Communicable Disease Manual for Child Care Providers

Health Promotion 

And 

Infectious Disease 

Control 

In Child Care 

Compiled by 

Lake County Health Department: 

Child Care Nurse Consultant 

Nurse Epidemiologist 

Supported by 

Illinois Department of Human Services 

Lake County Health Department/CHC 

YWCA of Lake County 

2004

TABLE OF CONTENTS 

General Information 

Important Phone Numbers 

The Morning Health Check 

Healthy Day Care Providers 

Understanding the Spread of Disease 

Communicable Disease Guide/Letters to Parents 

Illinois Reportable Diseases 

Communicable Disease Guide 

Letter to Parents for Fall Season* 

Animal Bites (potential for rabies) 

Rabies Information 

Animal Rabies Risk Categories Chart 

Campylobacteriosis 

Chickenpox (Varicella) 

Monthly Report of Selected Communicable Diseases 

Letter to Parents * 

Common Cold (upper respiratory infection) 

Conjunctivitis (pink eye) 

Letter to Parents* 

Croup 

Cytomegalovirus (CMV) 

Diphtheria 

E. Coli 0157:H7 

Fever 

Fifth Disease/Erythema Infectiosum 


Gastroenteritis, Viral 

Giardiasis 


Hand, Foot and Mouth Disease (Coxsackievirus A 16) 


Head Lice (Pediculosis) 

Head Lice Information 


Hepatitis A Virus 

Hepatitis A Information 


Hepatitis B Virus 

Herpes Simplex Virus-HSV (Cold Sores or Genital Herpes) 

HIV 

Impetigo 


Influenza 

Measles 

(1)

Meningitis, Bacterial 


Meningitis, Viral (Aseptic Meningitis) 


Molluscum Contagiosum 

Mononucleosis (Epstein-Barr virus, or EBV) 


Mumps 

Pertussis 

Cough Assessment 

Pertussis Fact Sheet 


Pinworms 


Rash Illness 

Childhood Maculopapular Rash Illustration & Chart 

Respiratory Syncytial Virus (RSV) 

Ringworm (of the body and scalp) 


Roseola 


Rotavirus Infections 


Rubella 

Salmonellosis 


Scabies 


Shigellosis 


Shingles (Herpes Zoster) 


Streptococcal Infections 

Streptococcal Sore Throat and Scarlet Fever 


Thrush 

Tuberculosis (TB) 

Children From Developing Nations 

Immunization Information 

When Do Children and Teens Need Vaccinations 

Recommended Childhood and Adolescent Immunizations 

Schedule – 2005 

Lake County Community Health Partnership Immunization Clinics 

(2)

Standard Precautions 

Universal Precautions 

Hand Washing 

Gloving 

Cleaning and Disinfecting 

First Aid/Choking Poster 

Health Promotion 

Cover your Cough 

Hand Washing 

Diapering/Toileting 

Reptile Rules 

Possible Choking and Suffocation Hazards 

Safe Food Handling 

Child Care Centers 

Clean, Separate, Chill and Cook 

Childhood Lead 

Lead Poisoning Pamphlet 

IDPH Risk Assessment Questionnaire 

IDPH Pediatric Lead Poisoning High-Risk ZIP Code Areas 

Keeping Healthy Pamphlet 

* English/Spanish 

(3)

General Information

MORNING HEALTH CHECK 

STOP 

DISEASE 

MORNING HEALTH CHECK 

Signs to Observe: 

• General mood and changes in 

behavior 

• Fever or elevated body temperature 

• Skin rashes, unusual spots, swelling 

or bruises 

• Complaints of pain and not feeling 

well 

• Signs/symptoms of disease 

(severe coughing, sneezing, breathing 

difficulties, discharge from nose, 

ears or eyes, diarrhea, vomiting etc.) 

• Reported illness in child or family 

members 

Use all of your senses . . . 

• LOOK - for signs 

• LISTEN - for complaints 

• FEEL - for fever 

• SMELL - for unusual odor 

Rev. 01/03 

California Childcare Health Program 

www.ucsfchildcarehealth.org

HEALTHY DAY CARE PROVIDERS 

Many day care providers get sick frequently, particularly when first starting to work, 

because they are exposed to a wider variety of infectious diseases. Also, caring for others 

can be stressful. Because stress lowers resistance to illness and contributes to burnout, 

which in itself can contribute to illness, administrators should encourage providers to take 

care of themselves. Providing quality care should be of paramount concern to all 

administrators and day care providers. Healthy day care providers are the key to a 

healthy, happy childcare experience for both the children and their families. 

