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COMMON CONCERNS PARENTS HAVE ABOUT THE HEALTH OF THEIR SCHOOL-AGE CHILD

| | | | |INCUBATION |SCHOOL ACTION AND COMMENTS |SOURCE OF INFECTION AND |

| | |DISEASE |SYMPTOMS/SIGNS |PERIOD |ON COMMUNICABILITY |MODE OF TRANSMISSION |

|Many students and parents are frequently concerned about when | |Chicken pox |Fever and skin rash that comes in crops. Rash begins|Usually 14-16 days; |Exclude from school until blisters have dried into |Virus spread by direct contact with the blister fluid|

|students should stay home or attend school. | |(Varicella) |on the chest, back, under arms, neck, and face; |can be as long as 3 |scabs, usually about 6 days after the rash appears. |or by droplets - from the nose and throat of an |

| | | |changes to blisters and then scabs. |weeks | |infected person during sneezing and coughing. |

|You can expect your child to be ill 5-7 days during a school | | | | |Shingles, is caused by inactive varicella from your |Readily communicable. One attack usually confers |

|year. Please have a child | | | | |own previous case of chickenpox. Exposure to fluid |immunity. DO NOT give aspirin as there is a risk of |

|care plan when your child is ill. | | | | |from the blisters can cause chickenpox in another |Reye Syndrome. Children on immuno-suppressive drugs |

| | | | | |person. Exclusion for shingles is only necessary if |are at high risk. |

| | | | | |the blisters can not be covered, in which case | |

| | | | | |exclusion is until blisters are dried into scabs. | |

|Remember that a child, ill with an infectious | | | | | | |

|disease, can spread the disease when in contact with others in | |Cold Sores (Herpes |Cold sores (fever blisters) appear on the lips and |2-14 days |No exclusion necessary for mild oral herpes in |Virus is transmitted by direct contact with infected |

|the family and community. | |Simplex) |face, less often in the mouth. Sores usually crust | |children who are in control of their mouth |persons, a majority of whom have no apparent |

| | | |and heal within a few days. May be confused with | |secretions. |infections. |

| | | |impetigo. | | | |

|The following information is intended to help with this decision.| |Common Cold |Runny nose, sneezing, chills, tiredness, fever, |Colds: 1-3 days |Exclude from school until child is without fever for |Different viruses spread directly through coughing, |

| | |Respiratory |muscle aches, sore throat, cough, which may last 2-7 |Other acute |24 hours and is well enough to participate in normal,|sneezing, and explosive manner of speech in which |

|•If a student has an oral temperature of 100 degrees or higher | |Infections (viral) |days. |respiratory illness:|daily activities. |droplets are cast; indirectly through articles |

|indicating a fever, the student must stay home for a minimum of | | | |up to 10 days | |freshly soiled by discharges of infected person. |

|24 | | | | | | |

|hours after the temperature returns to normal without fever | |Fifth Disease |Rarely any symptoms other than a rash ("slapped |4-21 days |No exclusion necessary unless fever is present. |Human Parovirus B19 spread through contact with |

|reducing medication. | | |cheek") that begins on cheeks; later found on the | | |infected respiratory secretions; good hand washing |

| | | |backs of arms and legs. Rash is very fine, lacy, | | |decreases transmission. |

|•If student has vomited or had diarrhea, the student must stay | | |pink, and tends to come and go in sunlight or heat. | | | |

|home until a minimum of 24 hours after the last episode. | | | | | | |

| | |Influenza |Sudden onset of fever, headache, muscle pain, |1-4 days |Exclude from school until temperature has been normal|Virus spreads directly through coughing, sneezing, |

|•If student has had any rash that may be | | |generalized discomfort, cough and sore throat. | |for 24 hours and child is well enough to participate |and contact with nose or throat discharges of |

|disease-related or the cause is unknown, check | | | | |in normal activities. |patient. |

|with family physician before sending the student to school. | |Impetigo |Blister-like sores that form an oozing, sticky, |Usually 1-10 days |Exclude from school until child has been treated with|Bacteria spreads by direct contact with persons or |

| | | |yellow crust and itching. | |antibiotics for at least a full 24 hours. Encourage |articles freshly soiled with discharges from nose or |

|•If student is ill, please call the school daily to report | | | | |good hand washing. Avoid close contact with other |throat of patient; airborne transmission also occurs.|

|illness. | | | | |children. | |

| | | | | | |Usually caused by staphylococcus or streptococcus. |

|If you have any questions regarding the above information or your| |Infectious |Fever, sore throat, tiredness, and swollen glands, |4-6 weeks |Exclude from school until the child is well enough to|Epstein-Barr virus spreads person to person through |

|child's illness, please call your school nurse or family | |Mononucleosis |especially behind the neck. Sometimes there is a | |return to normal activities. |saliva; spread can also occur by kissing or sharing |

|physician. | | |rash. Often children have no symptoms at all. | | |items such as drinking cups, bottles or toys. |

