to common infections - The Windsor

Escherichia coli (E. coli)
Rotavirus
Ringworm
Salmonella
Strep throat
Amoebiasis
Hepatitis B
Bite (child to child)
Shigella
Roseola (sixth disease)
Measles (red measles)
Whooping Cough (pertussis)
Influenza
Diarrhea
Impetigo
A GUIDE
Common Cold
Scabies
Norwalk Virus and Norwalk-like Virus
to common infections
Mumps
Yersinia
Varicella
Chicken Pox
Hepatitis A
Giardia
Herpes Simplex (cold sores)
Hand/Foot/Mouth Disease (cocksackie virus)
Lice
Pinkeye (Conjunctivitis)
Mononucleosis
Shingles
Tick Bite
Scarlet Fever
Thrush
Fifth Disease
Cold Sore
Rubella (German measles)
Campylobacter
Meningitis
Pinworm
August 2015
INFECTION INDEX
Amoebiasis 7
Herpes Simplex (cold sores) Bite (child to child) 4
Impetigo Campylobacter 7
Influenza Chicken Pox (Varicella) 7
Lice Common Cold 8
Measles (red measles) Cold Sore 8
Diarrhea Rotavirus 17
12
Rubella (German measles) 17
12
Salmonella 18
Scabies 18
13
Scarlet Fever 20
Meningitis 13
Shigella 19
4
Mononucleosis 14
Shingles 19
Escherichia coli (E. coli) 9
Mumps 14
Strep Throat 20
Fifth Disease 9
Norwalk Virus and Norwalk-like Virus 15
Tick Bite 6
Pinkeye (Conjunctivitis) 15
Thrush 20
Hand/Foot/Mouth Disease (cocksackie virus) 10
Pinworm 15
Varicella 7
Hepatitis A 11
Ringworm 16
Whooping Cough (pertussis) 21
Hepatitis B 11
Roseola (sixth disease) 16
Yersinia 21
Giardia 10
8
6
INTRODUCTION
This booklet will help you determine your role in the event a child attending your facility has a communicable disease. The charts provide information
about communicable diseases, including signs and symptoms, how they are spread, if it’s a reportable disease and links to additional resources. If a person is
infected with a disease from the Reportable Disease List, the Windsor-Essex County Health Unit (WECHU) must be informed.
The Health Protection and Promotion Act
(R.S.O. 1990, CHAPTER H.7; Part IV)
If a principal of a school or a manager of an institution, such as a day care, has knowledge of, or
suspects that a child in their facility has a reportable disease, they must monitor and report to
the Windsor-Essex County Health Unit immediately.
Reporting Absenteeism
In order to remain proactive in preventing the spread of communicable diseases, we ask that you report
to the Health Unit Outbreak team at ext. 1444 if the absenteeism rate in your facility is 10% or more.
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WHAT IS A COMMUNICABLE DISEASE?
Any disease that can be spread from one person to another is considered
to be a communicable or contagious disease. When a person is sick with a
virus or bacteria there are only certain times that they can give the disease
to others (known as the contagious period). During this contagious period
a child may be excluded from school or day care to prevent the spread of
infection to others.
How is an infection spread?
Communicable diseases are illnesses that are caused by germs, which include bacteria, viruses, parasites, or fungi. These germs
are found in body secretions, such as stool, mucus, phlegm or in tiny droplets that are breathed, coughed, or sneezed out.
Germs that cause communicable diseases are spread from person-to-person in different ways. Some germs are spread through
the air, like influenza (flu) and fifth disease. Others are spread by touching a person infected with the illness or by touching an
object that has the germ, like chickenpox and pink eye. Germs can also be spread through water or contaminated food, like
salmonella and E. coli.
Note: This guide is for information purposes only. Diagnosis of the following infections must be made by a health care provider.
Preventing Infection
In your school or institution you can control germs effectively by:
•Washing your hands thoroughly and frequently using warm water, soap,
and rubbing your hands together for 10 to 15 seconds, about the length
of time it takes to sing “Happy Birthday”.
•Facilitating hand hygiene by ensuring that there’s always a supply of
soap and paper towels available, and teach good hand hygiene practices
often. Hand washing is the single most important measure to prevent
the spread of infections. Allow time for children to wash hands after
washroom breaks and before eating.
•Teaching and practicing respiratory etiquette – which includes coughing
and/or sneezing into your elbow or tissue, disposing of the tissue, and
then washing your hands. Ensure tissues are available.
•Stressing the importance of not sharing any personal items such as drinking
cups and glasses, eating utensils, chapsticks, brushes, etc.
