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Communicable Disease Guide for Schools and Child Care Settings
Contra Costa County works closely with K-12 school partners to keep students, staff, and their families safe and healthy.
This page contains information for K-12 and Childcare facilities about a variety of infectious diseases, as well as information for disease prevention and control. Information is intended for childcare providers, and school health staff. It contains handy information on diseases (like chickenpox) and nuisance conditions (such as lice) commonly encountered in school and child care settings. In addition to this page, CDPH has resources for Schools and Childcare facilities. Their guidance focuses on considerations when a child has symptoms of illness without a diagnosis.
Questions about what is reportable? Visit our report a disease or outbreak page. For questions call us at 925-313-6740. If you suspect you have an outbreak report to public health. Outbreaks typically mean having two or more cases of a confirmed disease but the definition varies by disease type. Schools and childcare facilities can often identify outbreaks by changes in absenteeism. If you notice an unusual change in attendance give us a call.
- Report an Outbreak (non-COVID)
- Covid-19 Outbreaks use SPOT.
When to report:
Chickenpox must be reported to your local Public Health Department when an outbreak, hospitalization, or death occur.
Symptoms:
The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may first show up on the face, chest, and back then spread to the rest of the body, including inside the mouth, eyelids, or genital area. It usually takes about one week for all the blisters to become scabs.
Other typical symptoms that may begin to appear 1-2 days before rash include high fever, tiredness, loss of appetite, and headache.
The virus spreads from person to person by direct contact with blister fluid or airborne spread of aerosolized blister secretions and respiratory secretions. Indirect spread is possible through articles recently soiled by infected respiratory secretions or blister fluid.
A person with chickenpox is contagious as long as 5 days before the rash begins, but usually 1 to 2, until all lesions are crusty/scabbed (usually 5 days after their appearance). Immunocompromised individuals may have a longer period of communicability.
What can you do to prevent chickenpox:
All children should be vaccinated with two doses of varicella vaccine; the first dose is at age 12-15 months and the second dose is typically at 4-6 years of age.
Clean and sanitize mouthed toys, objects, and surfaces and clean and disinfect objects and surfaces contaminated with secretions from the nose or mouth and/or blister fluid at least daily, and when soiled.
Cover nose and mouth with a tissue when coughing or sneezing or cough/sneeze into your elbow. Dispose of used tissues.
Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth or blister fluid.
What to do if you get chickenpox or are exposed to chickenpox:
Children should be excluded from childcare and school until all the blisters have scabbed (usually 5 days after their appearance), regardless of vaccination status. Exclude a child with chickenpox symptoms until the blisters have scabbed regardless of whether or not they have received varicella vaccine.
Susceptible persons (did not receive varicella vaccine) who have been exposed to someone with chickenpox should call their healthcare provide immediately. This is especially important for pregnant women and persons with a weakened immune system.
When to report:
COVID-19 must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
COVID-19 is a contagious respiratory illness caused by coronaviruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and at times can lead to death.
People who have COVID-19 often feel some or all of these signs and symptoms:
Fever or chills
Cough
Shortness of breath or difficulty breathing
Sore throat
Congestion or runny nose
New loss of taste or smell
Fatigue
Muscle or body aches
Headache
Nausea or vomiting
Diarrhea
Symptoms start 1 to 7 days after being exposed to the virus and may last up to one week or longer. Complications caused by the COVID-19 can include; pneumonia, ear infections, sinus infections, and dehydration. COVID-19 can also make a person’s chronic medical conditions (e.g. asthma, heart or lung disease, etc.) worse.
What can you do to prevent COVID-19:
Stay up to date with vaccinations.
Cover nose and mouth when sneezing or coughing. Use a tissue or your sleeve. Dispose of used tissue. Consider wearing a mask.
Wash hands after touching anything that could be contaminated with the secretions from the mouth or nose. Your child may need help with handwashing.
DO NOT share drink containers and cups or silverware. Wash all dishes with hot soapy water between uses.
Clean and disinfect anything that comes in contact with secretions from the nose or mouth. Use a product that kills germs.
Improve indoor air quality by opening windows and/or using air filters.
DO NOT expose your child to second-hand tobacco smoke. Smoking and vaping increase the risk for serious respiratory infections and middle ear infections.