For day care providers to stay healthy, remember the importance of: 

• Hand washing 

• Good nutrition 

• Regular exercise 

• Sufficient daily rest 

• Staying current with immunizations 

• Taking scheduled breaks and vacations 

• Participating in extracurricular hobbies and activities that do not involve care 

giving 

Providers who are ill should be taking care of themselves, not someone else. In addition 

to spreading germs to others, a person who is ill cannot provide the usual quality of care 

and will take longer to get well without the opportunity to recuperate properly. Even in 

times of emergencies, it is important to encourage providers not to report to work if they 

are ill.

Communicable Disease 

Guide 

Letters to Parents

ILLINOIS REPORTABLE DISEASES 

LAKE COUNTY HEALTH DEPARTMENT and COMMUNITY HEALTH CENTER 

CLASS I A: 

THE FOLLOWING SHALL BE REPORTED IMMEDIATELY OR WITHIN 3 HOURS 

BY TELEPHONE (847) 377-8130 OR FAX (847) 360-7365: 

Anthrax Plague Smallpox 

Botulism (Foodborne) Q Fever Tularemia 

Any suspected bioterrorist threat or event 

After Hours: On Call Pager (847) 389-4431 

CLASS I B: THE FOLLOWING SHALL BE REPORTED AS SOON AS POSSIBLE BY TELEPHONE BUT 

WITHIN 24 HOURS 

Botulism (infant, wound, other) 

Neisseria Meningitidis, (meningitis and invasive disease) 

Chicken Pox (adults over 20) 

Pertussis (whooping cough) 

Cholera 

Poliomyelitis 

Diarrhea of the Newborn (birth to 28 days) 

Rabies, Human 

Diphtheria 

Rabies, Potential Human Exposure 

Enteric Escherichia coli infection 

Smallpox Vaccine Reactions 

(E. Coli 0157:H7 and other enterohemorrhagic Staphylococcus Aureus infections with intermediate 

enterotoxigenic E. coli, enteropathogenic E. coli) or high level vancomycin resistance 

Hemolytic Uremic Syndrome, post diarrheal 

Streptococcal Infection, Group A, Invasive Disease 

Haemophilus influenzae, meningitis (including toxic shock syndrome and sequelae to Group A, 

and other invasive disease rheumatic fever, and acute glomerulonephritis ) 

Hepatitis A 

Typhoid fever 

Measles 

Typhus 

Any unusual case or cluster of cases, which may indicate a public hazard, 

including foodborne, waterborne, and other outbreaks. 

CLASS II: THE FOLLOWING SHALL BE REPORTED AS SOON AS POSSIBLE BY TELEPHONE 

BUT WITHIN 7 DAYS 

Amoebiasis 

Lyme disease 

Blastomycosis 

Malaria 

Brucellosis 

Meningitis, Aseptic (including arboviral infections) 

Campylobacteriosis 

Mumps 

Chickenpox (under 20) 

Psittacosis 

Cryptosporidiosis 

Rocky Mountain Spotted Fever 

Cyclosporiasis 

Rubella, including congenital rubella syndrome 

Ehrlichiosis, Human Granulocytic 

Salmonellosis (other than typhoid fever) 

Ehrlichiosis, Human Monocytic 

Shigellosis 

Encephalitis 

Staphylococcus Aureus Infections occurring in infants 

Giardiasis 

under 28 days (within a health care institution or 

Hantavirus Pulmonary Syndrome 

with onset after discharge) 

Hepatitis B (cases and carriers) Streptococcal Infections, Group B: 

Hepatitis C (cases and carriers) 

invasive, disease in the newborn 

Hepatitis, Viral, Other 

Streptococcus Pneumoniae, Invasive Disease 

Histoplasmosis 

(including antibiotic susceptibility test results) 

Legionnaires’ Disease (legionellosis) 

Tetanus 

Leprosy 

Toxic Shock Syndrome (Staphylococcus aureus) 

Leptospirosis 

Trichinosis 

Listeriosis 

Yersiniosis 

LCHD requests that Shigellosis and Salmonellosis be reported by telephone. (847) 377-8130 

LCHD REQUESTS THAT SEXUALLY TRANSMITTED DISEASE BE REPORTED TO THE STD CLINIC 

WITHIN 7 DAYS AT: (847) 377-8450 

Acquired immunodeficiency syndrome (AIDS) 

Gonorrhea and Ophthalmia neonatorum (gonococcal) 

Chancroid 

HIV infection 

Chlamydia 

Syphilis 

Sexually transmitted diseases, if child

Dear Parents: 

Due to the high absence level normally seen at this time of year, we would like to give you some 

guidelines to help with your decision on whether or not to send your child to school. Please be 

advised that if your child has any of the symptoms listed below he/she should not attend school: 

1. Fever 

2. Rash 

3. Sore throat with fever 

4. Persistent cough 

5. Nausea and vomiting 

6. Occasionally diarrhea 

If your child has recently been ill, please be aware of the following guidelines before having your 

child return to school: 

1. He/she should be feeling fit for 24 hours before returning to school, athletic or social 

activities. 