•Being vigilant about cleaning and disinfecting surfaces and objects
(e.g., toys, books, desks, doorknobs, workstations, countertops, etc.)
that come in contact with children.
•Increasing the frequency of cleaning and disinfecting when indicated,
(to control certain communicable diseases).
•Handling and disposing of contaminated items properly.
•Encouraging parents to keep their child at home if they are sick and show
signs of illness.
FAQ’S
What do I do if a child has diarrhea?
What do I do if a child is bitten by another?
Generally, all the germs that cause diarrhea are found in the feces of an
infected person. These germs can spread directly from person-to-person and
indirectly from contaminated hands of staff and children, as well as objects,
surfaces, food, or water.
Young children often bite. Most bites are harmless and don’t break the skin.
If a biter breaks the skin or if blood is drawn into the mouth of the biter,
germs can be transmitted. If that happens, it’s recommended that the child
that was bit be seen by a health care provider.
Diarrhea may be dangerous in infants and young children because the
loss of fluid may cause dehydration. Some signs of dehydration to look for
include: decreased urination, no tears, dry skin, mouth, and tongue, sunken
eyes, and grayish skin.
Children should be excluded from school until the diarrhea is gone or a
doctor determines the child is not infectious.
Parents should be notified at once if any of the following are present:
•Diarrhea
• Fever
• Vomiting
How should you care for a wound?
Always wear gloves when handling blood and bodily fluids. If the skin is not
broken clean the wound with soap and water, and apply a cold compress.
If the skin is broken:
1. Let the wound bleed freely.
2. Clean with soap and water.
3. Report the incident/bite to the parents.
4. Encourage medical follow-up.
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What do I do if a child is bitten by a tick?
Children who get bitten by a tick are at risk for
Lyme Disease. Ticks vary in size and colour, but
the species that spreads Lyme Disease is the
blacklegged deer tick, which is usually small
(3 to 5mm) and dark. If a child has been bitten by a
tick, it is important to remove the tick as soon as possible,
as the likelihood of infection increases if a tick has been
attached for 24 hours or more. If a child is bitten by a tick:
1. Using tweezers, grasp the tick close to the skin.
2. Pull the tick gently and do not twist.
3. Do not squeeze, smother or burn the tick.
4. Gently wash the bite with a disinfectant (e.g., alcohol).
5. Save the tick in a container and advise the parent to
contact the Health Unit. The Health Unit will accept
ticks removed from people for laboratory identification
and testing.
6. Recommend to the parent to follow-up with their health
care provider to notify them of their child’s tick bite.
7. Refer to www.wechu.org for further information.
Source: ©All Rights Reserved.
Public Health Agency of Canada.
Reproduced with permission from
the Minister of Health, 2015.
What do I do if a child has lice?
Outbreaks of head lice are common among children in schools
and institutions everywhere. Transmission is via direct contact
with infested persons and through objects used by them such
as headgear and hairbrushes. As long as there are viable eggs on
the person or on objects the person touches, the head lice can be
passed from person-to-person. Lice eggs can remain viable away from the
host for up to 7 to10 days in good conditions.
If a child has head lice, the parents should be advised that:
1. Clothing, bedding, and other objects used by the infested person
should be treated by laundering with hot water, drying in a hot dryer,
dry cleaning, or using an effective chemical insecticide.
2. Household and close personal contacts should be examined and
treated if applicable.
How is head lice treated?
Head lice can be treated by using specific chemical shampoo and removing all lice eggs or by
using the wet combing method, which is non-chemical but less effective.
How do I prevent head lice?
Head lice can be prevented by encouraging parents to check their children for lice routinely,
and discouraging children from sharing towels, clothing, combs, and hats.
INFECTIOUS DISEASE AND PREGNANCY
If you are pregnant or planning to become pregnant:
1. Review your immunization status and occupation with a family doctor,
preferably before pregnancy.
2. Avoid contact with people who appear ill.
3. Wash your hands often.
A resource that provides evidence-based information about the safety
of drugs, chemicals, and diseases (including infectious disease) during
pregnancy is www.motherisk.org or call Mother Risk at 1-877-439-2744.
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INFECTION
Amoebiasis
Parasite
HOW IT SPREADS
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Signs and symptoms are
commonly seen 2-4 weeks after
Putting anything in the mouth exposure:
•Diarrhea
that has had contact with
•Stomach cramps or pain
infected stool (e.g., toys).
Swallowing contaminated food •Bloody stool
•Fever
or water.
Campylobacter Person-to-person by fecal-oral
route (e.g., unwashed hands).
Bacteria
Putting anything in the mouth
that has had contact with
infected stool (e.g., toys).