| | |Lice (head) |Itching of the scalp. Look for: crawling lice in the|Nits (eggs) hatch in|At end of school day, exclude from school until first|Louse transmitted primarily by direct contact with |

| | | |hair, and scratch marks on scalp or back of neck at |7-10 days |treatment is completed. |infested persons. Lice can also be transmitted |

| | | |hairline. | | |through combs, brushes, bedding, wearing apparel, |

| | | | | | |headwear including hair ornaments, helmets, and |

| | | | | | |sleeping bags. |

| | |INCUBATION |SCHOOL ACTION AND COMMENTS |SOURCE OF INFECTION AND |

|DISEASE |SYMPTOMS/SIGNS |PERIOD |ON COMMUNICABILITY |MODE OF TRANSMISSION |

|Hand, Foot, and |Sores occur toward the front of the mouth, on the |Usually 3-6 days |Exclude until temperature is normal for |Coxsackievirus spread through contact with nose and |

|Mouth Disease |sides of the tongue, inside the cheeks, and on the | |24 hours and child is well enough to participate in |throat discharge and stool |

| |gums; may last | |normal, daily activities. |of infected persons. Hand washing important. |

| |7-10 days. In most cases, sores can be found on the | |Sores may still be present. | |

| |palms of the hands, the fingers, and the soles of the| | | |

| |feet. A low-grade fever may last 1-2 days. | | | |

|Pink Eye |Bacterial: pink or red conjunctiva with pus that |1-12 days |Refer for medical diagnosis and treatment. No |Most are viral in etiology, some bacterial. May be |

|(Conjunctivitis) |causes matting of the eyelids, pain or redness of | |exclusion necessary unless fever is present. |spread through hand-eye contact. |

| |eyelids. | | | |

| |Viral: pink conjunctiva with clear watery discharge | | | |

| |and without pain or redness of eyelids. | | | |

|Reye Syndrome |Sudden onset of violent vomiting, mental confusion, |1-7 days following |1. If one or more symptoms appear, call physician |Usually follows viral infection. It is not |

| |extreme sleepiness, or fatigue, twitching or jerking |viral infection |immediately. |contagious. Cause unknown. No prevention. Requires|

| |movements, hostility, coma. |(cold, flu, chicken |2. Go to emergency room of hospital. |immediate attention at onset of symptoms. Most |

| | |pox) |3. Do not give aspirin to a child with a viral |common in young children. |

| | | |illness. | |

| | | |4. Exclude from school until clinically well. | |

|Ringworm |Body: Ringworm appears as flat, spreading |Body: 4-10 days |Exclude from school until 24 hours after treatment |Fungus spread by contact with infected person, animal|

| |ring-shaped lesions. The edge of the lesion may be | |has been started. |or contaminated articles. |

| |dry and scaly or moist and crusty. As the lesion | | | |

| |spreads outward, the center often becomes clear. | |Lesions must be covered when participating in contact| |

| |Scalp: Ringworm may be hard to detect in the early |Scalp: 10-14 days |sports. | |

| |stages. It often begins as a small, scaly patch on | | | |

| |the scalp. Mild redness and swelling may occur. | | | |

| |Infected hairs become brittle and break off easily. | | | |

|Scabies |Rash and intense itching which may be more severe at |2 weeks - 2 months: |Exclude from school until 24 hours after treatment |Mite is transferred by direct contact with skin or |

| |night. Common locations to see the rash are folds of|Symptoms may appear |begins. |through shared bedding, towels, and clothing of a |

| |skin between fingers, around wrists, elbows, and |in less than 1 week | |person with scabies. Treat all members of household |

| |armpits. Other areas where rash may appear are |if the person has | |at the same time. |

| |knees, waistline, thighs, male genitals, abdomen, |had scabies before. | | |

| |chest, and lower portion of buttocks. Infants may be| | | |

| |infected on head, neck, palms, and | | | |

| |soles of feet. | | | |

|Streptococcal Sore |Sudden onset of fever, sore throat, swollen glands, |Usually 1-3 days |Exclude until throat culture report is received. If |Bacteria spreads directly from nose and throat |

|Throat/Scarlet Fever|headache, abdominal pain, nausea and vomiting in | |positive for strep, exclude from school until 12 |discharges of infected persons. |

| |severe cases. With scarlet fever a very fine raised | |hours after antibiotic treatment is started and until| |

| |rash is present. A fuzzy, white tongue may occur. | |clinically well. Communicable until 12 hours after | |

| |The rash appears most often on the neck, chest, in | |treatment is started. Exclude from school until | |

| |folds of the armpit, elbow, groin, and the inner | |temperature has been normal for 24 hours. | |

| |thigh. Later there may be peeling of the skin on the| | | |

| |fingertips and toes. | | | |

References Infectious Diseases in Child Care Setting, Epidemiology Program of Hennepin County Community Health Department

2018 Red Book Report of the Committee on Infectious Diseases, American Academy of Pediatrics 31st Edition SHS Form #501

2014 Control of Communicable Diseases Manual, American Public Health Association, 20th Edition Revised 6/2019

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