2. He/she should be free of a temperature for at least 24 hours. 

3. He/she should be free of vomiting and diarrhea for at least 24 hours. 

4. He/she should be taking an antibiotic for at least 24 hours before returning after strep throat. 

5. He/she should be on prescription antibiotic eye drops for conjunctivitis for 24 hours before 

returning to school. 

6. He/she should be home for at least 5 days after the appearance of the rash or until all blisters 

have scabbed. 

To help keep your children healthy, make sure they have plenty of rest and a good, nutritious diet. 

Make sure they are dressed properly when playing out of doors. Please notify the school if your 

child has been diagnosed with strep throat, chickenpox, scarlet fever, etc. 

The single most important thing you can do to keep your child free of illness is to teach him the 

proper way to wash his hands. Make sure he uses soap and rubs his hands together for 20 

seconds. He should then rinse his hands in running water and dry them thoroughly. 

Please help us keep our children healthy by keeping your child home if ill. Remember, one sick 

child can spread his illness to all his classmates. 

Thank you for your cooperation. 

Information provided by Lake County Health Department/Community Health Center

Estimados Padres: 

Debido a la cantidad niño que faltan a la escuela durante esta temporada de año. Le 

queremos dar algunas sugerencia para ayudarlos a determinar se debe mandar a su niño a 

la escuela o no. Por favor recuerde si su niño muestra algunos de los siguientes síntomas 

el no debe ir a la escuela: 

1. Fiebre (calentura) 

2. Ronchas 

3. Dolor de garganta con calentura 

4. Tos persistente 

5. Nausea y vómitos 

6. Diarrea ocasional 

Si su niño ha estado enfermo recientemente, siga las siguientes reglas antes de enviar a su 

niño a la escuela: 

1. Su niño debe de se debe sentir bien por 24 horas antes de regresar a la escuela, o 

resumir actividades escolares. 

2. Deben haber pasado 24 horas desde que su niño tuvo calentura. 

3. 24 horas deben haber pasado desde la ultima vez que tuvo vómitos. 

4. 24 horas deben haber pasado desde que empezó a tomar antibióticos par 

enfermedad de estreptoco. 

5. Deben de haber pasado 24 horas desde que empezo antibioticos para la 

conjunctivitis. 

6. Debe de mantener a us niño en su casa por 7 días si le da varicela. 

Para ayudar a mantener a su niño saludable asegúrese de que descanse bastante y que 

coma una dieta nutricios. Asegúrese que se vistan apropiadamente cuando va a jugar 

afuera. Por favor llame a la escuela si el doctor le dice que su niño tiene estreptococo, 

varicela o fiebre escarlatina, etc. 

Lo mas importante que su niño puede hacer para mantenerse saludable es lavarse las 

manos apropiadamente. Asegúrese que use jabón y agua usando mucha fricción por 20 

segundos. Después debe enjuagarse las manos bajo agua corriente y secarlas. 

Por favor ayude a mantener a nuestros niños saludable manteniéndolos en su casa. 

Recuerde, un niño enfermo puede transportar su enfermedad a los demás en su salón. 

Gracia por su cooperación. 


abies 

mhtml:file://E:\CC%20Manual%20Additions.05\Rabies.mht 

Page 1 of 3 

3/31/2005 

RABIES 

What is rabies 

CDC Rabies Web Page for Kids 

Rabies is a deadly disease caused by a virus that attacks the central nervous system. The 

virus is present primarily in the saliva, brain tissue and spinal fluid of a rabid animal. 

What animals can get rabies 

Rabies can affect all mammals. Since 1995 in the United States, more than 7,000 animals per 

year--most of them wild--have been diagnosed as having the disease. The disease is found in 

all states except Hawaii, as well as in Canada, Mexico and most other countries around the 

world. In Illinois, 101 animals were diagnosed with rabies from 1999 through 2003. 

Rabies is common in bats, skunks, raccoons and foxes, but the disease also has been found in 

deer and in large rodents, such as woodchucks. Cats, dogs and livestock can get rabies, too, if 

they are not vaccinated. Some animals, including chipmunks, gerbils, guinea pigs, hamsters, 

mice, rabbits, rats and squirrels, rarely get rabies. Birds, fish, insects, lizards, snakes and 

turtles never get rabies. 

Most of the recent cases of human rabies that have occurred in the United States have been 

caused by rabies virus from bats. In Illinois, rabid bats can be found anywhere. Awareness 

that bats can be a source of the rabies virus can help people protect themselves. 