What to do if you get COVID-19:
Children should be excluded from school or childcare until at least 24 hours after they no longer have a fever or signs of a fever (chills, feeling very warm, flushed appearance, or sweating) without the use of fever-reducing medicine and overall symptom improvement.
When to report:
Diarrheal illness must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Diarrhea is an increased number of stools (compared with a person’s normal pattern), along with decreased stool form or watery, bloody, and/or mucus-containing stools. Diarrhea often is a symptom of infection caused by germs such as bacteria, parasites, or viruses.What can you do to prevent Diarrheal Illness:
Wash hands thoroughly with soap and warm running water after using the toilet and changing diapers and before preparing or eating food. Staff should closely monitor handwashing of all children after children have used the bathroom or have been diapered.Clean and disinfect diapering area and potty chairs after each use and bathroom toilets, sinks, and toys at least daily and when soiled.
Clean and sanitize mouthed toys, objects and surfaces at least daily, and when soiled.
May attend* school or childcare unless the child has one of the following:
Stool not contained in the diaper or toilet (when toilet-trained)
Stool looks like it contains blood or mucus, or appears like sticky black tar
Yellow skin/eyes (jaundice)
Diarrhea that occurs during an outbreak, and exclusion is recommended by the local health department
*Note: If the child has been diagnosed with a specific infection (such as Shigella, Salmonella/typhoid, Shiga toxin-producing E. Coli, norovirus, etc.), follow the advice of the local health department if they are involved, or the guidance of the child’s health care professional. If there is concern for an outbreak (more persons with diarrhea than would be expected in the setting for that time of year), contact the local health department for guidance.
When to report:
Hib must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Children age 2 and under are most likely to develop symptoms, although those up to age 5 are still at some risk. Invasive disease most commonly occurs in children who are too young to have completed their vaccination series.Typical symptoms of Hib are:
Meningitis: unusual sleepiness, fever, stiff neck, vomiting, headache, irritability, lack of appetite.
Cellulitis: a tender, rapid swelling of the skin, usually on the cheek or around the eye; may also have an ear infection on the same side and/or a low-grade fever.
Epiglottitis: fever, trouble swallowing, tiredness, difficult and rapid breathing (often confused with viral croup, which is a milder infection and lasts longer.)
Pneumonia: fever, cough, chest pains, difficulty breathing.
Bacteremia: sudden onset of fever, chills, tiredness, irritability.
Arthritis: swelling, redness, and loss of movement in the joints.
Please note that Haemophilus influenzae type B is a bacterial infection and not associated with the typical seasonal influenza. People can get infected when a person with Hib disease coughs or sneezes into the air and another person breathes them in. A person can also get infected from touching these secretions and then touching their mouth, eyes, or nose.
What can you do to prevent Hib infection:
Vaccination is the most effective way to prevent Hib infection. All infants should receive Hib vaccine as part of their routine vaccination schedule. Infants need four doses of Hib vaccine by age 1. Most persons 5 years and older do not need Hib vaccine. However, discuss the need for vaccine with your health care provider if the individual has sickle cell anemia or have a weakened immune system due to any of the following factors: HIV/AIDS, treatment with drugs such as long-term steroids, cancer treatment, bone marrow or organ transplant or a damaged spleen.What to do if you get Hib infection:
Children should be excluded from childcare and school until the child has been treated with antibiotics and is well enough to participate in routine activities.When to report:
If you suspect a head lice outbreak you can contact local Public Health Department for support and guidance.
Symptoms:
Head lice can colonize a person's head and cause an infestation. It may take four to six weeks for itching to appear the first time a person has head lice. Signs and symptoms of an infestation include:
Itchiness of the head, neck and ears
Small, red bumps on the scalp, neck and shoulders
Tiny white specks (the eggs or nits) on the bottom of each hair shaft that are hard to remove
Head lice infestation is often asymptomatic. Any human with hair can get a head lice infestation.
Head-to-head contact with an infested person is the most common way to get head lice.
Head-to-head contact is common:
During play at school
At home
During sports activities
At the playground
At slumber parties
It is also possible, although uncommon, to get head lice through sharing items that may be infested with lice such as:
Clothing (hats, scarves)
Hair accessories (combs, brushes, ribbons, ties)
Towels
Bed
Pillow
Carpet
Couch
Dogs, cats, and other pets do not play a role in the spread of head lice.