Swallowing contaminated
food or water, such as raw or
undercooked meats.
Chicken Pox
(Varicella)
SIGNS / SYMPTOMS
Signs and symptoms are
commonly seen 1-10 days
after exposure:
•Diarrhea
•Fever
•Nausea
•Vomiting
•Stomach cramps or pain
Contact with infected pets and
animals (e.g., field trips).
Person-to-person via contact
Signs and symptoms are
with fluid filled rash.
commonly seen 14-21 days
By breathing in contaminated after exposure:
•Mild Fever.
air from an infected person
•Small red pimples which
who is sneezing, coughing,
develop into blisters, then
or speaking.
become encrusted.
May develop after contact with
•Usually affects face, hands,
a person who has shingles.
neck and extremities.
CONTAGIOUS PERIOD
A person is capable of
passing the infection to
others as long as the germ
is present in the feces.
A person is capable of
passing the infection to
others as long as the germ
is present in the feces;
typically several days to
several weeks.
1-5 days before rash starts
and until all pox have dried
and scabbed over.
RECOMMENDED
SCHOOL
EXCLUSION
24 hours after
diarrhea resolves.
REPORTABLE
DISEASE
Yes
OR
48 hours after
completion of
antibiotic treatment.
24 hours after
symptoms resolve.
Yes
Return to school or
Yes
childcare when child
Chickenpox
is
well
enough
(no
Virus
reporting forms
fever) to participate are available on
in all activities and
the Health Unit
when all blisters
website at
have scabs (usually
www.wechu.org
6 days after start of
* See note below
the rash).
on chickenpox
*Note: Parents, and staff (especially pregnant staff or those immunocompromised) should be notified of chickenpox in the classroom. Pregnant contacts should consult
their health care provider promptly.
INFECTION
Common cold
Virus
HOW IT SPREADS
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
SIGNS / SYMPTOMS
Signs and symptoms are
commonly seen 2-14 days after
exposure:
•Runny nose
CONTAGIOUS PERIOD
Usually a few days before
signs and symptoms
appear and while runny
secretions are present.
Can also be spread by
•Sneezing
touching contaminated hands,
surfaces, or objects (e.g., toys). •Sore throat
•Cough
RECOMMENDED
SCHOOL
EXCLUSION
Do not exclude
unless too ill
(if fever present,
excessive coughing
and sneezing)
to take part in
activities.
REPORTABLE
DISEASE
No
•Decreased appetite
Cold Sore
Person-to-person via saliva
(Herpes
of infected person or items
Simplex Type 1) wet with infected saliva, such
as kissing or sharing eating
Virus
utensils, towels, or washcloths.
The virus persists in the body
and infections may reoccur.
•Fever (with some colds)
Signs and symptoms are
commonly seen 2-12 days after
exposure:
Infectious for at least a
week during the infection.
•Tingling sensation or itching
at site of sore.
•May cause high fever and
painful ulcers in mouth.
Exclude if too ill to
participate in all
activities.
No
Avoid direct contact
with lesions, cold
sores, or drool.
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INFECTION
HOW IT SPREADS
Escherichia coli Person-to-person by fecal-oral
(E. coli)
route (e.g., unwashed hands).
Bacteria
Putting anything in the mouth
that has had contact with
infected stool (e.g., toys).
Swallowing contaminated
food or water, such as raw or
undercooked meats .
Fifth Disease
Virus
Contact with infected pets
and animals (e.g., at farms and
petting zoos).
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
SIGNS / SYMPTOMS
Signs and symptoms are
commonly seen 2-10 days after
exposure:
Typically 1 week in adults
and up to 3 weeks in
children.
REPORTABLE
DISEASE
Yes
•Diarrhea (may be bloody)
•Fever (rarely)
•Nausea and/or vomiting
•Stomach cramps or pain
Signs and symptoms are
commonly seen 4-20 days
after exposure:
•May have a low-grade fever
Can also be spread by
and cold-like symptoms
touching contaminated hands, 7-10 days before rash appears.
surfaces, or objects (such as
•Rash begins as a solid red
drinking cups and utensils).
area on cheeks (like a slapped
Mother to fetus transmission
(rare).
CONTAGIOUS PERIOD
RECOMMENDED
SCHOOL
EXCLUSION
Exclude at the
direction of the
Health Unit.
cheek), spreading to upper
arms, legs, trunk, hands,
and feet.
•The rash may reappear,
1-3 weeks later, if exposed to
sunlight or heat.
Most contagious starting
Do not exclude if
from a few days before the well enough to take
appearance of a rash until
part in activities.
the rash has faded, usually
a span of 1 week to 10 days.
