COMMUNICABLE DISEASE PREVENTION AND CONTROL 

Students are excluded from school in cases of communicable diseases which pose a threat to the well being of other students and staff.  When a student is suspected of having one of the following communicable diseases, it is the responsibility of the parent to take the child to the health department or family physician for verification and treatment before that student can return to school.  The principal or designee may request a written statement.

1. Chickenpox (Varicella):  Student is excluded for at least five (5) days after the rash appears or until all blisters have formed scabs.  The incubation period is from 10-21 days.  Period of communicability is from 1 day before the rash appears to 5-6 days after the onset of the rash. Transmission is by secretions from the respiratory tract of the infected persons and to a lesser degree the discharge from skin lesions and scabs until dry.
2. Measles (Rubeola/Rubella):  Student is excluded from school immediately and may return to school a minimum of 5 days after rash appears or until physician’s approval is given and student is no longer contagious.  The incubation period is from 10-12 days. Period of communicability is for at least 7 days after the onset of first symptoms.  Transmission is by respiratory droplet and by contact with articles contaminated with nose, throat, mouth, and eye secretions.
3. Mumps (Infectious Parotitis):  Student is excluded from school and may return a maximum of 9 days after start of swelling.  The incubation period is 14-24 days. The period of communicability is approximately 6 days before and 9 days after salivary gland swelling has appeared.  Transmission is from direct contact, airborne droplets, saliva, and possibly urine from an infected individual. 
4. Pediculosis (Head Lice):  Upon identification of live lice, the school nurse will notify the parent/guardian and provide education regarding identification and treatment of lice.  The student may stay at school for the remainder of the school day (in the classroom) or may be picked up if the parent chooses. Upon return to school the next day, the student should be checked by school personnel and/or provide proof of treatment. If live lice are found, then the student will be excluded from school until treated. School nurses will also provide education to staff and students regarding classroom prevention measures as needed. Classroom screening and notification is not required according to the NC Parent Bills of Rights.  
5. Scabies:  Student is excluded until 24 hours after treatment has been completed with one application of Permethrin lotion.  Instruct parents that all family members should be treated. They will also need to wash all bed linens, towels, underwear, etc., in hot water.  The incubation period is 4-6 weeks for new infestations.  If a person who has been infected previously, symptoms appear in a few days.  Period of communicability is while the mite is still alive.  The mite cannot live over 48-72 hours without a host. 
6. Conjunctivitis (Pink Eye):  Student is excluded if eye is severely red and swollen, there is purulent discharge, excessive itching, or condition has lasted more than three days. Student is allowed to return to school 24 hours after treatment has started. Student with allergic conjunctivitis is not excluded from school.  
7. Impetigo:  Student is excluded from school if he has more than three to four sores and until seen by physician and treated with a prescription antibiotic for 24 hours.  Without medical treatment, a student cannot return to school until lesions are dry.  Incubation period is 2-5 days.  Period of communicability is until lesions are dry.  Transmission is by direct contact.  
8. Streptococcal and Staphylococcal Infections:  Student is excluded from school until treated with a prescription antibiotic for 24 hours and if no fever for 24 hours without use of fever reducing medications.  
9. Influenza: Student is excluded from school for at least 5 days from the onset of symptoms or until free from fever without use of medications x 24 hours.
10. Mononucleosis: Student is excluded from school until free from fever without use of medications x 24hrs.  Student may return after acute symptoms have disappeared. The incubation period is 3-7 weeks. Period of communicability may last for months in viral secretions, making asymptomatic carriers common.  Transmission is generally by direct, intimate contact with infected saliva.  Repeated and prolonged contact with infected oral secretions is thought to be required. Individualized health plan can be created by school nurse/physician when student returns to school if necessary.
11. Whooping Cough (Pertussis): Student is excluded from school until the paroxysmal cough stage has started, usually 1-2 weeks or as determined by a physician.
12. Fever: Student is excluded from school for oral temperature of 100.0 or higher.  Student must be fever free for 24 hours without use of fever reducing medication prior to returning to school.
13. Diarrhea: Student generally will not be excluded for one or two loose stools unless other signs of illness exist.  Student must be fever free for 24 hours without the use of fever reducing medications.
14. Vomiting: Student will be excluded from school until no episodes of vomiting for 24 hours have occurred.  
15. Pinworms: Children can return to school after taking the first dose of medicine, bathing, trimming, and scrubbing their nails. At that time they can also take part in regular activities, such as swimming, sports, and after-school events.  It is usually suggested that people with symptoms get a second treatment 2 weeks after the first treatment to kill any adult worms that may have hatched from eggs during that time. Pinworm medicine does not kill pinworm eggs.  Transmission is either directly by the transfer of infective eggs by hand from the anus to the mouth or indirectly through articles contaminated with eggs.  The eggs can survive up to 2 weeks without a human host on objects such as bed linens, underwear, food, shared toys, bath items, door knobs, and toilet seats.
16. Fifth Disease:  Student will be excluded from school if he or she has a temperature of 100.0 or higher and until a rash has erupted.  Students are not thought to be contagious once an appearance of rash has occurred.  The incubation period is less than one month.  The period of communicability is up to the appearance of the rash.
17. Hand, Foot, and Mouth Disease:  Students will be excluded from school during the acute phase and until fever free for 24 hours without use of fever reducing medications.  The incubation period is 4-6 days. The period of communicability is during the acute phase of illness. Transmission is from person to person by direct contact with nose and throat secretions or the stool of infected persons.
18. Shingles: Students will be excluded from school until lesions are crusted which may be 1-2 weeks.  Students may return to school if lesions can be covered.  Transmission is by direct contact with un-crusted lesions.

19. Ringworm: Exclusion depends on the age and developmental level of the student.  If younger students or disabled and lesions cannot be covered, exclude students from school until treatment has started.  After treatment, recheck in 1-2 weeks for improvement. If no improvement, refer the student back to the primary care provider. 
20. HIV/AIDS:  

• North Carolina General Statute 130A-136 requires school officials to report certain diseases, including HIV/AIDS to the local health department.  Confidentiality of such reports is protected by law.
• Most children with AIDS or HIV infection represent no threat for HIV transmission in the classroom and should be provided an education in the usual manner.
• Children with HIV infection who have behavioral abnormalities (e.g., aggressive and/or destructive behaviors, biting others) or who have open oozing wounds or sores which cannot be adequately covered may pose a risk for HIV transmission to others.  If the attending physician of a child infected with HIV believes that the child may pose a risk of transmission in the classroom, the physician shall notify the local health director.  The local health director and the school superintendent shall then act in accordance with public health regulations to determine whether the child can safely attend school, and - if necessary - define an appropriate alternative educational setting.
• Confidentiality must be strictly protected by the school system for all children known to have HIV infection.
• School officials should notify parents of children known to have AIDS or HIV infection when illnesses that may represent a threat to immunosuppressed children are occurring in the school.  These include chickenpox, measles, whooping cough, meningitis, and influenza, or other serious reportable diseases.
• School personnel will receive training in how HIV/AIDS and other infectious diseases are acquired, how transmission can be prevented, and how to handle body fluids in schools.
• North Carolina law requires that public schools educate students about AIDS and how they can protect themselves from acquiring HIV infection (G.S. § 115C-81(El).

21. COVID-19:

• • • According to the CDC, students or staff members testing positive for COVID-19 should stay home and away from others until at least 24 hours after symptoms are improving and they have not had a fever for 24 hours without the use of fever reducing medications.