What can you do to prevent head lice:
There are practices that you can take to get rid of head lice or nits remaining in your home:
Wash clothing and bedding in hot water for at least 20 minutes.
Seal items that may have been infested in bags for two weeks (to stop the lice from feeding).
Boil in water or soak in rubbing alcohol: combs, brushes, and hair accessories.
Vacuum carpets and furniture.
Fellow household member of the lice-infested child should have their scalp examined.
What to do if you get head lice:
Contact a physician for treatment of a child under the age of 2. For individuals over the age of 2, there are several available treatments for head lice infestations, some of which are:
Nit combing and removal
Nit combs can be purchased at your local pharmacy.
Comb hair with a nit comb every day for about two weeks.
Nits that cannot be removed with a comb can be picked out with your fingernails or tweezers.
Over-the-counter head lice treatments from a pharmacy
These treatments involve using products to wash and treat the hair which kill the lice and nits.
Please note that the following treatments have not been proven to be effective:
Vinegar
Compounds that say they dissolve the glue on the nits "to ease their removal"
Mayonnaise
Olive oil
Tea tree oil
Lotions that "suffocate" lice
In the event that your child may have a head lice infestation you should inform the school nurse or administration. Schools and childcare facilities have varying rules about whether your child will be able to attend while infested with head lice. As of May 2024, California Department of Public Health no longer recommends a no live lice policy for schools.
When to report:
Hand, foot, and mouth disease must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Hand, foot, and mouth disease is a viral infection that causes a blister-like rash involving the hands, feet, and mouth. The infection occurs most commonly in children less than 10 years of age and most often in the summer and fall months. Outbreaks may occur in childcare settings and preschools.
Symptoms:
Low-grade fever lasting 1 to 2 days, runny nose, and/or sore throat. Blister-like rash occurs in the mouth, on the sides of the tongue, inside the cheeks, and on the gums. These sores may last 7 to 10 days. Blister-like rash may occur on the palms and fingers of the hands and on the soles of the feet. The disease is usually self-limited, but in rare cases has been fatal in infants.What can you do to prevent Hand, foot, and mouth disease:
Cover nose and mouth with a tissue when coughing and sneezing or cough/sneeze into your sleeve. Dispose of used tissues.
Wash hands thoroughly with soap and warm running water after using the bathroom, after changing diapers, after handling anything soiled with stool or secretions from the nose or mouth, and before preparing food or eating. Staff should closely monitor handwashing of all children after children have used the bathroom or have been diapered. If soap and water are not available, use alcohol-based hand sanitizer.
Clean and disinfect diapering area and potty chairs after each use and bathroom toilets, sinks, and toys at least daily and when soiled. Clean and sanitize mouthed toys, objects, and surfaces at least daily and when soiled.
May attend* school or childcare unless the child has one of the following:
Oozing, open wound or infection that cannot be covered and is in an area that might come in contact with others.
Skin that looks bruised without a known injury or in an unusual location.
Rapidly spreading dark red or purple rash (may indicate a rare but severe bacterial infection; usually accompanied by fever).
Tender, red area of skin, rapidly increasing in size or tenderness.
Associated symptoms of a serious allergic reaction (rash with throat closing, abdominal pain, vomiting, or wheezing).
Fever (see Fever for return guidance)
There is concern for a disease like chickenpox or measles. If this is the case, the child should see a healthcare provider and the local health department should be contacted.
Note: For diagnosed conditions, follow the advice of the healthcare provider. In general, for conditions such as lice, impetigo, ringworm, scabies, and pinworms, no waiting period is typically necessary after starting treatment and the child may return after the appropriate treatment is started.
When to report:
Impetigo must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Typically begins at a break in the skin (e.g., insect bite, cut). Sores form on the skin and produce a thick golden-yellow discharge that dries, crusts, and sticks to the skin. Rarely, problems such as kidney disease or cellulitis (skin infection) may develop if children do not receive proper treatment.What can you do to prevent Impetigo:
Wash hands thoroughly with soap and warm running water after contact with sores.Wear disposable medical gloves if applying ointment to sores or use cotton-tipped swabs.
Cover sores whenever possible to prevent spread. Discourage children from scratching infected areas.
DO NOT share towels, washcloths, or clothing.
Clean and sanitize mouthed toys, objects, and surfaces at least daily and when soiled.