Although bats can carry the rabies virus, most bats are not infected with it. The only way 

rabies can be diagnosed in a bat, however, is by laboratory testing. There are several signs, 

though, that could indicate a bat is more likely to be infected with the rabies virus. Bats seen 

during the day, those found in a place where bats are usually not found (e.g., in a room in 

your home, on your lawn, etc.) or bats that are unable to fly are more likely to be infected 

than others. Bats, like all wild animals, should never be handled. 

People usually know when they have been bitten by a bat, but there are instances when a bite 

may not be apparent. Bats have very small teeth and marks made by these teeth may not be 

easy to see. If you find yourself in close proximity to a bat and cannot assure you were not 

exposed to it, you should call your doctor or your local health department; they can help to 

determine if you could have been exposed to rabies. For example, if you awaken and find a 

bat in your bedroom, if you see a bat in the room of an unattended young child, or if you see 

a bat near a mentally impaired or intoxicated person, a doctor or local health department 

should be consulted. Do not discard the bat and do not damage the bat's head.

abies 


Page 2 of 3 

3/31/2005 

What are the signs of rabies in an animal 

The first sign of rabies is usually a change in the animal's behavior. An animal need not be 

"foaming at the mouth" to have rabies. Other signs include difficulty walking, a general 

appearance of sickness or a change in the animal's normal behavior. For example, if an 

animal that is normally wild and avoids contact with humans approaches a picnic area, 

campsite or home and appears tame or friendly, consider it rabid. Conversely, if a normally 

tame and friendly animal becomes hostile or aggressive without provocation, it too should be 

considered rabid. A rabid animal usually dies within one week after showing signs of the 

disease. 

Animal Species Testing Positive for Rabies in Illinois 

Species 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005* 

Bat 11 11 27 19 16 12 23 16 16 10 22 24 31 24 50 0 

Cat 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 

Cattle 2 0 2 0 0 1 0 0 0 0 0 0 0 0 0 1 

Dog 0 2 2 1 1 0 0 0 0 0 0 0 0 0 0 0 

Fox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 

Horse 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 

Skunk 17 20 9 3 4 2 1 4 1 0 0 0 0 0 0 0 

Raccoon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 

TOTAL 30 36 40 23 21 15 25 20 17 10 22 24 31 24 51 1 

How are people exposed to rabies 

* Animals tested positive as of January 21, 2005 

People usually are exposed to the rabies virus when an infected animal bites them. Exposure 

also may occur if a person is scratched by an infected animal or if the animal's saliva enters 

an open cut or mucous membrane (nose, mouth, eyes). The presence of a bat in a home, or 

any contact with a bat, represents a possible hazard for rabies and should be reported to the 

local health department so that the circumstances can be evaluated. The last human case in 

Illinois was reported in 1954. 

What should a person do if an animal bite occurs 

Wash the wound thoroughly with soap and water and seek medical attention immediately. 

The local health department or the county animal control office also should be notified 

immediately. The animal should be captured without damaging its head and only if direct 

contact with the animal can be avoided. 

If an apparently healthy domestic dog, cat or ferret bites a human, it must be captured, 

confined and professionally observed daily for 10 days following the bite. If the animal 

remains healthy during this period, it would not have transmitted rabies at the time of the 

bite. There is no reliable observation period established for non-domestic animals. If a person 

is bitten by a non-domestic animal and it is available for testing, testing should be done 

immediately. All animal bites should be reported to the local animal control office.

abies 


Page 3 of 3 

3/31/2005 

If an animal suspected of having rabies cannot be observed or tested, or if it tests positive for 

rabies, treatment of the individual with rabies immune globulin and the vaccine series must 

begin immediately. Vaccine injections are given in the arm. 

People in high-risk occupations--for example, veterinarians, wildlife biologists, wildlife 

rehabilitators, animal control officers and taxidermists--should consider getting the rabies 

vaccine to protect themselves from exposures that could occur in their work. This type of 

vaccination (pre-exposure vaccination) consists of three rabies vaccine injections. Periodic 

single boosters are generally required every two years if the risk of contact continues. A 

person already vaccinated and later exposed to rabies must receive two booster injections 

three days apart immediately after exposure. 

What if a pet is exposed to a rabid animal 

If your pet has been in a fight with another animal, wear gloves to handle your pet. Call your 

veterinarian and isolate the pet from other animals and people for several hours. A vaccinated 

pet may need a booster dose of rabies vaccine as soon as possible. Unvaccinated animals 

exposed to a known rabid animal must be confined and professionally observed for six 

months or euthanized. 

What can people do to protect themselves and their pets from rabies 

• Do not feed, touch or adopt wild animals or stray dogs or cats. 

