List Of Reportable Diseases

Transcription

1 Procedure INFECTIOUS DISEASES An infectious disease is caused by the presence of certain microorganisms in the body. Infectious diseases may or may not be communicable or in a contagious state. Diseases in a contagious state may be controlled by the exclusion from the classroom or by referral for medical attention of the infected student. Staff members of a school must advise the principal when a student possesses symptoms of an infectious disease. The principal must be provided with as much health information as is known about the case in a timely manner so that appropriate action can be initiated. (See Infectious Disease Control Guide) List Of Reportable Diseases The following diseases require an immediate report to the local health department at the time a case is suspected or diagnosed: 1. Diphtheria, noncutaneous 2. Measles (rubeola) and 3. Poliomyelitis The following diseases or conditions require a case report within one day of diagnosis: 1. Gastroenteritis of suspected food-borne or water-borne origin 2. Hemophilus influenza invasive disease (excluding otitis media) in children age five years and under 3. Hepatitis A and B, acute 4. Meningococcal disease 5. Pertussis 6. Rubella, including congenital 7. Salmonellosis, including paratyphoid fever and typhoid fever and 8. Shigellosis The following diseases or conditions require a case report within seven days of diagnosis: 1. Acquired immunodeficiency syndrome (AIDS) and class IV human immunodeficiency virus, (HIV), 2. Viral encephalitis 3. Giardiasis

2 INFECTIOUS DISEASES Page 2 of 7 Procedure Hepatitis non-a, non-b, and unspecified 5. Mumps 6. Kawasaki syndrome 7. Lyme disease 8. Reye Syndrome 9. Rheumatic fever 10. Tetanus 11. Toxic shock syndrome and 12. Tuberculosis In addition to rash illnesses, any unusual cluster of diseases must be reported. In order to prevent outbreaks of measles and spread of the disease in a school, any rash illness suspected of being measles must be reported immediately. The occurrence of any generalized rash with or without fever, cough, runny nose, and reddened eyes in a school MUST be reported IMMEDIATELY by individual case (by telephone) to the local health department. Localized rash cases such as diaper rash, poison oak, etc. need not be reported. Identification And Follow-Up 1. The length of absence from school for a student ill from a contagious disease is determined by the directions given in the Infectious Disease Control Guide or instructions provided by the attending physician, or instructions from the local health officer. 2. The principal has the final responsibility for enforcing all exclusions. 3. When the principal suspects a nuisance disease such as pediculosis (lice), the principal may institute screening procedures to determine if, in fact, the disease exists, he/she may exclude the student from school until successfully treated. 4. Follow-up of suspected communicable disease cases should be carried out in order to determine any action necessary to prevent the spread of the disease to additional children. Reporting At Building Level 1. A student who is afflicted with a reportable disease shall be reported by the school principal or school nurse to the local health officer as per schedule. Employees learning of a student with a sexually transmitted disease shall report directly to the health department and shall otherwise maintain the information is strict confidence.

3 INFECTIOUS DISEASES Page 3 of 7 Procedure When symptoms of communicable disease are detected in a student who is at school, the regular procedure for the disposition of ill or injured students shall be followed unless the student is fourteen years or older and the symptoms are of a sexually transmitted disease. In those instances the student has confidentiality rights that proscribe notification of anyone but the health department. The principal or designee will: a. Call the parent, guardian or emergency phone number to advise him/her of the signs and symptoms. b. Determine when the parent or guardian will pick up the student. c. Keep the student isolated but observed until the parent or guardian arrives. d. Notify the teacher of the arrangements that have been made prior to removing the student from school. First Aid Procedures 1. Wound cleansing should be conducted in the following manner: a. Soap and water are recommended for washing wounds. b. Gloves must be worn when cleansing wounds which may put the staff member in contact with wound secretions. c. Gloves and any cleansing materials will be discarded in a lined trash container that is disposed of daily according to WAC , Bloodborne Pathogens and included in the June 1992 SPI Infectious Disease Control Guide. d. Hands must be washed before and after treating the student and after removing the gloves. e. Treatment must be documented in a health log program. 2. Thermometers shall be handled in the following manner: a. Only disposable thermometers or thermometers with disposable sheath covers should be used when taking student's temperatures. b. Disposable sheath covers will be discarded in a lined trash container that is secured and disposed of daily. Handling Of Body Fluids The following guidelines are meant to provide simple and effective precautions against transmission of disease for all persons, including pregnant women, potentially exposed to the blood or body fluids of any student. No distinction is made between body fluids from students with a known disease or those from students without symptoms or with an undiagnosed disease.

