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Infectious Diseases in Childcare Settings and Schools Manual

Introduction

The Infectious Diseases in Childcare Settings and Schools Manual informs administrators, childcare providers, caregivers, parents/guardians, and school health staff about specific infectious disease conditions they may encounter in the childcare or school setting. This manual is designed to provide specific disease prevention and control guidelines which are consistent with the national standards put forth by the American Public Health Association, the American Academy of Pediatrics, and are in line with Nevada Revised Statutes. 

This manual contains: 

  • Fact sheets specifically for parents/guardians of childcare and school-aged children. Each of these are labeled Parent Fact Sheet. 
  • Technical fact sheets for childcare providers about specific infectious disease problems. This information precedes the Parent Fact Sheet. 
  • Some technical fact sheets indicate when immediate action is necessary. Per Nevada Revised Statutes (NRS 441A), providers MUST report certain known or suspected disease conditions to the health authority; this is indicated on the fact sheets labeled “Reportable”. 
  • Links to helpful guidance graphics and downloadable content. 
Acknowledgements

This manual has been adapted from the Hennepin County, Minnesota Human Services and Public Health Department’s Infectious Diseases in Childcare Settings and Schools Manual as well as the Washoe County Nevada Health Department, and Centers for Disease Control and Prevention (CDC) guidance.  

We at the Nevada Division of Public and Behavioral Health (DPBH) would like to thank those who were acknowledged by Hennepin County and Washoe County and to offer our great appreciation to Hennepin County, Minnesota PHD for creating such a quality, comprehensive manual and encourage any who find this manual to be helpful to direct their appreciation to Hennepin County as well. 

 

Section I

Exclusion Guidelines for Staff and Children

Section II

Guidelines for Prevention and Control of Communicable Diseases

Section III

Communicable Disease Concerns for Pregnancy

Section IV

Guidelines: Environment and Sanitation

Section V

Communicable Disease Reporting and Management

Section VI

Communicable Disease Fact Sheets

Reportable Disease Index
Other Resources

A. IMMUNIZATION WEB RESOURCES 

Immunize Nevada www.immunizenevada.org  

To Find an Immunization Clinic in Your Area (Nevada):  

www.immunizenevada.org/adults/where-get-immunizations 

Immunization Action Coalition www.immunize.org  

InFLUence Others: Get Vaccinated (Flu Vaccine Information)  

www.influencenevada.org 

Centers for Disease Control – Vaccines and Immunizations www.cdc.gov/vaccines  

National Vaccine Information Center http://www.nvic.org  

Nevada State Health Division www.health.nv.gov/Immunization.htm 

Nevada Immunization Schedule for Birth to 18 years  

www.health.nv.gov/Immunization_Schedule_0-18.htm 

 Nevada Immunization Schedule for Adults  

www.health.nv.gov/Immunization_Schedule_Adult-VaccineAge.htm 

Guidance Graphics and Downloadable Content 

https://www.cdc.gov/handwashing/posters.html 

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/healthy-schools.htm 

For more information, please contact your local health department. 

Southern Nevada Health District (Clark County) 775-759-1300 (24 hours) 

Northern Nevada Public Health  (Washoe County) 775-328-2447 (24 hours) 

Carson City Health & Human Services (Carson City, Douglas, Lyon Counties) 775-887-2190 (24 hours) 

Division of Public and Behavioral Health (All other Counties) 775-400-0333 (24 hours) 

Email: dpbhepi@health.nv.gov 

 

B. EMERGENCY PREPAREDNESS 

Since September 11, 2001, public and private organizations have been encouraged to develop emergency response plans that establish procedures to minimize the effects of disasters (natural or man-made). In any type of emergency, the goal is to have a plan in place that will: minimize damage, ensure the safety of staff, children, and students, protect vital records/assets, allow for self-sufficiency for at least 72 hours, and provide for continuity of your critical business operations.  

In addition, each organization should develop an appendix to their plan on how they would handle a long-term event that could result in a significant reduction of workforce, such as an influenza pandemic.  

The importance of planning prior to an event is critical to any organization and cannot be stressed enough. It is essential to have a written plan that has been discussed and practiced with all employees and discussed with children and their families as well. This preparation will allow everyone to be better prepared both physically and mentally and be familiar with their roles and responsibilities when an emergency occurs.  