Not reportable
to Health Unit.
Should advise
pregnant staff
and parents
who may have
had exposure
to inform their
health care
provider. See
page 6 for more
information.
INFECTION
Giardia
Parasite
HOW IT SPREADS
SIGNS / SYMPTOMS
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Signs and symptoms are
commonly seen 3-25 days after
exposure:
Putting anything in the mouth
that has had contact with
infected stool (e.g., toys).
CONTAGIOUS PERIOD
Entire period of infection;
often months.
RECOMMENDED
SCHOOL
EXCLUSION
Exclude until
symptom free.
REPORTABLE
DISEASE
Yes
*Child should not
use recreational
water venues
(e.g., swimming
pools, and splash
pads) for 2 weeks
after symptoms have
resolved.
•Diarrhea
•Bloating
Swallowing contaminated food •Foul-smelling feces
or water.
•Frequent loose, pale
greasy stools
•Fatigue
•Weight loss
Hand, Foot, and
Mouth Disease
(coxsackie
virus)
Virus
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
Sometimes no symptoms are
present.
Signs and symptoms are
commonly seen 3-6 days after
exposure:
•Fever and sore throat.
Can also be spread by
•Rash then develops on the
touching contaminated hands, palms of hands, bottom of feet
surfaces, or objects.
and inside of mouth.
Fecal-oral route.
Rash may look like tiny red dots
Most contagious when
symptoms are present,
usually 7-10 days.
The virus may still be
present in the stool for up
to 3 weeks after the start
of the infection.
Exclude until child
is well enough to
participate in daily
activities.
No
or blisters.
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INFECTION
Hepatitis A
Virus
HOW IT SPREADS
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Putting anything in the mouth
that has had contact with
infected stool (e.g., toys).
RECOMMENDED
SIGNS / SYMPTOMS
CONTAGIOUS PERIOD
SCHOOL
EXCLUSION
Signs and symptoms are
Contagious in the 2 weeks Exclude at the
commonly seen between 15-50 before illness and
direction of the
days with an average of 28-30
continues until shortly after Health Unit.
days after exposure:
the onset of jaundice.
REPORTABLE
DISEASE
Yes
•Asymptomatic or mildly ill
Swallowing contaminated food in children.
or water.
•Sudden loss of appetite.
•Nausea and abdominal
pain/discomfort.
Hepatitis B
Virus
Person-to-person via
contaminated blood and
bodily fluids that enter a break
in skin, wound, or mucus
membrane.
•Yellowing of eyes and skin
(jaundice), and darkening
of urine.
Signs and symptoms are
commonly seen up to 8 weeks
after exposure.
From weeks before onset
to months or years after
recovery from illness.
•50-70% show no symptoms.
May be infectious for life.
•Poor appetite.
Sharing contaminated needles,
•Weakness/fatigue.
sexual contact, household
•Nausea, vomiting, abdominal
contacts, and mother
pain and/or yellowing of
to neonate.
skin and eyes.
Hep B is not spread by water,
food, or by casual contact.
•Rash.
•Dark urine.
•Joint pain.
No exclusion
required.
Yes
INFECTION
Impetigo
Bacteria
HOW IT SPREADS
Person-to-person through
direct skin contact with
wounds or discharges from the
infected area.
Can be spread by touching
contaminated hands, surfaces,
or objects.
Influenza
Virus
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
SIGNS / SYMPTOMS
CONTAGIOUS PERIOD
Signs and symptoms
From onset of symptoms
commonly develop 7-10 days
until 24 hours after start of
after bacteria attach to the skin: treatment with antibiotics.
•Pustules or crusted rash on
face or exposed parts of the
body (arms and/or legs).
•Can be itchy, and scratching
will spread the infection.
Signs and symptoms are
commonly seen 1-3 days
after exposure:
•Sudden onset of fever
and chills.
From 24-48 hours before
symptoms occur to
5-7 days after symptoms
have started.
RECOMMENDED
SCHOOL
EXCLUSION
Exclude until
antibiotic treatment
has been taken for
24 hours.
Exclude until
well enough to
participate in all
activities.
REPORTABLE
DISEASE
No
Yes
Can also be spread by
touching contaminated hands, •Headache.
surfaces, or objects.
•Generalized aches and pains.
•Loss of appetite.
•Cough, runny or stuffy nose.
•Fatigue.
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INFECTION
Measles
(Red Measles)
Virus
HOW IT SPREADS
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
SIGNS / SYMPTOMS
Signs and symptoms are
commonly seen 7-18 days after
exposure:
•Fever.
