Communicable Diseases Signs and Symptoms
For the welfare of all the children in the classroom, please do not send your child to school when she/he is ill and is unable to participate meaning in routine activities at school. Your child needs to stay home if she/he has a productive cough, difficulty breathing, and/or colored nasal discharge. If your child has a rash, with mild symptoms cover with band-aid, if rash is worsening, causing pain, has blisters, or is not healing she/he must have a doctor’s note for readmittance. For vomiting, stay home if vomiting has occurred 2 or more times in 24 hours. For a fever greater than 100.4 stay home until the fever went away over the night without the use of medications such as Tylenol, Advil, or Motrin.
When to Keep Your Child Home from School or Child care
Cuándo no enviar a su hiji a la escuela o a la guardería
Please report any confirmed communicable diseases to your child's school.
We appreciate your help in preventing the spread of disease and in keeping our children healthy, well and ready to learn. If you have further questions about the diseases discussed below or need further assistance, please call Ventura County Public Health at 805-981-5221 or your family physician.
See below the most common communicable diseases:
- Chicken Pox
- Fifth Disease
- Hand, Foot and Mouth Disease
- Hepatitis A
- Impetigo
- Mononucleosis
- Mumps
- Pink Eye - Conjunctivitis
- Pinworm
- Ringworm
- Scabies
- Strep and Scarlet Fever
- Whooping Cough (Pertussis)
Chicken Pox
Chicken Pox is a very contagious disease caused by the varicella-zoster virus. The virus spreads easily from people with chickenpox to others who have never had the disease or been vaccinated. The virus spreads mainly by touching or breathing in the virus particles that come from chickenpox blisters, and possibly through tiny droplets from infected people that get into the air after they breathe or talk.
Mode of Transmission: A person with chickenpox can spread the disease from 1 or 2 days before they get the rash until all their chickenpox blisters have formed scabs (usually 5-7 days.)
Signs or Symptoms: Before the chickenpox blisters appear, a slight fever, headache, not feeling well, loss of appetite are symptoms, then a red rash that begins on the chest, back, and face will appear.
Prevention: The best prevention is receiving the chickenpox (varicella) vaccination.
Please keep your child home until all the chickenpox blisters have scabbed.
If your child has been vaccinated for Chickenpox, it is unlikely that he/she will contract the virus.
If your child is immunosuppressed; has eczema; has asthma and is on oral prednisone; has leukemia or malignancies, we advise you to consult with your physician or the Ventura County Health Department.
EXCLUSION FROM ATTENDANCE: Until all lesions are completely crusted and no new lesions (approximately 6 days).
Fifth Disease
The symptoms of fifth disease are usually mild and may include: fever, runny nose, headache, rash
Transmission:Parvovirus B19—which causes fifth disease—spreads through respiratory secretions, such as saliva, sputum, or nasal mucus, when an infected person coughs or sneezes. You are most contagious when it seems like you have “just a fever and/or cold” and before you get the rash or joint pain and swelling. After you get the rash you are not likely to be contagious, so then it is usually safe for you or your child to go back to work or school.
People with fifth disease who have weakened immune systems may be contagious for a longer amount of time.
Parvovirus B19 can also spread through blood or blood products. A pregnant woman who is infected with parvovirus B19 can pass the virus to her baby.
Once you recover from fifth disease, you develop immunity that generally protects you from parvovirus B19 infection in the future.
Prevention: There is no vaccine or medicine that can prevent parvovirus B19 infection. You can reduce your chance of being infected or infecting others by:
Treatment: Fifth disease is usually mild and will go away on its own. Children and adults who are otherwise healthy usually recover completely. Treatment usually involves relieving symptoms, such as fever, itching, and joint pain and swelling.
People who have complications from fifth disease should see their healthcare provider for medical treatment.
EXCLUSION FROM ATTENDANCE: If there is a rash a physician's note is required to state that child is not contagious, otherwise no exlusion.