In addition to the organization having an emergency response plan, it is necessary for employees to have individual and family preparedness plans. An organization is only as prepared as their workforce. With everyone prepared, your organization will be in a better position to manage any type of emergency.  

Sections VII-C through VII-E provides multiple resources for childcares, schools and individuals to help you create your own emergency plan. (See also: http://www.washoecounty.us/em/preparedness.html) If you have questions relating to emergency planning, you can contact your local or state health department or childcare licensing groups, Department of Human Services or Department of Education

 

C. EMERGENCY PREPAREDNESS PLANNING RESOURCES FOR CHILDCARE 

National Association of Child Care Resource & Referral Agencies (NACCRRA) http://www.naccrra.org/programs-services/crisis-and-disaster-resources  

  • Provides an assortment of resources for Parents, Caregivers, School Professionals, and Child Care Resource and Referral Agencies. Also provides Child Care Aware© of America Disaster Related Publications. – Emergency Preparedness for Child Care: A How-to Guide 

http://www.naccrra.org/programs-services/crisis-and-disasterresources/emergency-and-disaster-publications 

Emergency Response Planning for Child Care Providers Toolkit www.naccho.org/pubs/product1.cfm?Product_ID=161 

 or 

 http://www6.montgomerycountymd.gov/content/hhs/phs/APC/childcaremanual.pdf  

  • This toolkit is designed to prepare childcare providers for emergency events and to assist in the recovery effort by helping children cope with the traumatic event. A train-the-trainer guide is included along with a CD that contains Microsoft PowerPoint presentations. You can download this toolkit for free or order hard copies for a fee on the NACCHO website. The Montgomery County web address will take you to the free PDF version. National Child Care Information Center (NCCIC) http://www.nifa.usda.gov/nea/family/part/childcare_part_nccic.html
  • The NCCIC Child Care Resources for Disasters and Emergencies website brings together information and key resources about emergency preparedness, disaster response, and recovery that relate specifically to childcare. Head Start Disaster Preparedness Workbook http://www.cphd.ucla.edu/headstartwb.html
  • This workbook is designed to guide Head Start programs through the development and implementation of comprehensive disaster plans. It is based on information obtained directly from Head Start personnel regarding their disaster preparedness and planning needs. Ready to Respond Emergency Preparedness Plan: http://www.brighthorizons.com/resources/pdf/talktochildren/docs/emergency_plan.doc
  • This plan covers medical emergencies, natural disasters, utility disruptions, fire emergencies, hazardous materials, bomb threats, violent situations, parent/guardian issues, hostage situations, and missing children. Day Care Planning Tool Kit: http://tinyurl.com/PA-daycare-planning-tool-kit
  • This kit includes a three-part plan (Basic Plan, Checklists and Supporting Documents), a PowerPoint presentation to use in introducing the planning process and a Daycare Facilities Planning Guide that helps fill in the blanks to complete the plan. This ‘tinyurl’ redirects to the PA archives and presents a choice between Word and PDF formats.

 

D. EMERGENCY PREPAREDNESS PLANNING RESOURCES FOR SCHOOLS 

Checklists  

www.flu.gov/planning-preparedness/school/schoolchecklist.pdf 

www.flu.gov/planning-preparedness/community/child_care.pdf 

www.ready.gov/sites/default/files/documents/files/R3_3panel_ReadyBrochure.pdf 

www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Documents/aapfrkfull.pdf 

 Practical Information on Crisis Planning: A Guide for Schools & Communities www.ed.gov/admins/lead/safety/emergencyplan/crisisplanning.pdf 

Emergency Planning and Procedures Guide for Schools  

www.accem.org/pdf/schoolplanningguide.pdf 

 Practice Good Hygiene CDC  

www.cdc.gov/germstopper/home_work_school.html 

 National Science Foundation  

www.scrubclub.org/home.aspx 

 Health Information Available in Different Languages ECHO  

www.echominnesota.org 

 Washington State Dept of Health Fact Sheets www.doh.wa.gov/Emergencies/EmergencyPreparednessandResponse/Factsheets.aspx 

CDC  

http://www.cdc.gov/flu/avianflu/ 

or www.cdc.gov/flu/avian/index.ht

 

E. INDIVIDUAL AND FAMILY EMERGENCY PREPAREDNESS 

These sites are comprehensive and contain in-depth information on emergency planning for individuals, families with children, senior citizens, persons with special needs, and those with pets. Many sites have several brochures that can be downloaded.  

