COMMUNICABLE DISEASE CONTROL



COMMUNICABLE DISEASE CONTROL

07/2012

Legislative Background

Communicable diseases, the leading cause of childhood morbidity, are easily transmitted in the school environment. Control measures include: immunizations, sanitation, tuberculosis surveillance, mass prophylaxis and treatment, isolation, and quarantine. School Nurse are responsible for the detection, notification, exclusion, referral for treatment, follow-up, and reporting of communicable diseases.

Education Law Article 19, Section 906 requires the exclusion from school of students who, upon investigation, show symptoms of any contagious or infectious disease reportable under the Public Health Law. The School Physician or School Nurse may examine any student returning to a school without a certificate from the public health officer of the city or town or the student’s health care provider after absences due to illness or from unknown cause. The School Physician or School Nurse may examine or evaluate District employees when in their opinion such evaluations are necessary to protect the health of the school population.

Control Guidelines

Guidelines for the control of select communicable diseases in school settings have been issued by the New York State Department of Health and the New York State Education Department. Decisions regarding various control measures are best made by consultation between the Bureau of Health and Physical Education and the Albany County Health Department

Though the primary responsibility for reporting communicable disease rests with the physician, School Nurses are required by Law (10NYCRR 2/10) to report to the Health Department any incidence of the diseases listed below.

Those in bold must be reported immediately.

Amebiasis

Animal Bites (for which rabies prophylaxis is given)

Anthrax

Arboviral Infection

Babesiosis

Botulism

Brucellosis

Campylobacteriosis

Chancroid

Chlamydia Trachomatis

Cholera

Cryptosporidiosis

Cyclosporiasis

Diptheria

E. Coli

Ehrlichiosis

Encephalitis

Foodborne Illness

Giardiasis

Glanders

Gonococcal Infection

Haemophilus Influenzae

Hantavirus Disease

Hemolytic Uremic Syndrome

Hepatitis A

Hepatitis A (in a Food Handler)

Hepatitis B, C

Pregnant Hepatitis B Carrier

Legionellosis

Listeriosis

Lyme Disease

Lymphogranuloma Venereum

Maleria

Measles

Melioidosis

Meningitis

Haemophilus

Meningococcal

Meningococcemia

Monkeypox

Mumps

Pertussis

Plague

Poliomyelitis

Psittacosis

Q Fever

Rabies

Rocky Mountain Fever

Rubella

Salmonellosis

Severe Acute Respiratory Syndrome

Shigatoxin Producing Infection

Shigellosis

Smallpox

Staphylococcus

Staphylococcal Enterotoxin B Poisoning

Streptococcal Infection (Invasive)

Group A Beta Hemolytic Strep

Group B Strep

Streptococcus Pneumonia

Syphilis

Tetanus

Toxic Shock Syndrome

Trichinosis

Tuberculosis (Current)

Tularemia

Typhoid

Vibriosis

Vaccinia Disease

Viral Hemmorhagic Fever

Yellow Fever

Yersiniosis

While Individual cases of some diseases (e.g.: streptococcal sore throat, head lice, impetigo, scabies, and pneumonia) are not reportable, a cluster or outbreak of cases of any communicable disease is a reportable event.

School Nurses must notify the Bureau of Health and Physical Education when large numbers of the school population must be excluded, when massive screening must be accomplished, or when the communicable disease poses a serious threat to unimmunized or immunosuppressed students.

Exclusion

Students and staff with symptoms of a communicable disease must be excluded from school until they receive appropriate medical treatment and are no longer deemed a risk to the student population. When students are excluded for extended periods of time, at the request of the student’s parent/guardian and attending physician, home schooling may be arranged through Pupil Personnel Services.

Students and staff who have been excluded due to reportable communicable diseases must present a certificate from their medical provider indicating that treatment was provided and that the individual poses no threat to the school population. In the absence of a certificate, the individual must be seen by the School Nurse and/or the school physician.

Mild illnesses are common during the school year. The incidence of acute common respiratory diseases such as the common cold, croup, bronchitis, or pneumonia is not always reduced by exclusion. Children with minor illness should not be excluded from school unless:

• The illness prevents the child from participating in school activities

• The child requires more care than school staff can provide

• Fever, lethargy, difficulty breathing, or signs of serious illness exist

In all cases of illness and exclusion, the School Health Services personnel must exercise professional judgment to insure the health and safety of the school population.

Notification of Parent/Guardian

When students present signs and symptoms of communicable diseases, the School Nurse must notify the parent/guardian and refer the student for appropriate treatment. The Bureau of Health and Physical Education furnishes forms for parent/guardian notification of the most common communicable diseases. The parent/guardian or emergency contact of a student who is to be excluded must be contacted by phone in order to arrange for safe transportation and care of the excluded student.

Notification of Teacher and Related Staff

Where confidentiality issues do not restrict notification, the School Nurse, in the interest of disease control, may notify the teachers and related staff of the presence and/or exclusion of a student with symptoms of a serious communicable disease.

Notification of Parents/Guardians of Unimmunized or Immunosuppressed Students

The School Nurse must notify the parent/guardian of an unimmunized or immunosuppressed student when a communicable disease in the school setting poses a threat to that student’s health and safety. The Albany County Health Department will advise the District regarding the need to exclude students who are unimmunized when there is an incidence of immune preventable communicable disease.

Notification of the General School Population

The School Nurse may notify any portion of the school population of the incidence of a communicable disease when notification is deemed necessary for the control of that disease. The Bureau of Health and Physical Education furnishes forms for parent/guardian notification of the most common communicable diseases.

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