- washing your hands often with soap and water
- covering your mouth and nose when you cough or sneeze
- not touching your eyes, nose, or mouth
- avoiding close contact with people who are sick
- staying home when you are sick
Hand, Foot and Mouth Disease
CLINICAL MANIFESTATIONS
The most common presentation is nonspecific fever with a sudden onset, sore throat and oral blisters on the cheeks, gums and sides of the tongue. These lesions may persist from 7 to 10 days and also occur commonly as a rash, especially on the palms and soles; occasionally they appear on the buttocks.
OCCURRENCE
Probably throughout the world, both sporadically and in epidemics; greatest incidence is in summer and early autumn; occurs mainly in children under 10 years, but adult cases are not unusual. These diseases frequently occur in outbreaks among groups of children in nursery schools child-care centers, etc.
MODE OF TRANSMISSION
Direct contact with nose and throat discharges and feces of infected persons (who may be asymptomatic) and by droplet spread, but no reliable evidence of spread by insects, water food or sewage.
INCUBATION PERIOD
Usually 3 to 5 days
PERIOD OF COMMUNICABILITY
During the acute stage of illness and perhaps longer, since these viruses persist in stools for several weeks.
CONTROL MEASURES
Treatment: none
Isolation: none
Concurrent disinfection: of nose and throat discharges, feces and soiled articles.
Investigation of contacts and source of infection: of no practical value except to detect other cases in groups of pre-school children.
Particular attention should be given to hand washing and personal hygiene, especially after diaper changing.
EXCLUSION FROM ATTENDANCE: Generally not required if able to participate as usual, unless fever than, exclude until fever free for 24 hours.
Hepatitis A
Hepatitis A infection is caused by the hepatitis A virus. Hepatitis A virus is passed in the stool of infected persons.
Common Symptoms: Children infected with hepatitis A virus often have no symptoms. Most adults have symptoms that develop over several days. Symptoms include: fever, tiredness, loss of appetite, nausea, and jaundice.
Mode of Transmission: Hepatitis A virus is usually spread from person to person. People get hepatitis A infection by putting something in the mouth that has been contaminated with stool of an infected person. The virus is not spread by casual contact, as in the usual work or school setting.
Incubation Period: Average 28-30 days (range 15-50 days)
Method of Control: To prevent person-to-person spread, good personal hygiene and proper sanitation are important. Always wash hands with soap and warm water after using the toilet and changing a diaper and before eating or preparing food.
EXCLUSION FROM ATTENDANCE: Until seven days after onset of illness & until jaudice (if present) has disappeared.
Impetigo
What is Impetigo: Impetigo is a very common and contagious skin disease characterized by fluid-filled blisters or red pimples that may become crusted. It is seen primarily in infants and children.
They are most commonly found on the face, but may be anywhere on the body. Impetigo is caused by a bacterial infection. Streptococcal bacteria and Staphylococcus aureus are the most common cause of impetigo.
How Impetigo is spread: It is spread primarily through direct contact, although it can be transmitted through a contaminated surface. Germs enter through a break in the skin (e.g., insect bite, a cut, a burn). Contamination lasts until all skin lesions are dry and healed, or child has been on antibiotics for 24 hours.
Treatment: Although impetigo usually heals spontaneously within two weeks without scarring, treatment helps relieve discomfort, improve cosmetic appearance, and prevent the spread of bacteria that may cause other illnesses. There are two ways to treat impetigo:
1. Topical treatment with antibiotic ointment or cream when it is not widespread. (eg. Mupirocin/Bactroban or Retapamulin/Altabax/Altargo, or Fusidic Acid/Fucidin).
2. Oral antibiotics, including: penicillin, amoxicillin/clavulanate, cephalosporins, and macrolides.
Patients need to be encouraged to complete the entire course of antibiotics, as prescribed by the physician, even if the lesions have gone away. If lesions do not go away with treatment, sometimes they are swabbed and then cultured to identify the type of bacteria, and new treatments are started.
EXCLUSION FROM ATTENDANCE: 24-48 hourse of effective therapy and fever free for 24 hours.
Mononucleosis
Mononucleosis called mono for short is caused by the Epstein-Barr Virus (EBV).