What to do if you get Impetigo:
If impetigo is confirmed by a healthcare provider, do not return to school or daycare until 24 hours after treatment has been initiated and sores are drying or improving.
When to report:
Influenza must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
The flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and at times can lead to death.People who have the flu often feel some or all of these signs and symptoms:
Fever, or feeling feverish/chills
Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headaches
Fatigue (tiredness)
Some people can also have vomiting and diarrhea. Symptoms start 1 to 3 days after being exposed to the virus and may last up to one week or longer. Complications caused by the flu can include: pneumonia, ear infections, sinus infections, and dehydration. The flu can also make a person’s chronic medical conditions (e.g. asthma, heart or lung disease, etc.) worse.
What can you do to prevent the flu:
The best way to prevent flu illness is by getting vaccinated. Influenza vaccination is recommended yearly for everyone 6 months and older. It is safe and effective to receive both flu and COVID vaccine at the same visit.The single best way to prevent the flu is to get a flu vaccine each season.
Wash hands often with soap and warm water.
Use tissue or upper arm when you cough and sneeze. Dispose of the tissue in a covered trash bin.
Clean shared items (e.g. phones, keyboards, office equipment, toys, etc.) more often.
Avoid crowds.
Avoid people who are sick with respiratory illness.
Exclude children with respiratory illness from daycare and school.
Stay home for at least 24 hours after becoming fever free or finishing medication if you are ill with flu or any respiratory illness.
What to do if you get the flu:
Stay home for at least 24 hours after becoming fever free or finishing medication if you are ill with flu or any respiratory illness.When to report:
Measles must be reported to your local Public Health Department when a suspected case, outbreak, hospitalization or death occur.
Symptoms:
Measles (also called rubeola, red measles, or hard measles) is a serious illness that may be prevented by vaccination. Currently, measles most often occurs in susceptible persons (those who have never had measles or measles vaccine) who are traveling into and out of the United States. Once measles cases occur, there may be spread to persons or groups of people who have not been vaccinated.The first symptoms seem like the beginning of a cold with a high fever, watery eyes, runny nose, and cough. A red blotchy rash appears on the third to seventh day, usually beginning on the face (hairline), spreading down the trunk and down the arms and legs. The fever may still be present after the rash starts. The rash usually lasts 4 to 7 days. Measles is sometimes complicated by diarrhea, ear infection or pneumonia. About one child in every 1000 who gets measles will develop encephalitis (inflammation of the brain). Encephalitis can lead to seizures, deafness, or mental retardation.
What can you do to prevent Measles:
The best way to prevent Measles is vaccination. Measles vaccine is combined with mumps and rubella vaccine (MMR) with the first dose at age 12-15 months and the second at age 4-6 years. There is also a vaccine that protects against varicella (MMRV), with the same dosing schedule as MMR. Two doses or a valid exemption notice from a licensed medical provider are required for kindergarten and seventh grade enrollment.Unvaccinated people who have been exposed to measles virus should call their healthcare provider or local public health clinic as soon as possible to be vaccinated.
If measles vaccine is given within 72 hours of exposure, it may provide some protection. Encourage parents/guardians to notify the childcare provider or school when their child is vaccinated so their records can be updated. Immune globulin (IG), if given within 6 days of exposure, can prevent or make the symptoms of measles milder. This should be strongly considered for contacts younger than one year of age, pregnant women who have never had measles or measles vaccine, or persons with a weakened immune system.
Recommend staff stay home if they develop symptoms of measles. Encourage parents/guardians to keep their child home if they develop symptoms of measles.
Teach children and staff not to touch their eyes, nose, or mouth.
Cover your nose and mouth with a tissue when coughing or sneezing, or cough/sneeze into your sleeve. Dispose of used tissues.
Clean and sanitize mouthed toys, objects, and surfaces at least daily and when soiled.
Wash hands thoroughly with soap and warm running water after touching secretions from the nose or mouth.
What to do if you get Measles:
Children should be excluded from school or childcare until 4 days after the rash appears. A child with measles is contagious from 4 days before to 4 days after the rash appearance. Exclude unvaccinated children and staff within 72 hours of exposure for at least 2 weeks.If you are planning to go to a healthcare facility, call or alert healthcare staff beforehand so that steps can be taken to prevent the spread of measles to others.