Can also be spread by
•Cough, runny nose.
touching contaminated hands,
•Red, watery eyes.
surfaces, or objects.
•Small, red, spots on the inside
Very Contagious.
of the cheeks with whitish or
bluish centres.
Meningitis
Bacterial
Viral
Fungal
Other causes
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
•Red rash on face which then
spreads over body.
Start date of signs and
symptoms can vary depending
on the germ:
•Severe headache.
Can also be spread by
•High temperature.
touching contaminated hands,
•Vomiting.
surfaces, or objects.
•Stiff neck.
•Drowsiness.
•Confusion.
•Coma.
•May develop a red
pin-point rash.
RECOMMENDED
CONTAGIOUS PERIOD
SCHOOL
EXCLUSION
4 days before rash is
Exclude at the
present, during period of
direction of the
illness and until 4 days after Health Unit.
the onset of rash.
Dependent on type of
germ (bacterial, viral,
or fungal)
Remain at home
until allowed to
return by a doctor.
REPORTABLE
DISEASE
Yes
Yes
INFECTION
HOW IT SPREADS
Mononucleosis Person-to-person via the saliva
(Mono)
of an infected person or items
wet with infected saliva, such
Virus
as through kissing or sharing
objects contaminated with
saliva (toys, toothbrush, cups,
bottles).
SIGNS / SYMPTOMS
CONTAGIOUS PERIOD
Signs and symptoms
commonly appear around
30-50 days after exposure:
Can last for a year or more
after infection.
•Usually mild or no symptoms.
RECOMMENDED
SCHOOL
EXCLUSION
Exclude until child
is well enough to
participate in daily
activities.
REPORTABLE
DISEASE
No
•Fever.
•Sore throat.
•Swollen glands.
•Fatigue.
Mumps
Virus
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
•Possible skin rash and
enlarged liver and/or spleen.
Signs and symptoms are
commonly seen 14-25 days
after exposure:
•Chills, discomfort.
Can also be spread by
•Headache, pain below ears.
touching contaminated hands,
•Fever.
surfaces, or objects.
•Swelling of salivary glands
Contact with saliva through
(below and in front of ear).
kissing and by sharing food,
7 days before to 5 days
after symptoms develop.
1/3 of mumps infections
do not develop symptoms
but they can still spread
the virus.
Excluded at the
direction of the
Health Unit.
Yes
and drinks.
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INFECTION
HOW IT SPREADS
Norwalk virus/
Norwalk-like
virus
(viral
gastroenteritis)
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Virus
Pinkeye
(conjunctivitis)
Virus
Bacteria
SIGNS / SYMPTOMS
Signs and symptoms are
commonly seen 1-2 days after
Swallowing contaminated food exposure:
or water.
•Nausea, vomiting.
Touching surfaces or objects
(e.g., toys) contaminated with
the virus, then placing your
hands in your mouth.
Parasite
Usually 10-72 hours.
No
•Headache.
•Red or pink eyes, swelling,
itching, irritated, and painful
eyes.
•Discharge from eye. After
sleep the discharge forms dry,
yellowish crusts on eyelashes.
Pinworm
Duration of illness.
REPORTABLE
DISEASE
•Watery diarrhea, abdominal
cramps.
•Low grade fever.
Sharing foods or eating utensils
with someone who is infected.
Person-to-person via direct
Signs and symptoms are
contact with discharges from
commonly seen 1-3 days after
the eye of an infected person. exposure:
Indirectly by touching
contaminated objects (towels,
toys, and fingers).
CONTAGIOUS PERIOD
RECOMMENDED
SCHOOL
EXCLUSION
24 to 72 hours after
symptoms have
stopped.
Person-to-person via fecal-oral
route (e.g., unwashed hands).
Many infections occur without
symptoms.
Eggs survive on surfaces
(e.g., bed linens, towels, toys,
clothing, toilet seats, or baths).
Any signs and symptoms
commonly occur 1-2 months
after exposure:
Transmission of eggs by hand
to mouth, after touching
infected surface.
•Itching around the anus
(rectum).
Bacterial
Infectious until 24 hours
of appropriate antibiotic
treatment received and
symptoms are no longer
present.
Viral
Infectious as long as there
is eye discharge and signs
and symptoms are present.
As long as the parasite
deposits its eggs on the
infected person’s perianal
skin.
Eggs can remain infective
for about 2 weeks in an
indoor environment.
Generally children
should not attend
school while
untreated and
symptomatic if
cause is viral or
bacterial.
No
No
No
Child to see health
care provider for
assessment.