4 INFECTIOUS DISEASES Page 4 of 7 Procedure Does contact with body fluids present a risk? The body fluids of all persons should be considered to contain potentially infectious agents (germs). The term "body fluids" includes: blood, semen, vaginal secretions, drainage from scrapes and cuts, feces, urine, vomitus, respiratory secretions (e.g., nasal discharge), saliva, and tears. Contact with body fluids presents a risk of infection with a variety of germs. In general, however, the risk is very low and dependent on a variety of factors including the type of fluid with which contact is made and the type of contact made with it. Examples of particular germs that may occur in body fluids of children and the respective transmission concerns follows. It must be emphasized that with the exception of blood, which is normally sterile, the body fluids with which one may come in contact usually contain many organisms, some of which may cause disease. Furthermore, many germs may be carried by individuals who have no symptoms of illness. These individuals may be at various stages of infection: incubating disease, mildly infected without symptoms, or chronic carriers of certain infectious agents including the AIDS and hepatitis viruses. In fact, transmission of communicable diseases is more likely to occur from contact with infected body fluids of unrecognized carriers than from contact with fluids from recognized individuals because simple precautions are not always carried out. What should be done to avoid contact with body fluids? When possible, direct skin contact with body fluids should be avoided. Disposable gloves must be available in at least the office of the custodian, nurse, or principal. Gloves are recommended when direct hand contact with body fluids is anticipated (e.g., treating bloody noses, handling clothes soiled by incontinence, cleaning small spills by hand). If extensive contact is made with body fluids, hands should be washed afterwards. Gloves used for this purpose should be put in a plastic bag or lined trash can, secured, and disposed of daily. BODY FLUID SOURCE OF INFECTIOUS AGENTS BODY FLUID SOURCE ORGANISM OF CONCERN TRANSMISSION OF CONCERN Blood cuts/abrasions nosebleeds menses contaminated needle Hepatitis B virus AIDS virus Cytomegalovirus Bloodstream inoculation through cuts and abrasions on hands. *Feces incontinence *Urine incontinence Salmonella bacteria Shigella bacteria Rotavirus Hepatitis A virus Cytomegalovirus Oral inoculation from contami - nated hands. Bloodstream and oral inoculation from contaminated hands.

5 INFECTIOUS DISEASES Page 5 of 7 Procedure Respiratory secretions saliva nasal discharge *Vomitus Semen Mononucleosis virus Common cold virus Influenza virus AIDS virus Hepatitis B virus Gastrointestinal viruses, e.g., Norwalk agent Rotavirus Hepatitis B AIDS virus Gonorrhea Oral inoculation from contami - nated hands. Bloodstream inoculation through cuts and abrasions on hands; bites. Oral inoculation from contami - nated hands. Sexual contact (intercourse) * Possible transmission of AIDS and Hepatitis B is of little concern from these sources. There is no evidence at this time to suggest that the AIDS virus is present in these fluids. What should be done if direct skin contact occurs? In many instances, unanticipated skin contact with body fluids may occur in situations where gloves may be immediately unavailable (e.g., when wiping a runny nose, applying pressure to a bleeding injury outside the classroom, helping a child in the bathroom). In these instances, hands and other affected skin areas of all exposed persons should be routinely washed with soap and water after direct contact has ceased. Clothing and other nondisposable items (e.g., towels used to wipe up body fluid) that are soaked through with body fluids should be rinsed and placed in plastic bags. If presoaking is required to remove stains (e.g., blood, and feces), use gloves to rinse or soak the item in cold water prior to bagging. Clothing should be sent home for washing with appropriate directions to parents/teachers. Contaminated disposable items (e.g., tissues, paper towels, diapers) should be handled with disposable gloves. How should spilled body fluids be removed from the environment? Most schools have standard procedures already in place for removing body fluids (e.g., vomitus). These procedures should be reviewed to determine whether appropriate cleaning and disinfection steps have been included. Many schools stock sanitary absorbent agents specifically intended for cleaning body fluid spills (e.g., *ZGOOP, Parsen Mfg Co., Philadelphia, PA). Disposable gloves should be worn when using these agents. The dry material is applied to the area, left for a few minutes to absorb the fluid, and then vacuumed or swept up. The vacuum bag or sweepings should be disposed of in a plastic bag. Broom and dustpan should be rinsed in a disinfectant. No special handling is required for vacuuming equipment. Handwashing Procedures: Proper handwashing requires the use of soap and water and vigorous washing under a stream of water for approximately 10 seconds.