When to report:
Meningococcal Disease must be reported to your local Public Health Department when a case, outbreak, hospitalization or death occur.
Symptoms:
Symptoms will depend on the site of the infection. Generally, signs and symptoms may include sudden onset of fever, chills, feeling unusually weak or tired, stiff neck, headache, nausea, vomiting, mental confusion, sleepiness and being difficult to wake or a rash anywhere on the body.
Baby’s symptoms are poor feeding, irritability, fever and sometimes vomiting. Any of these symptoms require immediate medical attention.
What can you do to prevent Meningococcal Disease:
All 11-12 years olds should be vaccinated with meningococcal conjugate vaccine. A booster dose should be given at age 16 years. For adolescents who receive the first dose at age 13 through 15 years, a one-time booster dose should be administered, preferably at age 16 through 18 years, before the peak in increased risk. Adolescents who receive their first dose of meningococcal vaccine at or after age 16 years do not need a booster dose. The new vaccine is also recommended for certain high-risk persons. The risk of disease may be reduced by not smoking, and by minimizing upper and lower lung infections. Get appropriate vaccines to reduce your risk of respiratory infection such as influenza and pneumococcal vaccine. Last but not least, good hand washing and covering your cough will go a long way in preventing illness for yourself and others.
What to do if you get Meningococcal Disease:
Exclude child from school or childcare until the child has been on appropriate antibiotics for at least 24 hours and is well enough to participate in routine activities. The childcare provider or school may choose to exclude exposed staff and attendees until preventive treatment has been started, or if there is concern that they will not follow through with recommended preventive treatment otherwise.When to report:
Mono must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Fever, sore throat, swollen glands (especially behind the neck), headache, tiredness, and sometimes a rash. Mono can last up to several weeks. It may take weeks to months to regain energy; however, this will vary from person to person.Less common problems include jaundice (yellowing of the skin or eyes) and/or enlarged spleen or liver. Although rare, the spleen may rupture in extreme cases.
What can you do to prevent Mono:
Wash hands completely with soap and warm running water after any contact with saliva or items contaminated with saliva.DO NOT allow sharing of drinking cups, bottles, straws, cigarettes, mouthed pens and pencils, toothbrushes, or lip balm.
Avoid kissing an infected child on the lips or having contact with their saliva.
Clean and sanitize mouthed toys, objects, and surfaces at least daily and when soiled.
What to do if you get Mono:
No exclusion is necessary, as long as the child is able to participate in routine activities. Because students/adults can have the virus without any symptoms and can be contagious for such a long time, exclusion will not prevent spread.When to report:
MRSA must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Most MRSA infections are skin infections that typically cause local redness and warmth of the infected area with or without pus/drainage. These infections commonly occur at sites of visible skin trauma, such as cuts and abrasions, and areas of the body covered by hair (e.g., back of neck, groin, buttock, armpit). Localized infections include boils, impetigo, cellulitis, and wound infections. More serious infections, such as pneumonia, bloodstream infections, or bone infections, are very rare in healthy people who get MRSA skin infections.What can you do to prevent MRSA:
Encourage careful and frequent hand washing with soap and water - the single most effective way to control spread of MRSA.Encourage students to keep their fingernails clean and clipped short.
Avoid contact with other people’s wounds or anything contaminated by a wound.
Avoid sharing personal items such as razors, body jewelry, towels, deodorant, or soap that directly touch the body.
Clean and disinfect objects (such as gym and sports equipment) before use.
Wash dirty clothes, linens, and towels with hot water and laundry detergent. Using a hot dryer, rather than air-drying, also helps kill bacteria.
Encourage students who participate in contact sports to shower immediately after each practice, game, or match.
Keep open or draining sores and lesions clean and covered. Anyone assisting with wound care should wear gloves and wash their hands with soap and water after dressing changes.
What to do if you get MRSA:
MRSA is treated with antibiotics. Children with draining sores should not participate in any activities where skin-to-skin contact is likely to occur until their sores are healed. This means no contact sports.When to report:
Mumps must be reported to your local Public Health Department when a case, outbreak, hospitalization or death occur.
Symptoms:
The most common symptoms include swollen glands in front of and below the ear, headache, low-grade fever, muscle pain and earache. Of all people infected with the mumps virus, about 70% will have symptoms.Rarely, swelling of the spinal cord and brain (encephalomyelitis), swelling of the meninges (meningitis), inflammation of the ovaries (oophoritis) or breasts (mastitis), and deafness may occur. Serious problems from mumps are more common among adults than children.