www.codeready.org 

www.ready.gov 

www.fema.gov 

www.prepare.org 

www.redcross.org 

Additional Information to Prepare Children 

The American Academy of Pediatrics has addressed emergency preparedness for children. The following are highlighted materials from the Academy’s website:  

Family Readiness kit with information on different types of disasters and a readiness guide.  

www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Documents/aapfrkfull.pdf 

Emergency Preparedness for Children with Special Health Care Needs 

https://www.aap.org/en/community/aap-committees/committee-on-pediatric-emergency-medicine/emergency-preparedness-for-children-with-special-health-care-needs/ 

 The Department of Health and Human Services Nevada Division of Public and Behavioral Health (DPBH) has a link to a comprehensive resource for families of children with special needs.  

https://dpbh.nv.gov/Programs/CYSHCN/CYSHCN-Home/ 

 Nevada Office of State Epidemiology Facility Infection Prevention & Special Population Epidemiology 

Facility Infection Prevention | The Office of State Epidemiology (nvose.org) 

 Additional Information for Seniors   

A 12-page brochure, entitled Emergency Readiness for Older Adults and Caregivers. This website is available in large print on the internet with a very helpful section done by seniors for seniors. 

http://www.aoa.gov/AoARoot/AoA_Programs/HCLTC/Caregiver/docs/Just_in_Case0307 06_links.pdf 

 Disability.gov  

www.disability.gov/emergency_preparedness 

 National Council on Disabilities  

www.ncd.gov/

Pandemic Flu Websites  

U.S. Government  

www.flu.gov 

 World Health Organization (WHO) 

www.who.int/topics/influenza/en/ 

 Nevada State Health Division 

 http://health.nv.gov/Influenza_PandemicFlu.htm 

  Avian Flu (Bird Flu) Websites  

Center for Disease Control and Prevention (CDC)  

http://www.cdc.gov/flu/avianflu/ 

or www.cdc.gov/flu/avian/index.htm 

U.S. Department of Agriculture (USDA) www.usda.gov/wps/portal/usdahome?navtype=SU&navid=AVIAN_INFLUENZA 

U.S. Geological Survey National Wildlife Health Center www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp 

World Health Organization (WHO) www.who.int/csr/disease/avian_influenza/en/index.html 

Information Available in Different Languages ECHO (Emergency & Community Health Outreach) www.echominnesota.org 

Washington State Department of Health Fact Sheets www.doh.wa.gov/Emergencies/EmergencyPreparednessandResponse/Factsheets.aspx 

Volunteer Opportunities Medical Reserve Corps of Washoe County http://www.washoecounty.us/health/ephp/mrc.html 

Medical Reserve Corps  

www.medicalreservecorps.gov 

 Community Emergency Response Teams  

www.citizencorps.gov/cert 

Terms and Definitions

Appendix A – Terms and Definitions

ACUTE

An infection that has a sudden onset and lasts a limited period of time, usually days or a few weeks.

ALCOHOL-BASED HAND RUB

Products that can be used to clean hands and perform the same function as soap and water. These products most commonly have 70% alcohol as the active ingredient.

ANAL AREA

The area around where the stool comes out, also called rectal area.

ANTIBIOTIC

Powerful medications that fight infection-causing bacterial germs. Antibiotics are used to treat infections/diseases caused by bacteria, but they cannot kill viruses and cannot cure or stop the spread of diseases caused by viruses.

ANTIBIOTIC MISUSE

Taking or prescribing antibiotics when they are not needed (such as for a viral infection), stopping antibiotics when feeling better and not finishing the prescription, saving antibiotics for a future illness, or giving someone antibiotics prescribed for someone else.

ANTIBIOTIC-RESISTANT BACTERIA

Bacteria that have mutated (or changed) so that antibiotics that are meant to kill them are no longer effective. Antibiotic-resistant bacteria require stronger, more expensive medications that sometimes must be given in a person’s vein (IV).

ANTIBODY

Protein produced by white blood cells in response to an antigen to fight off infection. Antibodies are produced specific to an antigen.

ANTIGEN

Any substance that when introduced into the body stimulates the production of an antibody specific to that antigen.

ASYMPTOMATIC

Without symptoms. For example, a child may have hepatitis A virus in the stool and not have symptoms, but still be able to infect others.