INFECTION
Ringworm
Fungus
HOW IT SPREADS
SIGNS / SYMPTOMS
Direct skin-to-skin contact with Signs and symptoms usually
infected person or animal.
can range between 4-14
days depending on the area
Can also be spread by
touching contaminated hands, infected:
surfaces, or objects such as
combs, unwashed clothes,
towels, clothes, or bedding.
RECOMMENDED
SCHOOL
EXCLUSION
As long as rash is untreated Exclude until seen
and/or uncovered.
by a doctor and
treatment started.
CONTAGIOUS PERIOD
REPORTABLE
DISEASE
No
•Skin: red, raised, ring shaped
sores (edge of sores may be
scaly and itchy).
•When it occurs between the
toes it’s called Athlete’s Foot.
Roseola
Virus
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
•Scalp: small, scaly patch,
which spreads leaving scaly,
temporary bald patches.
Signs and symptoms
commonly occur 5-15 days
after exposure:
Unknown
•Sudden high fever (above
39.5°C and lasts 3-7 days).
Exclude until child
is well enough to
participate in daily
activities.
No
•Red, raised rash (lasts hours to
days) that appears when fever
breaks (usually 4th day).
•Many children will not have
fever and rash.
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WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | ESSEX | LEAMINGTON | www.wechu.org
INFECTION
HOW IT SPREADS
Rotavirus
(viral
gastroenteritis)
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Virus
Signs and symptoms
commonly occur 1-3 days after
Swallowing contaminated food exposure:
or water.
•Fever, nausea and vomiting
followed by watery diarrhea.
Can also be spread by
touching contaminated hands
or objects such as toys and
hard surfaces.
Rubella
(German
Measles)
Virus
SIGNS / SYMPTOMS
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
Infectious just before start
of symptoms and as long
as 3 weeks later.
RECOMMENDED
SCHOOL
EXCLUSION
Exclude until
diarrhea and
vomiting have
stopped and
well enough to
participate in
activities.
Children: 3-4 days before
rash appears and 7 days
after the rash appears.
Exclude at the
direction of the
Health Unit
CONTAGIOUS PERIOD
•Dehydration may occur
rapidly.
•May last 4-6 days.
Signs and symptoms
commonly occur 14-21 days
after exposure:
•Widespread rash (red or pink).
Can also be spread by
•Swollen glands behind the
touching contaminated hands, ears.
surfaces, or objects, such
•Many have no signs and
as tissues.
symptoms.
•Fever.
•Mild coughing, sneezing, and
reddened eyes.
REPORTABLE
DISEASE
No
Yes
INFECTION
Salmonella
Bacteria
HOW IT SPREADS
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Swallowing contaminated
food or water, such as raw or
undercooked meats, eggs or
unpasteurized milk.
Can also be spread by
touching contaminated hands
or objects.
Scabies
Parasite
When coming into contact
with infected pets and animals
such as dogs, cats, turtles,
snakes, and salamanders.
By direct and prolonged
skin-to-skin contact with an
infected person.
By sharing contaminated
clothing, towels, and bedding.
SIGNS / SYMPTOMS
Signs and symptoms
commonly occur 6-72 hours
after exposure:
•Nausea or vomiting.
•Fever.
•Diarrhea.
CONTAGIOUS PERIOD
A person is capable of
passing the infection to
others as long as the germ
is present in the feces;
typically several days to
several weeks.
RECOMMENDED
SCHOOL
EXCLUSION
24 hours after
symptoms resolve.
REPORTABLE
DISEASE
Yes
•Abdominal pain/cramps.
•May have mucous and blood
in stool.
Signs and symptoms may occur
2-6 weeks after exposure. If
previously infected, symptoms
may develop 1-4 days after
re-exposure:
Until mites are destroyed
by treatments. Considered
not contagious after
48 hours of treatment.
Exclude until seen
by a doctor and
treatment started.
No
•Pimple-like, very itchy rash
(usually most itchy at night)
usually on fingers, elbows,
armpits, and abdomen.
•Caused by mites under
the skin.
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INFECTION
Shigella
Bacteria
HOW IT SPREADS
SIGNS / SYMPTOMS
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Signs and symptoms
commonly occur 1-7 days after
exposure:
Swallowing contaminated
food or water, such as raw or
undercooked meats.
Can also be spread by
touching contaminated hands
or objects.
Shingles
Virus
RECOMMENDED
CONTAGIOUS PERIOD
SCHOOL
EXCLUSION
From time of infection until Exclude at the
4 weeks after symptoms
direction of the
have stopped.
Health Unit.
Yes
•Diarrhea.
•Nausea.
•Fever.
•Blood and/or mucus in stool.