• Vaccinated pets serve as a buffer between rabid wildlife and humans, so be sure dogs 

and cats are up-to-date on their rabies vaccinations. Consult with your veterinarian 

about when your pet needs to be vaccinated . 

• Do not allow pets to roam free. 

• Do not attract wild animals to your home or yard. Store bird seed or other animal feed 

in containers with tight-fitting lids. Feed pets indoors. Make sure garbage cans are 

tightly capped. Board up any openings to your attic, basement, porch or garage. Cap 

chimneys with screens. 

• Encourage children to immediately tell an adult if they are bitten or scratched by an 

animal. Teach children not to approach or to touch any animal they do not know. 

• Report all animal bites to the local health department. 

• If a wild animal comes on your property, let it wander away. Bring children and pets 

indoors and alert neighbors. You may contact a nuisance wildlife control officer who 

will remove the animal for a fee. 

Last updated March 31, 2005 

Illinois Department of Public Health 

535 West Jefferson Street 

Springfield, Illinois 62761 

Phone 217-782-4977 

Fax 217-782-3987 

TTY 800-547-0466 

Questions or Comments

mhtml:file://E:\CC%20Manual%20Additions.05\Rabies%20Fast%20Facts.mht 

3/31/2005 

CDC's Rabies Web Page That's Just for Kids 

Page 1 of 3 

What is Rabies is a serious disease that is caused 

rabies by a virus. Each year, it kills more than 

50,000 people and millions of animals 

around the world. 

Is rabies a Rabies is a big problem in Asia, Africa, 

problem and Central and South America. In the 

everywhere United States, rabies has been reported 

in every state except Hawaii. 

Who gets Any mammal can get rabies. Raccoons, 

rabies skunks, foxes, bats, dogs, and cats can 

get rabies. Cattle and humans can also 

get rabies. Only mammals can get 

rabies. Animals that are not mammals -- 

such as birds, snakes, and fish -- do not 

get rabies. 

How does an Rabies is caused by a virus. An animal 

animal get gets rabies from saliva, usually from a 

rabies bite of an animal that has the disease. 

You cannot get rabies from blood. 

How do you Animals with rabies may act differently 

know if an from healthy animals. Wild animals may 

animal has move slowly or may act as if they are 

rabies tame. A pet that is usually friendly may 

snap at you or may try to bite. Some 

signs of rabies in animals are: 

• changes in an animal’s behavior 

• general sickness 

• problems swallowing 

• increased drooling 

• aggression 

Can rabies be Yes! Rabies can be prevented by rabies



Page 2 of 3 

3/31/2005 

prevented 

How can I 

prevent 

rabies 

vaccine and thorough cleaning of the 

wound. If you are bitten by an animal 

that could have rabies, tell your parents 

right away so they can clean the bite 

wound with soap and water and take you 

to see a doctor. 

• Vaccinate your dogs, cats, and 

ferrets against rabies. 

• Keep your pets under supervision. 

• Do not handle wild animals. If you 

see a wild animal or a stray, 

especially if the animal is acting 

strangely, call an animal control 

officer. 

• If you do get bitten by an animal, 

wash the wound with soap and 

water for at least 5 minutes. Make 

sure you tell an adult and call your 

doctor to see if you need shots. 

• Get your pets spayed or 

neutered. Pets that are fixed are 

less likely to leave home, become 

strays, and make more stray 

animals. 

Back to Top 

| Home | Fast Facts | The Virus | Animals | 

| Warning Signs | Vaccination | Prevention |Statistics| Activities | 

| CDC Rabies Home Page | DVRD Home Page | NCID Home Page | 

CDC Home | Search | Health Topics A-Z 

CDC's Rabies Web Page That's Just for Kids! 

Viral and Rickettsial Zoonoses Branch (VRZB) 

Division of Viral and Rickettsial Diseases (DVRD) 

National Center for Infectious Diseases (NCID) 

Centers for Disease Control and Prevention (CDC) 

Mailing address: 

Rabies Section MS G-33 

Centers for Disease Control and Prevention 

1600 Clifton Road, NE 

Atlanta, GA 30333 

(404)639-1050 

URL: http://www.cdc.gov/www.cdc.gov/ncidod/dvrd/rabies/



Page 3 of 3 

3/31/2005 

This page last reviewed February 6, 2003 


US Department of Health 

and Human Services 

Privacy Policy | Accessibility

LAKE COUNTY HEALTH DEPARTMENT 

AND 

COMMUNITY HEALTH CENTER 

CAMPYLOBACTERIOSIS 

(CAMPYLOBACTERENTERITIS) 

REPORTABLE DISEASE 

See: Illinois Reportable Disease list in front of section. 

* What is Campylobacteriosis 

Campylobacteriosis is a bacterial infection in the intestinal tract. 