AXILLARY AREA

Armpit.

BACTERIA

Germs that can cause a variety of infections and can also survive in and out of the body. They are much larger than viruses, and they can often be treated effectively with antibiotics.

BODY FLUIDS

Urine, stool (feces), blood, eye and nasal secretions, wound drainage, and saliva.

BRONCHIOLITIS

An infection of the smaller airways of the lungs; most commonly found with a viral infection.

BRONCHITIS, ACUTE (chest cold)

Inflammation or swelling of the tubes leading into the lungs. Often caused by a viral infection, therefore, antibiotics are not needed.

CARRIER

A person who has no symptoms of disease but who is infected with a specific germ and can spread the disease to others. For example, some children may be carriers of Giardia lamblia (parasite) and have no symptoms.

CELLULITIS

An infection involving the skin and area below the skin caused by specific bacteria (e.g., Streptococcus, Staphylococcus, and Haemophilus influenzae).

CHRONIC

An infection or illness that lasts a long time (months or years).

CLEANING

The removal of dirt, debris, waste material (e.g., blood, urine, and stool), and a large number of germs by scrubbing using soap/detergent and water. Vacuuming is also a form of cleaning.

COLONIZATION

When bacteria are present on or in the body without causing illness (e.g., Staphylococcus aureus or Streptococcus pneumoniae).

COMMUNICABLE DISEASE

Illness caused by germs (e.g., bacteria, viruses, fungi, parasites) that can be spread from person to person or by touching objects contaminated with body fluids. Illness can be spread from infected pets. Many communicable diseases are reportable by law to the local or state health department.

CONJUNCTIVITIS (PINKEYE)

Redness and swelling of the delicate tissue which lines the eyelids and covers the eyeball (conjunctiva).

CONTAGIOUS PERIOD

The period of time when an infected person is capable of spreading infection to another person.

CONTAMINATION

The presence of infectious germs in or on the body, on environmental surfaces, on articles of clothing, or in food or water.

CROUP

Spasms of the airway that cause difficult breathing and a cough sounding like a seal’s bark. Viruses most often cause croup; therefore, antibiotics are not needed.

DIARRHEA

Increased number of stools compared with a person’s normal pattern, along with decreased stool form and/or watery, bloody, or mucus-containing stools.

DISINFECTION

A physical or chemical process that eliminates virtually all disease-causing germs on environmental surfaces, except bacterial spores.

ENCEPHALITIS

Inflammation (swelling) of the brain which can be caused by a number of agents such as viruses, bacteria, or parasites.

EPIDEMIOLOGY

The scientific study of the occurrence and distribution of diseases in populations.

EXCLUSION (DUE TO ILLNESS)

Denying admission of an ill child or staff member to a childcare, preschool, school, or worksite.

FEBRILE

Having a fever.

FECES

Another name for stool or bowel movements. Waste material that is formed and not used by the body.

FEVER

An elevation of body temperature. This could be due to overheating, reactions to medications, or a response to infection.

FUNGI

Plant-like organisms, such as yeasts, molds, mildew, and mushrooms, which get their nutrition from other living organisms or from dead organic matter.

GERMS

A common term used to describe bacteria, viruses, parasites, and fungi.

HEPATITIS

Inflammation of the liver, which may be caused by a virus.

HYGIENE

Protective measures taken by individuals to promote health and limit the spread of infectious diseases, for example, handwashing and covering your cough.

IMMUNE GLOBULIN (IG)

An antibody preparation made from human plasma, providing temporary protection against diseases. For example, health officials may offer immune globulin injections to children and staff in a childcare setting when cases of hepatitis A occur.

IMMUNITY

The body’s ability to fight a particular infection. For example, a child acquires immunity to diseases such as measles, mumps, rubella, and pertussis after natural infection or by vaccination. Newborns initially have the same immune status as their mothers. This immunity usually disappears within the first 6 months of life.

IMMUNIZATIONS (VACCINATIONS)

Vaccines that are given to children and adults to help them develop protection (antibodies) against specific infections. Vaccines may contain an inactivated or killed agent or a weakened live organism.

IMMUNOCOMPROMISED

The state of having a weakened body defense (decreased immune responses) against diseases caused by bacteria, parasites, fungi, or viruses.

