects that childhood diseases could have on adults when those effects are unusual or particularly serious in adults. Examples include chickenpox, cytomegalovirus, Fifth Disease , measles, mumps, and rubella. Otherwise, this Guide is not intended to be inclusive of adult/employee illness or Disease . RCW Contagious Diseases, Limiting Contact Rules and Regulations ( ) requires the State Board of Health, in consultation with the Superintendent of Public Instruction (OSPI), to adopt rules and regulations regarding the presence of persons on or about any School premises who have, or who have been exposed to, contagious diseases deemed by the State Board of Health as dangerous to the public health (see Appendix II).