Incubation Period: (Time from exposure to infection to beginning of symptoms of illness). 

1-7 days usually 2-5 days. 

Period of Communicability: (Period person can give infection to another). 

After 2-3 days treatment with antibiotics, this bacteria is eradicated. If not treated with 

antibiotics, bacteria is in stool for 2-3 weeks. 

* What are the Symptoms of Campylobacteriosis 

Diarrhea (often bloody or with mucus), abdominal pain, fever, nausea, vomiting and listlessness. 

Symptoms may also be mild or absent. 

* How is Campylobacteriosis Spread 

Campylobacteriosis is spread by eating food contaminated by this bacteria, especially poultry, 

raw meat, or improperly cooked poultry, pork or unpasteurized milk or drinking contaminated 

water and using common cutting boards. Spread can also occur from contact with stool of 

infected pets (puppies, kittens) or from handling wild animals. Campylobacteriosis can be 

spread when the bacteria leave the body of an infected child/person through the stool and enter 

another child’s/person’s body when hands, food objects (toys) contaminated with the stool are 

put in the mouth. 

* How is Campylobacteriosis Treated 

- A child with symptoms that suggest possible campylobacteriosis infection must be separated 

from other children until a parent arrives to remove the child from the center. 

- Parents are advised to take their child to a physician for diagnosis and treatment to determine 

the cause of the infection. The physician will have the stool of the ill child examined. The 

physician’s treatment orders must be followed thoroughly. Usually antibiotics are given for 

5-7 days. 

* How Can the Spread of Campylobacteriosis be Prevented/Limited in Child Care 

Center 

- Outbreaks in child care centers are uncommon. Person-to-person spread is uncommon. 

- Educate parents, staff and children about the disease, how it is spread, preventive measures 

including frequent thorough hand washing, cleaning, and disinfecting of toys, equipment,

commonly shared items and the need to practice good health habits (rest, play, exercise, good 

nutrition, etc.) to keep children healthy and to decrease their chances of acquiring illnesses. 

- Thorough hand washing by children and staff is the most important means of preventing the 

spread of campylobacteriosis. Thorough hand washing after handling pets and cleaning 

cages or pens is important. 

- Special care needs to be taken when diapering and/or assisting children with toileting. Hand 

washing by staff and children after each diapering and toileting, cleaning and disinfecting of 

changing surface and potty chairs after each use, and proper disposal of soiled diapers and 

clothes will help prevent the spread of campylobacteriosis. 

- Disinfection of: 

- Toilets (seats, flush handles, etc.) must be cleaned and disinfected as necessary but at least 

daily. 

- Toys must be cleaned and disinfected when soiled with body secretions as often as necessary 

but at least daily. 

* Exclusion 

Until child has completed at least 2-3 days of treatment and diarrhea has stopped.


AND 


CHICKENPOX 

(VARICELLA) 



* What is Chickenpox 

Chickenpox is a very contagious viral infection, common in children and caused by the 

varicella-zoster virus. 


Can be 10-21 days, but commonly 14-16 days. 


The disease may be transmitted one to two days before onset of rash through the first four to five 

days, or until all lesions have formed crusts. 

* What are the Symptoms of Chickenpox 

Child may have fever, irritability, tiredness, and lack of appetite 1-2 days before the rash appears. 

A rash of small blisters appears on the trunk, then on the rest of the body. The rash can be 

extremely itchy. The blisters break easily and form scabs. The fluid in the blisters is highly 

contagious. 

* How is Chickenpox Spread 

Chickenpox is spread from person to person by direct contact with fluid from blisters (lesions), 

mucus from eyes, nose or mouth. Droplets from coughing and sneezing can spread the disease. 

Also, it can be spread by direct contact with articles contaminated with the fluid from the blisters 

or tissues with respiratory secretions. 

* How is Chickenpox Treated 

There is no specific treatment for healthy children other than those to relieve symptoms. Parents 

may consult their children’s physician for recommendations. 

CHILDREN WITH CHICKENPOX SHOULD NOT RECEIVE ASPIRIN 

(SALICYLATES) BECAUSE THERE HAS BEEN AN ASSOCIATION 

DEMONSTRATED BETWEEN ASPIRIN ADMINISTRATION AND SUBSEQUENT 

DEVELOPMENT OF REYE'S SYNDROME. 

* How Can the Spread of Chickenpox be Prevented/Limited in Child Care Center 

Chickenpox is highly contagious. Children are most contagious for 1-2 days prior to developing 

the rash. Because the pre-rash symptoms can be mild, in many centers children are already 

exposed to the virus before chickenpox is known. Frequent, thorough handwashing by children 

and staff, frequent cleaning and disinfecting of shared items (toys, equipment, table tops, door 

knobs, etc.) and practicing good health habits (rest, play, proper nutrition, exercise, etc.) will help 

keep children healthy and limit spread of illnesses.