INCUBATION PERIOD

The time between exposure to an infectious agent and the beginning of symptoms.

INFECTION

A condition caused by the multiplication of an infectious agent in the body.

INFECTIOUS

Capable of causing an infection.

INFESTATION

Common term referring to the presence of parasites, such as lice or scabies.

INFLUENZA

An acute viral disease of the respiratory tract caused by the influenza virus. Influenza should not be confused with a bacterial infection called Haemophilus influenzae or with “stomach flu” (usually vomiting and diarrhea).

JAUNDICE

Yellowing of the whites of the eyes or skin.

LOW-GRADE FEVER

A fever that is slightly higher than normal.

MENINGITIS

A swelling or inflammation of the tissue covering the brain and spinal cord. Meningitis is usually caused by a bacterial or viral infection.

MENINGOCOCCUS

Neisseria meningitidis bacteria which can cause meningitis, pneumonia, or blood infections.

ORAL

Having to do with the mouth.

OVER THE COUNTER (OTC)

Any medication that can be purchased without a prescription.

OTITIS MEDIA

Inflammation or infection of the middle part of the ear. Ear infections may be caused by Streptococcus pneumoniae or Haemophilus influenzae. They are not contagious.

PARASITE

An organism that must live on or in another living organism for all or part of its life.

PAROTID GLAND

A salivary gland situated at the base of each ear.

PEDICULOSIS

Another word for lice infestation.

PNEUMONIA

An acute or chronic disease marked by infection of the lung; may be caused by viruses, bacteria, or other germs and sometimes by physical or chemical irritants.

PROPHYLAXIS (PREVENTIVE TREATMENT)

Measures taken before, during, or shortly after exposure to an infectious disease to try to prevent the disease. This may include medications or vaccinations.

PUSTULES

Pus-filled bumps on the skin.

RECTAL

Having to do with the rectum, the last 6 to 8 inches of the large intestine that serves to store solid waste until it leaves the body through the anus.

RESPIRATORY SYSTEM

The nose, ears, sinuses, throat, and lungs.

SANITIZING

The chemical process of reducing the number of disease-causing germs to a safe level on cleaned food contact surfaces and mouthed toys, objects, and surfaces.

SECRETIONS

Wet material produced by cells or glands that has a specific purpose in the body, such as saliva.

SOILED

Contaminated with dirt; stool; urine; vomit; blood; saliva; or drainage from the eye, nose, or wound.

SORES

Open skin lesions usually caused by an infection.

STANDARD PRECAUTIONS

Are used in many settings where there is a possibility of exposure to blood and body fluids (e.g., urine, stool, secretions from the nose and mouth, drainage from sores or eyes). One aspect of standard precautions is the use of barriers. The purpose of using barriers is to reduce the spread of germs to staff and children from known/unknown sources of infections and prevent a person with open cuts, sores, or cracked skin (non-intact skin) and their eyes, nose, or mouth (mucous membranes) from having contact with another person’s blood or body fluids. Examples of barriers are gloves, safety needle/sharp devices and proper disposal of used needles and sharps, and CPR mask or shield.

STOOL

Another name for feces or bowel movements. Waste material that is formed and not used by the body.

TRANSMISSION

The spread of an infectious organism or germ from an infected person or animal or contaminated environmental surface to a person. Swimming in or drinking water from a contaminated water source can also spread organisms.

VACCINATIONS (IMMUNIZATIONS)

Vaccines that are given to children and adults to help them develop protection (antibodies) against specific infections. Vaccines may contain an inactivated or killed agent or a weakened live organism.

VARICELLA-ZOSTER

The herpesvirus that causes chickenpox (varicella) and shingles (zoster).

VIRUS

A type of germ that lives within cells that is smaller than bacteria. Viruses can grow or reproduce only in living cells. Antibiotics will not fight against viruses – viral infections clear up on their own and antibiotics will not help.

VOMITING

To throw up. The act of ejecting the stomach contents through the mouth.

 

Southern Nevada Health District (Clark County) 775-759-1300 (24 hours)

Northern Nevada Public Health  (Washoe County) 775-328-2447 (24 hours)

Carson City Health & Human Services (Carson City, Douglas, Lyon Counties) 775-887-2190 (24 hours)

Division of Public and Behavioral Health (All other Counties) 775-400-0333 (24 hours)

Email: dpbhepi@health.nv.gov