Common Symptoms: Mono almost always causes the feeling of being really tired, but other symptoms are fever, sore throat, headaches, sore muscles, and swollen lymph glands. Sometimes, it may seem like the flu or maybe strep throat because the symptoms are so much alike. The only way to tell for sure if you have mono is to go to a doctor, who will examine and draw blood for tests.
Mode of Transmissions: Mono is contagious, person-to-person contact via saliva. Coughing (while not covering your mouth) on someone or sharing pillows, straws, toothbrushes, or food from the same plate can also spread mono.
Method of Control: Using hygienic measures including hand washing to avoid salivary contamination from infected individuals; avoid drinking beverages from a common container to minimize contact with salvia. There is no vaccine for the Epstein-Barr Virus, but you can try to prevent your child from getting mono by making sure that he or she avoids close contact with other kids who have it.
EXCLUSION FROM ATTENDANCE: Until fever free for 24 hours
Mumps
Mumps is an acute viral disease characterized by fever, swelling, and tenderness of one or more of the salivary glands.
Who gets mumps? Although older people may contract the disease, mumps usually occurs in children between the ages of five and 15. Mumps occurs less regularly than other common childhood communicable diseases. The greatest risk of infection occurs among older children. Mumps is more common during winter and spring.
How is mumps spread? Mumps is transmitted by direct contact with saliva and discharges from the nose and throat of infected individuals.
What are the symptoms of mumps? Symptoms of mumps include fever, swelling, and tenderness of one or more of the salivary glands, usually the parotid gland (located just below the front of the ear). Approximately one-third of infected people do not exhibit symptoms.
When and for how long is a person able to spread mumps? Mumps is contagious three days prior to and four days after the onset of symptoms.
What can be done to prevent the spread of mumps? The single most effective control measure is maintaining the highest possible level of immunization in the community.
EXCLUSION FROM ATTENDANCE: Until five days past onset of parotid swelling.
Pink Eye - Conjunctivitis
This is a contagious eye infection frequently seen in school age children effecting one or both eyes.
Common symptoms: Are tearing, irritation and puffiness of the mucus membrane that line the eye lid and also extend over the "white" of the eye.
Mode of Transmission: By the eye drainage and by touching (person to person).
Cause: bacteria or virus
Note: a non-infectious conjunctivitis is caused by allergy and does not need exclusion.
Incubation Period: varies - 1-12 days
Period of Communicability: - continues during active infection.
Control measures: Close observation for any eye irritation. Frequent hand washing.
EXCLUSION FROM ATTENDANCE: Until asymptomatic or readmit with a note from physician, usually at least 24 hours of effective therapy.
Pinworm
Pinworm is a small, thin, white roundworm, the size of a staple, that sometimes lives in the colon or rectum of humans. While an infected person sleeps, female pinworms leave the intestine through the anus and deposit their eggs on the surrounding skin.
Symptoms: Causes itching around the rectal area.
Mode of Transmission: Infection is spread by the fecal-oral route, that is by the transfer of infective pinworm eggs from the anus to someone's mouth, either directly by hand or indirectly through contaminated clothing, bedding, food, or other articles. It is usually spread by school children who don't wash their hands properly after using the toilet.
Prevention & Control: Washing hands with soap and warm water after using the toilet, changing diapers, and before handling food.
EXCLUSION FROM ATTENDANCE: Until treated
Ringworm
Ringworm is not a worm. It is a shallow infection of the skin caused by a fungus. It may be ring-shaped.
The incubation period is 10 to 14 days. It is spread as long as the lesions are present and are not being treated by proper medication.
Ringworm of the skin: Red, flat ringshaped patch that may be moist and crusty, or dry and scaly. It may spread outward and leave a central clear area.
Ringworm of the scalp: Begins as a small patch and spreads to make a scaly ring of temporary baldness. The hair becomes brittle and breaks off easily.
The child is excluded from school until a doctor’s note indicates that he/she has been treated. Upon return to school, ringworm on exposed parts of the body should be covered with a small dressing/bandaid.