Chickenpox Vaccine: If vaccinated children do get chickenpox, they usually have a much 

milder illness. Varicella vaccine is required for all children in child care settings or on admission 

to child care between 12-18 months of age unless contraindicated. Vaccine often prevents 

shingles from occurring late in life. 

* Other Comments/Suggestions 

Inform staff and parents of other enrolled children who may have been exposed to the illness. 

There is a greater likelihood of serious infection in susceptible adults and adolescents and the 

potential for fetal damage if infection occurs during pregnancy 

* Exclusion 

Children are to be excluded from school until at least 6 days after the appearance of the rash. All 

blisters must have scabs before returning to school.

MONTHLY REPORT OF SELECTED *COMMUNICABLE DISEASES 

Submit this report first Monday each month for the previous month's disease. 

To report communicable diseases not listed, use the lower portion of form. 

County_________________________________ 

City____________________________________ 

Month__________________________________ 

Month/Year 

Disease 

Chickenpox 

CHIC 

Sex 

Male 

Female 

Unspec 

Age Breakdown 

Under 01 1 Yr 2 Yr 3 Yr 4 Yr 5-9 Yr 10-14 Yr 15-19 Yr 20-24 Yr 25-29 Yr 30-29 Yr 404-49 Yr 50-59 Yr 60-99 Yr Unknown 

Physician Confirmed 

Name and Address Phone Age Sex Disease Suspected Onset Date Yes No 

Reported By____________________________________________________Position/Facility___________________________________________ 

Date__________________________________ 

Phone Number___________________________________

NOTIFICATION OF CHICKENPOX 

(An acute, viral infection)* 

Dear Parent: 

A case of chickenpox has been reported in your child’s school. 

Incubation period: (the time between exposure to the disease and the appearance of symptoms) 

Can be 10 – 21 days, but is usually 14-16 days. 

Contagious period: (when the disease can be transmitted to another person) 

Usually 1 – 2 days before the rash appears (when the infected person coughs or sneezes) until all 

the blisters have crusted. 

Signs and symptoms: 

Child may have fever, irritability, tiredness, and lack of appetite 1 – 2 days before the rash 

appears. A rash of small blisters appears on the trunk, then on the rest of the body. The rash can 

be extremely itchy. The blisters break easily and form a scab. The fluid in the blisters is highly 

contagious. 

Treatment: 

For most children, only supportive care is needed. Contact your doctor if you suspect your child 

has chickenpox. DO NOT GIVE YOUR CHILD ASPIRIN OR PRODUCTS CONTAINING 

ASPIRIN (A SALICYLATE). THIS CAN LEAD TO THE DEVELOPMENT OF 

ANOTHER DISEASE CALLED REYE’S SYNDROME. Encourage your child not to scratch 

or rub the blisters for this can lead to a secondary infection. 

How this disease is spread: 

Chickenpox is spread from person to person by direct contact with fluid from blisters (lesions), mucus from 

eyes, nose or mouth. Droplets from coughing and sneezing can spread the disease. Also, it can be spread 

by direct contact with articles contaminated with the fluid from the blisters or tissues with respiratory 

secretions. 

Control of cases: 

Children are to be excluded from school until at least 6 days after the appearance of the 

rash. All blisters must have scabs before returning to school. 

General prevention measures: 

Wash hands carefully and make sure children do not share eating/drinking utensils, clothing or 

tissues. A vaccine is now available. For more information consult with your child’s doctor. 

*Persons at risk include pregnant women, people with compromised immune systems and new 

born babies. 


Notificación de Varicela 

(Una enfermedad contagiosa causada por un virus).* 


Un caso de varicela ha sido reportado en el salón de su hijo (a). 

Periodo de Incubación: (el tiempo de exposición de la enfermedad y la apariencia de 

síntomas) 

Puede ser de 10 - 21 días, pero usualmente es de 14-16 días. 

Periodo contagioso: (cuando la enfermedad puede ser trasmitida a otras personas) 

De 1 -2 días antes de la erupción de ampollas (cuando la persona infectada destornuda ó 

tose) hasta que las ampollas se sequen y tengan costras. 

Síntomas: El niño puede tener fiebre, irritabilidad, cansancio y perdida de apetito de 1 a 

2 días antes de que salgan las ampollas. Las ampollas comienzan en el abdomen y luego 

en el resto del cuerpo. Las ampollas causan mucha picazón. El liquido en las ampollas es 

contagioso. Los brotes se secarán y harán costra antes de caerse. 

