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505.03AP Communicable Disease Control`

505.03AP

Administrative Regulations – COMMUNICABLE DISEASE CONTROL

The school nurse should assume a leadership role in establishing a communicable disease control program in the school.  The nurse works with the superintendent, principal, and teachers to develop written recommendations concerning:

Enforcement of the statutes regarding immunization for school attendance

Establishment of policies for handling children suspected of having communicable diseases

Investigation to determine whether the school is the source of epidemics of communicable diseases

Reporting to the Department of Public Health (1-800-362-2736) when there is an incidence of gastroenteritis or influenza like illness if the number is greater than 10% of the school district enrollment.

The nurse should be aware of all current communicable disease regulations.  If the nurse is not in the school on a daily basis, the staff member responsible for exclusions and readmissions should be kept informed of current regulations.  The nurse also helps teachers develop skills in observing symptoms which might indicate the onset of an acute communicable disease.

REPORTABLE INFECTIOUS DISEASES

The following infectious diseases must be reported to the state and local public health offices:

Acquired Immune Deficiency Syndrome (AIDS)

Amebiasis

Anthrax

Botulism

Brucellosis

Campylobacteriosis

Chlamydia trachomatis

Cholera

Diphtheria

E. Coli 0157:h7

Encephalitis

Giardiasis

Hepatitis, viral (A, B, Non-A, Non-B, unspecified)

Histoplasmosis

Human Immunodeficiency Virus (HIV) infection other than AIDS

Influenza

Legionellosis

Leprosy

Leptospirosis

Lyme disease

Malaria

Meningitis (viral or bacterial)

Mumps

Parvovirus B 19 infection (fifth disease and other complications)

Pertussis (Whooping Cough)

Plague

Poliomyelitis

Psittacosis

Rabies

Reye’s Syndrome

Rheumatic Fever

Rocky Mountain Spotted Fever

Rubella (German Measles)

Rubella (congenital syndrome)

Rubeola (measles)

Salmonellosis

Shigellosis

Tetanus

Toxic Shock Syndrome

Trichinosis

Tuberculosis

Tularemia

Typhoid Fever

Typhus Fever

Venereal disease  (chancroid, gonorrhea, granuloma inguinale, venereum, syphilis)

Yellow Fever

Any other disease which is unusual in incidence, occur in unusual numbers of circumstances or appear to be of public health concern, i.e.,  epidemic diarrhea, food or waterborne outbreaks, acute respiratory illness should also be reported.

AIDS/ACQUIRED IMMUNE DEFICIENCY SYNDROME

The following guidelines will be used with regard to students diagnosed as having AIDS/Acquired Immune Deficiency Syndrome:

  1. Routine screening of students for AIDS associated virus (HTLV-III/LAV) is not recommended.  Screening will not be a requirement for school entry.
  2. Children diagnosed as having AIDS, or with laboratory evidence of infection with the AIDS associated virus (HTLV-III/LAV), and receiving medical attention are able to attend classes in an unrestricted educational setting.
  3.  An appropriate alternative educational plan may include that a more restricted environment should be provided for the child diagnosed as having AIDS or laboratory evidence of infection with the HTLV-III/LAV virus if:
    1. Cutaneous (skin) eruptions or weeping lesions that cannot be medically covered are present
    2. Inappropriate behavior which increases the likelihood of transmission (i.e., biting or incontinence) is exhibite
    3. The child is too ill to attend school
  4. Decisions as to educational management should be shared utilizing expertise of the physician, parent or guardian, public health personnel and those associated with the educational setting.
    1. Notification of the school will be through the school nurse or person responsible for school health who will notify only those necessary to assure optimal management.
    2. Notification will be by a process that would maximally provide patient confidentiality.
    3. If school authorities believe that a child diagnosed as having AIDS or with laboratory evidence of infection with the AIDS associated virus (HTLV-III/LAV) has evidence of conditions described in #3 above, then the school authorities can dismiss the child from the class and request authorization from the child’s personal physician so that class attendance is within compliance with the school policy.
    4. If a conflict arises as to the child’s management, the case should be referred to the State Department of Health for review to determine the permissibility of attendance.
  5. Since the child diagnosed as having AIDS or with laboratory evidence of infection with the AIDS associated virus (HTLV-III/LAV) has a somewhat greater risk of encountering infections in the school setting, the child should be excluded from school if there is an outbreak of threatening communicable disease such as chicken pox or measles until he/she is properly treated and/or the outbreak is no longer a threat to the child.
  6. Blood or any other body fluids including vomitus and fecal or urinary incontinence in any child should be treated appropriately.  Gloves shall be worn when cleaning up any body fluids.
  7. Inservice education of appropriate school personnel should ensure that proper medical and current information about AIDS is available.

The herpes simplex virus and cytomegalovirus are ubiquitous agents infecting most of the population.  It is not possible with present medical knowledge and skills to totally prevent their transmission.  Under ordinary circumstances it is not reasonable to exclude infected individuals from school unless those infected are too ill to attend.  Infection control is best accomplished by maintaining appropriate hygienic practices such as avoiding other people’s secretions and careful washing of contaminated hands.  Under special circumstances when secretions cannot be adequately controlled because of individual behavior, it might be advisable to provide an alternative education plan until the problem is solved.

505-03_Communicable_Disease_Chart

Approved: ____1/25/87______  Reviewed: ____10/11/10____  Revised:     10/25/99___

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