•Abdominal cramps.
Shingles cannot be passed
Signs and symptoms that
From start of blisters until
from one person to another.
commonly occur 1-5 days
blisters scab over.
The varicella-zoster (chickenpox) before rash:
virus that causes shingles can
•Pain.
be spread from a person with
•Fever.
active shingles to a person
who has never had chickenpox •Headache.
Burning, red rash with
through direct contact with
the rash. The person exposed fluid-filled blisters typically scab
over within 7-10 days.
would develop chickenpox,
not shingles.
The virus is spread through
direct contact with fluid from
the rash blisters, not through
sneezing, coughing or casual
contact.
REPORTABLE
DISEASE
None
Keep rash covered.
Wash hands often.
Do not touch or
scratch the rash.
No
INFECTION
HOW IT SPREADS
Strep Throat
By breathing in contaminated
(Streptococcus) air from an infected person
who is sneezing, coughing,
Bacteria
or speaking.
SIGNS / SYMPTOMS
Signs and symptoms usually
appear 1-3 days after exposure:
•Fever
If treated with antibiotics,
will not be contagious
24 hours after start of
treatment.
Signs and symptoms usually
appear 1-3 days after exposure:
Untreated individuals are
contagious for 2-3 weeks.
•Fever.
If treated with antibiotics,
will not be contagious
24 hours after start of
treatment.
•Sore throat.
Can also be spread by
touching contaminated hands, •Swollen glands.
•Very fine, raised rash
surfaces, or objects.
appearing most often on neck,
Person-to-person via direct
chest, folds of armpit, groin,
contact with a person’s saliva,
elbow, and inner thigh.
nasal, or wound discharges.
Thrush
(Candidiasis)
Yeast
With very young children it
could pass from person to
person if children mouth the
same toys and objects and
share them without washing
and sanitizing in between.
Untreated individuals are
contagious for 2-3 weeks
after onset of infection.
•Sore throat
Can also be spread by
touching contaminated hands, •Swollen glands
surfaces, or objects.
Person-to-person via direct
contact with a person’s saliva,
nasal, or wound discharges.
Scarlet Fever
By breathing in contaminated
(Streptococcus) air from an infected person
who is sneezing, coughing,
Bacteria
or speaking.
CONTAGIOUS PERIOD
White patches on the inside
of cheeks and on gums and
tongue.
While there are symptoms
present.
RECOMMENDED
SCHOOL
EXCLUSION
Exclude until
24 hours after start
of treatment.
REPORTABLE
DISEASE
No
Exclude until
24 hours after start
of treatment.
No
None
No
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to common infections
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INFECTION
Whooping
cough
(Pertussis)
Bacteria
Yersinia
Bacteria
HOW IT SPREADS
By breathing in contaminated
air from an infected person
who is sneezing, coughing,
or speaking.
SIGNS / SYMPTOMS
CONTAGIOUS PERIOD
Signs and symptoms
commonly occur 5-21 days
after exposure:
If treated with antibiotics,
contagious until the fifth
day of treatment.
•Whooping (high pitched)
Can also be spread by
sound when inhaling after
touching contaminated hands, coughing.
surfaces, or objects such
•Cold-like symptoms.
as toys.
•After 1-2 weeks; cough
worsens with numerous
bursts of explosive coughing
that can interrupt breathing,
eating, and sleeping.
Person-to-person by fecal-oral
route (e.g., unwashed hands).
Swallowing contaminated
food or water, such as raw or
undercooked meats
Raw pork or pork products are
known sources of infection as
well as milk.
•Often followed by gagging,
vomiting, and exhaustion.
Signs and symptoms usually
appear within 10 days from
exposure:
•Watery diarrhea
(sometimes bloody).
RECOMMENDED
SCHOOL
EXCLUSION
Exclude until
5 days after start
of antibiotics.
Contagious from the
beginning of symptoms
until 2 weeks after cough
begins
OR
Infectious as long as
bacteria are in the stool.
Exclude until
diarrhea stopped
and have no other
symptoms for 24
hours.
If left untreated,
2-3 months.
Yes
3 weeks if no
treatment is given.
People in contact
with infected
person may need
antibiotics or
vaccine.
•Cramps.
OR
•Fever.
48 hours after
completion of
antibiotic therapy.
•Nausea and vomiting.
REPORTABLE
DISEASE
Yes
References:
Heymann D. L.(ED.).(2015), Control of Communicable Disease Manual, (20th Edition),
American Public Health Association.
Center for Disease Control and Prevention (2015). Accessed on July 30th, 2015 at
http://www.cdc.gov.
