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«Chapter 11 COMMUNICABLE DISEASES ♦ Communicable Disease ♦ Reportable Diseases List ♦ Chickenpox ♦ Fifth Disease (Erythema Infectiosum) ♦ ...»

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Transmission Contact with discharges from eyes and upper respiratory tract of infected persons and from contaminated fingers, clothing, or other articles. Presumed contagious until symptoms have resolved.

Treatment If bacterial, antibiotic ointments or drops prescribed by a physician. If viral, will clear up with no specific antiviral treatment.

Complications Unusual, if treated. Eye pain, impaired vision, photophobia School Action Students with suspected pink eye should be excluded from school until (a) a diagnosis in writing made by a physician indicates a non-contagious eye ailment; or (b) signs and symptoms have disappeared (usually within 48 hours after treatment begins).

Spread of infection is minimized by careful hand washing.

PINWORMS Signs and Symptom Perianal itching, disturbed sleep, irritability and local irritation with secondary infection as a result of scratching the skin. Worms usually come out of rectum at night and are most likely to be seen in anal region immediately after waking in the morning.

Cause Intestinal parasite (nematode) Incubation Period Life cycle of parasite is 2 to 6 weeks. Signs and symptoms may not be evident for months.

Transmission Direct transfer of infective eggs by hands from anus to mouth of the same or another person and indirectly through clothing, bedding, food, or other articles contaminated with eggs of the parasite.

Treatment Suspected cases should be seen by a physician for confirmation and treatment. One dosage treatment is now available. Bed linens and underwear should be changed daily.

Complications Uncommon Prevention Good hygiene, particularly hand-washing School Action Suspected cases should be referred to parent/guardian. If signs and symptoms persist or if the parent/guardian is unresponsive, refer to the school RN.

Unless symptoms are severe, exclusion is not necessary.

Stress good hygiene, particularly hand-washing and change of underwear daily.

RINGWORM Signs and Symptoms Ringworm of the Scalp - Small raised area spreads leaving scaly patches of temporary baldness. Infected hairs become brittle and break off easily.

Occasionally, raised and draining areas develop.

Ringworm of the Body - Flat, spreading, ring-shaped lesions. Outer edge is usually reddish and may contain clear fluid or pus. In later stages, outer edges will become scaly or crusted and central area will appear like normal skin.

Ringworm of the Foot - (Athlete's Foot) - Scaling or cracking of skin, especially between toes, and blisters containing watery fluid.

Cause Fungi Incubation Period Scalp - 10 to 14 days Body - 4 to 10 days Foot – unknown Transmission Direct or indirect contact with skin lesions of infected persons, contaminated articles and areas used by infected persons or with hair from infected persons and animals.

Treatment Usually topical antifungal to be applied as directed by label. For more serious cases, an oral antifungal medication may be prescribed.

School Action A student with suspected ringworm of scalp or body should be excluded until (a) a diagnosis in writing made by a physician indicates a non-contagious skin ailment; or (b) the student is being treated and lesions are satisfactorily covered.

All equipment and articles which an infected student comes in contact with should be disinfected when ringworm infestation has been identified.

Personal hygiene should be stressed.

RUBELLA (German measles or Three Day Measles) Signs and Symptoms A young child may have no signs and symptoms until rash appears; then low grade fever and tiredness. Older children and adults usually have symptoms one to five days before rash, along with joint pain and swollen lymph nodes. Swollen lymph glands behind the ears and at top of the back of head appear 5-10 days before the rash.

Rash Rash is pink in color and begins on face and neck and progresses downward to trunk, arms and legs. Lesions are usually discrete and begin to fade within 48 hours.

Cause Rubella virus Incubation Period Time from contact to development of signs and symptoms 14 - 21 days.

Transmission Transmission is by droplet spread (sneezing, coughing, etc.) or contact with infected persons. Period of infectiousness is from about one week prior to appearance of rash to about five days after it appears. Highly communicable.

Treatment Physician or public health department should be contacted so diagnosis can be confirmed.

Possible contacts with pregnant women should be identified and their immunity status determined. Children with rubella should be treated according to symptoms.

Complications There are seldom complications in young children. Rubella can cause birth defects in the offspring of women who acquire the disease during pregnancy (especially if acquired during the first trimester).

Immunization Available. Should be administered after 12 months of age. (Usually given with measles and mumps vaccines as MMR.) School Action Emphasize good personal hygiene, particularly hand washing, to all students and staff members.

SCABIES Signs and Symptoms Small raised areas or tiny raised burrows containing mites and eggs. Lesions are most around finger webs, inside surface of wrists, elbows and folds under arms, and around waist. The rash may appear generalized and secondary infection may occur due to scratching. Itching is intense, particularly at night.

Cause Mite (Sarcoptes scabiei) Incubation Period Two to six weeks after exposure until itching begins in persons with previous exposure.

Persons previously infected may develop symptoms 1-4 days after re-exposure.

Transmission Transfer of mite by direct skin-to-skin contact and to a limited extent by contaminated garments and bed linens. Communicable until mites and eggs has been destroyed, ordinarily after one or two treatments a week apart.

Treatment Parents/guardian should contact their licensed health care provider regarding diagnosis and treatment. Treatment requires a prescription specifically for scabies.

School Action A student with suspected scabies should be excluded from school until a diagnosis in writing by a physician indicates a non-contagious skin ailment; or upon completion of treatment. The student should be watched for re-infestation (appearance of new lesions or continued itching) for 7-10 days after initial treatment.

Persons with skin to skin contact with infested persons may need to be treated.

Launder or disinfect any articles used by infested persons.

SCARLET FEVER (Streptococcal Diseases) Signs and Symptoms Fever, headache, chills, general malaise, rash; sore throat and vomiting within 12 hours of onset of rash.

Rash Small, flat red dots. Red areas become white when pressure is applied. Rash develops most often on the neck, chest, axial, elbow, inner thighs, and groin. Scaling of skin on the feet and hands may occur.

Cause Group A beta hemolytic streptococci (Streptococci can be cultured from the throat).

Incubation Period Time from contact to the development of signs and symptoms: 1 - 3 days after close contact with an infected person. Incidence is highest among small children and during cold weather.

Transmission Usually by direct contact. By indirect contact through objects or hands (rare).

Occasionally by food contaminated through coughing and sneezing. Treated cases usually do not transmit infection after 48 hours. Untreated cases can transmit infection as long as 21 days.

Treatment A physician should see all suspected cases. Administration of an antibiotic is the usual treatment of choice.

Possible Complications Otitis media (ear infection), abscesses extending around the tonsils, sinusitis; in extreme cases, heart and kidney problems.

Immunization None

School Action A student with Scarlet Fever may be readmitted to school 1-2 days after treatment begins, with a note from the doctor.

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