What can you do to prevent Mumps:
The best way to prevent Mumps is vaccination. Mumps vaccine is combined with measles and rubella vaccine (MMR). The first dose is at age 12-15 months and the second is at age 4-6 years. Two doses or a personal belief exemption are required for kindergarten and seventh grade enrollment.Unvaccinated people who have been exposed to mumps should call their healthcare provider or local public health clinic as soon as possible to be vaccinated.
Encourage parents/guardians to notify their childcare provider or school when their child is vaccinated so their records can be updated.
Staff or children who develop symptoms of mumps are recommended to stay home.
DO NOT allow sharing of beverage containers, eating utensils, smoking materials (cigarettes, cigars, snuff, pipes, etc.), toothbrushes, lip gloss, lip balm, and lipstick.
Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth.
What to do if you get Mumps:
Children should be excluded from childcare and school until 5 days after onset of swelling. Unvaccinated children and staff should be excluded from childcare or school if two or more cases of mumps occur. Call Communicable Disease Programs at 925-313-6740 for more details.
When to report:
Norovirus must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
The symptoms of norovirus illness usually include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people also have a low-grade fever, chills, headache, muscle aches, and tiredness. People may suddenly feel very sick and vomit frequently or have several episodes of diarrhea, but most people get better within 1 or 2 days, and they have no long-term health effects related to their illness. Diarrhea is more common in children and vomiting is more common in adults. Dehydration may occur because of the loss of fluids through vomiting and diarrhea.What can you do to prevent Norovirus:
You can reduce your chances of getting sick by following these simple guidelines:Frequent handwashing with soap and water (especially after using the bathroom and before handling food)—alcohol‐based hand cleaners do not kill Norovirus.
Prompt disinfection of contaminated surfaces with a freshly prepared bleach solution (1/3 cup bleach to 1 gallon water). When vomiting has occurred, immediately close off the area and disinfect all surfaces within a 25 foot radius. Discard any food that was in the area.
Wear gloves when cleaning soiled surfaces.
Wash soiled clothing and linens as soon as possible.
Do not swim in a pool or any recreational water if you’ve recently had a diarrheal illness.
Stay home during illness and for at least 2 days (48 hours) after your symptoms have resolved.
Food handlers should stay home during illness and for at least 3 days (72 hours) after their symptoms have resolved.
What to do if you get Norovirus:
Children should be excluded from childcare and school until 48 hours after symptoms have stopped. Everyone with vomiting and/or diarrhea should NOT use pools, swimming beaches, recreational water parks, spas, or hot tubs for at least 72 hours (3 days) after diarrhea and/or vomiting symptoms have stopped.When to report:
Pertussis must be reported to your local Public Health Department when a case, outbreak, hospitalization or death occur.
Symptoms:
Illness starts out like the common cold: low-grade fever, runny nose, sneezing, and mild cough that increases in severity. As the cough continues, it worsens and is described as fits of coughing where the characteristic whoop may or may not be heard. Individuals may gag and vomit at the end of these fits.What can you do to prevent Pertussis:
The best way to prevent pertussis (whooping cough) among infants, children, teens, and adults is to get vaccinated. Also, keep infants and other people at high risk for pertussis complications away from infected people.People who are exposed to pertussis should contact their healthcare provider or public health clinic to either be vaccinated, if they are currently unvaccinated, or to possibly receive preventative antibiotics.
People who develop the symptoms of pertussis within 21 days of exposure should stay home and call their healthcare provider.
Cover your nose and mouth with a tissue when coughing or sneezing, or cough/sneeze into your sleeve. Dispose of used tissues.
Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth.
Clean and sanitize mouthed toys, objects, and surfaces at least daily and when soiled.
What to do if you get Pertussis:
Children should be excluded from school or childcare until 5 days after appropriate antibiotic treatment begins. If an individual is suspected, but not confirmed, for pertussis, exclude until 5 days of antibiotics are completed or until the laboratory test comes back negative.When to report:
If you suspect a Pinkeye outbreak you can contact local Public Health Department for support and guidance.