Aronson S.S., Shope T. R. (EDs.).(2013), Managing Infectious Diseases in Child Care in
Schools, (3rd Ed), American Academy of Pediatrics.
Health Canada (2014). Acessed on January 24, 2014 at http://www.hc-sc.gc.ca/
index-eng.php.
CONTACT INFORMATION
The Windsor-Essex County Health Unit has a variety of help lines that can be
called during business hours with questions, comments, or concerns. The
complete list of numbers can be found at www.wechu.org under contact us.
RELEVANT WINDSOR-ESSEX COUNTY
HEALTH UNIT DEPARTMENTS
519-258-2146 | 1-800-265-5822
For more information on infectious disease, consider the following resources:
Ministry of Health and Long-Term Care www.healthyontario.com
Public Health Agency of Canada www.phac-aspc.gc.ca
Canadian Paediatric Society www.caringforkids.cps.ca
Immunize Canada www.immunize.ca
Centres for Disease Control www.cdc.gov
Canada Food Inspection Agency www.inspection.gc.ca
Hospital for Sick Kids www.aboutkidshealth.ca
Healthy Schools Department
1555
Health Canada www.hc-sc.gc.ca
Infectious Disease Prevention
1420
World Health Organization www.who.int
Outbreak Team
1444
Telehealth Ontario 1-866-797-000
Motherrisk 1-877-439-2744
Immunization1222
TO REPORT:
•An increase in absenteeism call extension 1444.
•A reportable disease call extension 1420.
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to common infections
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WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | ESSEX | LEAMINGTON | www.wechu.org
reportableDISEASES
REPORT DISEASES LISTED BELOW TO:
Phone: 519-258-2146 or Fax: 519-258-8672 (8:30 a.m. to 4:30 p.m., Monday to Friday)
After hours, weekends, and holidays phone: 519-973-4510
Timely reporting of communicable diseases is essential for their control. If you suspect or have confirmation of the following specified “Reportable
Communicable Diseases” or their “etiologic agents,” (as per Ontario Reg 559/91 and amendments under the Health Protection and Promotion Act) please
report them to the local Medical Officer of Health.
REPORT BY THE NEXT WORKING DAY
REPORT IMMEDIATELY
Anthrax
Botulism
Brucellosis
Cholera
Cryptosporidiosis
Cyclosporiasis
Diphtheria
Encephalitis, including:
1. P rimary, viral
Food poisoning, all causes
Gastroenteritis, institutional
outbreaks
Giardiasis, except
asymptomatic cases
Haemophilus influenza b
disease, invasive
Hantavirus Pulmonary
Syndrome
Hemorrhagic fevers,
including:
1. Ebola virus disease
2. Marburg virus disease
3. Other viral causes
Hepatitis, viral
1. Hepatitis A
Lassa Fever
Legionellosis
Listeriosis
Measles
Meningitis, acute
1. bacterial
Meningococcal disease,
invasive
Paratyphoid Fever
Plague
Poliomyelitis, acute
Q Fever
Rabies
Respiratory infection,
institutional outbreaks
Rubella
Severe Acute Respiratory
Syndrome (SARS)
Shigellosis
Smallpox
Streptococcal infections,
Group A invasive
Tularemia
Typhoid Fever
Verotoxin-producing E. coli
infection indicator conditions
including: Haemolytic
Uraemic Syndrome (HUS)
West Nile Virus
Yellow Fever
Acquired Immunodeficiency
Syndrome (AIDS)
Acute flaccid paralysis (AFP)
Amebiasis
Campylobacter
Chancroid
Chickenpox (Varicella)
Chlamydia trachomatis
infections
Clostridium difficile
associated disease (CDAD)
outbreaks in public hospitals
Encephalitis, including:
1. Post-infectious
2. Vaccine-related
3. Subacute sclerosing
panencephalitis
4. Unspecified
Gonorrhea
Hepatitis, viral
1. Hepatitis B
2. Hepatitis C
Influenza
Leprosy
Lyme Disease
Malaria
Meningitis, acute
1. viral
2. other
Mumps
Ophthalmia neonatorum
Paralytic shellfish poisoning
(PSP)
Pertussis (Whooping Cough)
Psittacosis/Ornithosis
For more information contact the Windsor-Essex County Health Unit at 519-258-2146
www.wechu.org
Rubella, congenital
syndrome
Salmonellosis
Streptococcal infections,
Group B neonatal
Streptococcus pneumoniae,
invasive
Syphilis
Tetanus
Transmissible Spongiform
Encephalopathy, including:
Creutzfeldt-Jakob
Disease,
all types
Trichinosis
Tuberculosis
Yersiniosis