ILLNESSES

FIFTH DISEASE

Fifth disease is a rash illness that is caused by parvovirus B19. Most cases occur in late winter and early spring. Outbreaks among children in child care and elementary school are not unusual. In rare situations, miscarriages and stillbirths have been associated with fifth disease during pregnancy. If pregnant and working with young children, the pregnant woman should inform her health care provider of potential exposure to Fifth disease infection.

Symptoms can include:

• Fever

• Runny nose

• Headache

• Painful or swollen joints

• “Slapped cheek” rash, several days after initial symptoms.

Incubation Period: 4–14 days

Contagious Period: Before the appearance of the rash, during symptomatic phase.

HAND FOOT AND MOUTH

Hand, Foot and Mouth Disease is a viral illness.

Symptoms may include:

• Fever

• Reduced appetite

• Sore throat

• Sores or blisters on mouth, palms and soles 1-2 days after fever

Incubation Period: Usually 3 - 6 days

Contagious Period: Days to weeks after infection

Recommended Actions: Exclude from school while fever is present. Consider exclusion for very young children with mouth sores and uncontrolled drooling.

Transmission: Transmission may occur by contact with secretions from the nose, mouth, and throat, stool-to-mouth (fecal-oral) spread by way of unwashed hands, or foods contaminated by unwashed hands.

STREP

Streptococcal Sore Throat and Scarlet Fever

Strep Throat: Red, sore throat, fever, listlessness, swollen glands, nausea, stomach pain, swollen tonsils, and headache.

Scarlet Fever: As above, with a rash on the neck, face and underarm then spreading to all parts of the body including the hands and feet. The rash typically starts as small, flat blotches and then becomes sandpaper-like fine bumps. The rash clears in about 1 week and peeling of the skin is common. Fever often 101°F or above.

Incubation Period: Unknown

Contagious Period: If untreated, 10-21 days.

Cases: Exclude cases until they have been treated with antibiotics for 24 hours.

Transmission: Transmission occurs by contact with secretions from the nose, mouth, and throat of an infected individual. These secretions may be on surfaces or in infected droplets in the air.

Additional Information:

Scarlet fever is the result of a toxin produced by certain kinds of streptococcal bacteria. Treatment is usually the same as for “strep throat.” Streptococcal bacteria are responsible for other infections such as impetigo, and ear infections. If started on treatment, it must be completed, as some children may develop more serious complications affecting the ear, lung, sinuses, kidneys or heart (rheumatic heart disease).

INFESTATIONS

LICE

(Pediculosis)

Lice can be seen by the naked eye. As long as live lice are present on the head or in the environment, people can be exposed. Household pets are not a source of head lice. If a child has lice for the first time, it may take 4-6 weeks for itching to start. Head lice are parasites that are generally found on the head, eyebrows or eyelashes of individuals.

Signs can include:

• Small red bumps from scratching

• Lice eggs (nits)—yellow, tan, or brown dots near the scalp

• Adult lice and nymphs—size of a sesame seed, grayish-white or tan

Incubation Period: Head lice can survive off the body for 1-2 days, allowing for re-infestation.

Contagious Period: Lice are contagious (but don’t spread disease) and can be hard to get rid of if the correct steps are not taken.

Recommended Actions: AVOID situations with close head-to-head contact and sharing of clothing, linens, pillows, hats, helmets, and barrettes.

Cases: Exclude cases until treated with a pediculicide

Transmission: Head lice are spread by direct head-to-head contact between people, or indirectly through shared items including combs, brushes, head phones, hats, towels, coats, or sleeping mats. Carpeted or upholstered items and stuffed animals can harbor head lice.

Prevention: There are many over the counter products for the treatment of lice. Contact a health care provider for guidance, specifically if live lice are present after two treatments. Wash recently used clothing, bedding, towels, combs, and brushes with soap and hot water (at least 130° F) for 10 minutes or dry clean. Place items that cannot be cleaned (stuffed animals for example) in a sealed plastic bag for 10-14 days. Vacuum car seats/couches, ensure collected contents of vacuum bag/container are contained and disposed of immediately.

SCABIES

Scabies is a skin condition caused by tiny mites getting under a person’s skin. Mites can burrow under the skin in 2 minutes. Scabies can also affect pets, such as dogs, so it is advised to consult with a veterinarian. Environmental pesticide sprays are not recommended for management. Itching may continue for weeks after treatment is complete.

Symptoms can include:

• Dry, itchy, bumpy, reddish rash on the skin.

• Small blister-like sores or tiny burrows (short, wavy, dirty-looking

lines) that contain the mites and their eggs.

• Intense itching of the skin, especially at night

These sores and burrows are seen commonly around finger webs, creases of the wrists and elbows, belt line. In infants, the head, neck, palms, soles and buttocks may also be involved.

Incubation Period: 2–6 weeks before itching is noticed

Contagious Period: As long as live mites are present. The mite can survive off the body for only 2–3 days.

Recommended Actions: Refer to a health care provider for evaluation and diagnosis.

Transmission: Scabies is spread by direct skin-to-skin contact OR by contact with infested clothing and bed linens.

Prevention: Wash and dry, on the hot cycle, all washable items that the individual may have come into contact with in the previous 3 days. Include bed linens, towels, and clothes.