Symptoms:
Redness in the whites of the eyes
Swollen eyelids
Itchy eyes
Clear or yellow discharge that may make the eyelids stick together during sleep so pink eye is sometimes also called “sticky eyes”
Teary eyes
Symptoms can begin 24 to 48 hours after contact with the bacteria that cause pink eye. If a virus is the cause of pinkeye, symptoms can begin four to 12 days after contact. If you have severe symptoms such as eye pain, vision changes and sensitivity to light, call your health care provider for evaluation
What can you do to prevent Pinkeye:
Wash hands after touching or wiping eyes.
Exclude symptomatic children from school and day care setting until 24 hours after start of treatment and there is no more discharge from the eyes.
Cover nose and mouth when coughing or sneezing.
Dispose of soiled tissues in appropriate receptacle.
Disinfect contaminated surfaces.
Do not share personal items such as towels, eye makeup or washcloths.
Do not share binoculars, cameras or glasses with an infected person.
Throw away used eye makeup after pink eye infection.
What to do if you get Pinkeye:
Children should be excluded from school or childcare if they have red eyes and/or discharge.
When to report:
Respiratory infections must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Symptoms may include a runny nose, chills, muscle aches and a sore throat. Individuals may sneeze and cough and be more tired than usual. It is important to check for a fever. Symptoms can last about 7 days and the infection is contagious to others shortly before and while experiencing symptoms. One potential serious complication is pneumonia.What can you do to prevent Respiratory Infections:
Cover nose and mouth when sneezing or coughing. Use a tissue or your sleeve. Dispose of used tissue.Wash hands after touching anything that could be contaminated with the secretions from the mouth or nose. Your child may need help with handwashing.
DO NOT share drink containers and cups or silverware. Wash all dishes with hot soapy water between uses.
Clean and disinfect anything that comes in contact with secretions from the nose or mouth. Use a product that kills germs.
DO NOT expose your child to second-hand tobacco smoke. Smoking and vaping increase the risk for serious respiratory infections and middle ear infections.
What to do if you get Respiratory Infections:
Children should be excluded from school or childcare until at least 24 hours after they no longer have a fever or signs of a fever (chills, feeling very warm, flushed appearance, or sweating) without the use of fever-reducing medicine.When to report:
Ringworm should be reported to your local Public Health Department when outbreaks, hospitalizations or deaths occur.
Symptoms:
Vary by location of the fungal infection.
Body - Appears as flat, spreading, ring-shaped areas on the skin (lesions). The edge of the lesion may be dry and scaly, or moist and crusted. As the lesion spreads outward, the center often becomes clear.
Scalp - May be hard to detect in the early stages. It often begins as a small scaly patch on the scalp and may progress to larger areas of scaling. Mild redness, swelling, itching, and pustules (pus-filled bumps) may occur. Infected hairs become brittle and break off easily.
Feet - (Also called athlete’s foot) Scaling or cracking of the skin, especially between the toes, or blisters containing thin, watery fluid may be seen. Itching is common. Serious problems can include bacterial skin infection (cellulitis) and fungal infections of the toenails.
What can you do to prevent Ringworm:
Exclude infected children from school until treatment has startedWash towels and clothing with hot water and a bleach or hydrogen peroxide solution
Keep common areas such as showers stalls, benches, dressing rooms, clean; disinfect floors and benches with a bleach or hydrogen peroxide solution.
Do not share clothing, towels, hairbrushes or other personal items
If you have ringworm, stay away from community pools and gyms until you have had treatment; follow your primary health care provider's instructions regarding treatment.
What to do if you get Ringworm:
Children should be excluded from childcare and/or school until treatment has been started or if the lesion cannot be covered. If on the scalp, until 24 hours after treatment has been started. Any child with ringworm should not participate in gym, swimming, and other close contact activities that are likely to expose others until 72 hours after treatment has begun or until the lesions can be completely covered.When to report:
Rubella must be reported to your local Public Health Department when a case, outbreak, hospitalization or death occur.
Symptoms:
The symptoms of rubella are like a mild cold, starting with a slight fever, sore throat and enlarged lymph glands in the neck and behind the ears, followed by a rash 2 – 3 days later. The rash, which usually lasts about 3 days, first appears on the face and progresses to the chest and gradually works its way down the body. Congenital rubella, rubella infection passed from pregnant mother to fetus, can result in serious complications.What can you do to prevent Rubella:
Vaccination is the most effective way to prevent rubella infectionUnvaccinated people who have been exposed to rubella should call their healthcare provider or local public health clinic as soon as possible to be vaccinated.