6 INFECTIOUS DISEASES Page 6 of 7 Procedure Soap suspends easily removable soil and microorganisms allowing them to be washed off. Running water is necessary to carry away dirt and debris. Rinse under running water. Use paper towels to thoroughly dry hands. Disinfectants: An intermediate level disinfectant should be used to clean surfaces contaminated with body fluids. Such disinfectants will kill vegetative bacteria, fungi, tubercle bacillus, and viruses. The disinfectant should be registered by the U.S. Environmental Protection Agency (EPA) for use as a disinfectant in medical facilities and hospitals. Various classes of disinfectants are listed below. Hypochlorite solution (bleach) is preferred for objects that may be put in the mouth. 1. Ethyl or isopropyl alcohol (70 percent). 2. Phenolic germicidal detergent in a one percent aqueous solution (e.g., *Lysol). 3. Household bleach dilutes 1 part bleach to 10 parts water. 4. Quaternary ammonium germicidal detergent in two percent aqueous solution (e.g., *Tri-quat, *Mytar, or *Sage). 5. Iodophor germicidal detergent with 500 ppm available iodine (e.g., *Wescodyne). *Brand names are used only for examples of each type of germicidal solution and should not be considered an endorsement of a specific product. Disinfection of hard surfaces and care of equipment: After removing the soil, a disinfectant is applied. Mops should be soaked in the disinfectant after use and rinsed thoroughly or washed in a hot water cycle before rinse. Disposable cleaning equipment and water should be placed in a toilet or plastic bag as appropriate. Nondisposable cleaning equipment (dustpans, buckets) should be thoroughly rinsed in the disinfectant. The disinfectant solution should be promptly disposed down a drain pipe. Remove gloves and discard in appropriate receptacles. Disinfection of rugs: Apply sanitary absorbent agent, let dry, and vacuum. If necessary, mechanically remove the dustpan and broom, then apply rug shampoo (a germicidal detergent) with a brush and revacuum. Rinse dustpan and broom in disinfectant. If necessary, wash brush with soap and water. Dispose of nonreusable cleaning equipment as noted above. Laundry instructions for clothing soiled with body fluids: The most important factor in laundering clothing contaminated in the school setting is elimination of potentially infectious agents by soap and water. Addition of bleach will further reduce the number of potentially infectious agents.

7 INFECTIOUS DISEASES Page 7 of 7 Procedure Clothing soaked with body fluids should be washed separately from other items. Presoaking may be required for heavily soiled clothing. Otherwise, wash and dry as usual. If the material is bleachable, add 1/2 cup of household bleach to the wash cycle. If the material is not colorfast, add 1/2 cup nonclorox bleach (e.g., Clorox II, Borateem) to the wash cycle. *Brand names are used only for examples of each type of germicidal solution and should not be considered an endorsement of a specific product. Special Treatment Of Students Infected With HIV On the disclosure that a student has been identified as having acquired immunodeficiency syndrome (AIDS) being infected with HIV the superintendent, principal, parent, local health officer, school nurse and the private physician shall confer as necessary and determine the appropriate placement of the student. The student will be accommodated in a least restrictive manner, free of discrimination, without endangering the other students or staff. The student may only be excluded from school on the written concurrence of the public health officer and the student's personal physician, that remaining or returning to school would constitute a risk either to the student or to employees or other students. All discussions and records will be treated as confidential, consistent with RCW Release of information regarding the testing, test result, diagnosis or treatment of a student for a sexually transmitted disease, HIV, drug or alcohol or mental health treatment or family planning or abortion may only be made pursuant to an effective release and only to the degree permitted by the release. To be effective, a release must be signed and dated, must specify to whom the release may be made and the time period for which the release is effective. Students fourteen and older must authorize disclosure regarding HIV or sexually transmitted diseases, students thirteen and older must authorize disclosure regarding drug or alcohol treatment or mental health treatment, and students of any age must authorize disclosure regarding family planning or abortion. Parents must authorize disclosure pertaining to younger students. Any disclosure made pursuant to a release regarding sexually transmitted diseases, HIV or drug or alcohol treatment must be accompanied by the following statement: "This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is not sufficient for this purpose." P3: Administrative Procedure Bethel School District #403