EXCLUSION FROM ATTENDANCE: Until treatment started (on exposed body part), cover lesions.
Scabies
What is scabies?
Scabies is an infectious disease of the skin caused by mites. The mites burrow under the skin and lay eggs making a raised rash. This rash is frequently located on the fingers, wrists, thighs, feet, abdomen or around the sex organs. Intense itching occurs, especially at night. Scratching the rash can lead to infections.
How do you get Scabies?
The mites are passed by close contact with another person who has scabies or by contact with sheets or clothes contaminated by another infected person. Several days or even weeks may pass before you notice any itching.
How do you get rid of scabies?
See your physician for medication. Take a hot bath at night before going to bed and dry your body thoroughly. Then apply the prescribed medication (usually Kwell) to all skin areas from the chin down, including the toes. The lotion should be applied generously and worked into the skin, particularly hairy areas. Take another bath the next day and change into clean clothes. Air the mattress, change the sheets and pillowcases on your bed.
Clothing and all bedding, including blankets and bedspreads should be laundered in very hot water for at least five minutes. Non-washable clothing or bedding should be dry–cleaned. Lotion may be used again in three days if you are still itching or as recommended by your doctor.
What can be done to prevent re-infestation?
Take a bath and change underclothing daily. If you notice a rash on your body, go to a doctor or a clinic right away to prevent it from spreading to other people.
EXCLUSION FROM ATTENDANCE: Until treatment is completed.
Strep and Scarlet Fever
Cause and Definition:
Characteristic:
Strep Throat
Scarlet Fever
Incubations/Contagion:
Mode of Transmission & Control:
EXCLUSION FROM ATTENDANCE: Until on treatment for 24 hours.
- Strep throat and scarlet fever are both caused by Group A Streptococcus bacteria
- Children with scarlet fever have a fine “sandpaper” feeling red rash, but are not any sicker than children with strep throat who do not have the rash.
- A throat culture (or rapid strep test) is necessary to be certain of the diagnosis of strep throat.
- About 5-10% of people carry Strep in their nose and throat all the time and are not ill
- During outbreaks, up to half of children without illness may have Strep in their throat cultures.
- If untreated, most children and adults get better on their own. Some develop another infection (ear infection, sinusitis, abscess of the tonsils). Rheumatic heart disease or kidney complications are rare, but possible, after a Strep infection.
- Sore throat
- Fever
- Stomachache / Decreased appetite
- Swollen lymph nodes in neck
- Above symptoms may be present, or scarlet fever can be associated with a streptococcal infection in a part of the body that is not the throat.
- Rash feels like find sandpaper.
- Rash may be most prominent in armpits, groin area, creases in bend of elbow and knees
- Once infected, it takes 2-5 days to get symptoms
- Although during outbreaks, up to half of people without illness may have Strep in their throat cultures, they are not likely to spread the infection and are not considered contagious.
- Once started on antibiotics, risk of contagion is minimal for those who are ill.
- Spread by direct contact with nose and throat fluids
- Spread by respiratory droplets that are passed by coughing and sneezing
- Close contact helps spread the infection.
Whooping Cough (Pertussis)
Whooping cough, is an acute infectious disease caused by the bacterium Bordetella pertussis.
Common symptoms: The initial phase has a slow onset with an irritating cough that gradually becomes a repeated violent cough, usually with 1-2 weeks and lasts for 1-2 months or longer. Highly contagious in the early stages, the child is no longer contagious after 5 days of treatment.
Mode of Transmission: Direct contact with discharges from respirator mucous membranes of infected persons by the airborne route (coughing).
Incubation Period: Average 9-10 days
Period of Communicability: Highly communicable in the early phase and at the beginning of the paroxysmal cough stage (first 2 weeks). The child is no longer contagious after 5 days of treatment.
Methods of control: Immunization is the most rational approach to pertussis (whooping cough) control.
EXCLUSION FROM ATTENDANCE: Until five days after appropriate antibiotics or 21 days after cough onset. Physician note required to return.