Encourage parents/guardians to notify the childcare provider or school when their child is vaccinated, so their records can be updated.
Recommend staff stay home if they develop symptoms of rubella. Encourage parents/guardians keep their child home if they develop a rash, fever, and swollen glands behind the ears or neck.
Cover your nose and mouth with a tissue when coughing or sneezing, or cough/sneeze into your sleeve. Dispose of used tissues.
Clean and sanitize mouthed toys, objects, and surfaces at least daily, and when soiled.
Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth.
What to do if you get Rubella:
Children who have been diagnosed with Rubella should be excluded from childcare and school for seven (7) days after the rash appears. Unvaccinated children who are contacts to the case should be excluded from childcare and school until they are cleared by Contra Costa Public Health.When to report:
RSV must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Symptoms can be similar to a mild cold with low-grade or no fever, cough, watery eyes, runny nose, nasal stuffiness, and sneezing. However, the more severe form includes wheezing, as seen in bronchiolitis and lung congestion, as seen in pneumonia. In very young infants, irritability, decreased activity, and breathing difficulties may be the only symptoms of infection.What can you do to prevent RSV:
Cover nose and mouth with tissue when coughing or sneezing or cough/sneeze into your sleeve. Dispose of used tissues.Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth.
DO NOT share cups, glasses or eating utensils.
Clean and disinfect commonly touched surfaces (door knobs, refrigerator handle, water faucets, cupboard handles) at least daily.
Clean and sanitize mouthed toys, objects, and surfaces at least daily and when soiled.
Clean and sanitize all dishes and silverware after each use.
What to do if you get RSV:
Children should be excluded from childcare and/or school until fever is gone and the child is well enough to participate in routine activities.When to report:
Strep throat must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Strep throat: Sore throat (usually starting quickly), severe pain when swallowing, fever, red and swollen tonsils with white patches or pus, and/or tiny red spots on the area at the back of the roof of the mouth. Possibly headache, nausea and/or vomiting, swollen lymph nodes in the neck, or body aches.Scarlet fever: A red rash that makes the skin feel like very fine sandpaper, in addition to the above symptoms for strep throat. Although the cheeks might have a flushed appearance, there may be a pale area around the mouth.
What can you do to prevent Strep Throat:
Cover nose and mouth when coughing or sneezing or cough/sneeze into your sleeve.Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth, changing diapers, or using the toilet.
Clean and sanitize mouthed toys, objects, and surfaces with a hydrogen peroxide based spray or wipe at least daily, and when soiled.
Recommend individuals infected with strep throat should use a new toothbrush once they are no longer contagious.
What to do if you get Strep Throat:
Children should be excluded from school or childcare until at least 24 hours after they no longer have a fever or signs of a fever (chills, feeling very warm, flushed appearance, or sweating) without the use of fever-reducing medicine and 24 hours after antibiotic treatment begins.When to report:
TB must be reported to your local Public Health Department when a case, outbreak, hospitalization or death occur.
Symptoms:
A bad cough that lasts 3 weeks or longerPain in the chest
Coughing up blood or sputum
Weakness or fatigue
Weight loss without trying
No appetite
Chills
Fever
Sweating at night
Symptoms often develop gradually and worsen until treatment is started. If TB is elsewhere in the body, there may be other symptoms.
What can you do to prevent TB:
Get a TB test if exposed to active, infectious TB disease, or have symptoms or risk factorsWhen to report:
Viral Meningitis must be reported to your local Public Health Department when an outbreak, hospitalization or death occur.
Symptoms:
Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as:Nausea
Vomiting
Photophobia (sensitivity to light)
Confusion
What can you do to prevent Viral Meningitis:
Vaccination is the most effective way to prevent viral meningitisWash your hands thoroughly and often, especially after changing diapers, using the toilet, or coughing or blowing your nose.
Cover nose and mouth when coughing or sneezing or cough/sneeze into your sleeve. Dispose of used tissues.
Clean and sanitize mouthed toys, objects, and surfaces at least daily, and when soiled.
Avoid kissing or sharing cups or eating utensils with sick people; avoid sharing with others when you are sick.