Tratamiento: Para la mayoría de los niños solamente el apoyo suyo es necesario. Llame a 

su medico si usted sospecha que su niño tiene varicela. NO LE DE ASPIRINA A SU 

NIÑO Ó PRODUCTOS QUE CONTENGAN ASPIRINA. ESTO PUEDE CAUSAR 

EL SINDROME DE REYE. No deje que su niño se rasque las ampollas esto puede 

causar una infección secundaria. 

Propagación: La varicela es trasmitida de persona a persona por el contacto directo del 

fluido de ampollas (lesiónes), mucosidad de los ojos, nariz ó boca. Al estornudar y/ó 

toser se trasmite tambien la enfermedad por las gotas respiratorias que quedan en el aire. 

Tambien se transmite por el contacto directo con las articulos contaminados con la 

mucosidad del fluido de ampollas ó secreción del tejido respiratorio. 

Control de la enfermedad: Los niños deben ser excluidos de la escuela por 6 días 

después de la apariencia de las ampollas. Todas las ampollas deben de estar costradas 

antes de regresar a la escuela. 

Prevención: Lave sus manos y asegúrese que los niños no compartan utensilios de 

comer y de tomar ó ropa. Hay una vacuna disponible para la varicela. Para mas 

información llame al medico de su niño. 

* Las personas de alto riesgo son las mujeres embarazadas, las personas con el sistema 

inmune débil y los bebés recién nacidos. 

Information provided by Lake County Health Department/Community Health Center 

Chickenpox


AND 


COMMON COLD 

(upper respiratory infection) 

* What is the Common Cold 

The Common Cold is a mild infection of the upper respiratory tract (the nose, throat, ears 

and eyes) which is caused by over 100 different types of viruses. The most common of 

these is a rhinovirus (nose virus). 

Incubation Period: (Time from exposure to infection to beginning of symptoms) 

Two to 14 days. 


The virus concentration is usually highest and most contagious two to three days before a 

person develops symptoms of illness. Viruses continue to be present in respiratory 

discharges for three to five days after symptoms begin. As a result, infected children and 

staff have already spread viruses before they begin to feel ill. In fact, children and adults 

often have mild colds which may go undetected but still cause these persons to be 

contagious. 

* What are the symptoms of the Common Cold 

Cold symptoms include stuffy or runny nose, sore throat, coughing or sneezing, watery 

eyes, chills and fever. “Flu” is also caused by viruses (influenza A or B) and has 

symptoms of high fever, chills, congestion, coughing and muscle aches. Most people 

who get the flu feel too ill to attend child care. 

A runny nose generally accompanies a cold but can also accompany allergies. In the case 

of a cold, the mucus from the nose generally progresses from being very thin and watery 

in the beginning (when it is most contagious) to thick and cloudy as the cold progresses. 

At this time it can also become yellow or green. The green discharge is not as 

contagious, but become a problem for the child if it lasts more than 10 – 14 days. If 

accompanied by a fever or headache, it may indicate a sinus infection which will need 

medical treatment. A cold accompanied by wheezing or difficulty breathing requires 

medical attention. 

* How is the Common Cold spread 

The Common Cold virus is spread by the infected person coughing, sneezing and by 

mouthing or touching things. 

* How is the Common Cold treated 

There is no specific treatment for the Common Cold for healthy children other than those 

to relieve symptoms. 

* How Can the Spread of the Common Cold be Prevented/Limited in Child Care 

Center 

- Make sure that all children and staff use good hand washing practices.

- Wipe noses with clean tissues, dispose of them properly and wash your hands. 

- Don’t share food, bottle or toothbrushes. 

- Don’t kiss children on the mouth. 

- Open windows and maximize outdoor play. 

- Teach children to cough into their elbow and away from people. 

- Keep the environment clean. 

- Limit physical contact between very young infants and infected children. 

* Exclusion 

There is no need to exclude these children and staff if they feel well enough to attend and 

do not require more care and attention than the program can provide.


and 


CONJUNCTIVITIS 

(Pink-eye) 

* What is Conjunctivitis 

Conjunctivitis is a viral or bacterial infection of the eye. It is very contagious (catching). 

Children under 5 years are most affected. Pink-eye can also be caused by allergic reactions to 

dust, pollen and other materials. 


Maybe one to three days; may be up to 14 days for certain viruses. 


Children are considered to be infectious until symptoms are gone, unless documented that it is 

caused by non-infectious source. 

* What are the Symptoms of Conjunctivitis 

Include pink/red eyes, watery or mucous or yellow discharge from eyes, itching, burning, and 

eye pain. 

* How is Conjunctivitis Spread 

This disease is usually spread by direct person-to-person contact by dirty hands, but may also be 

spread by respiratory droplets from coughing or sneezing. 

* How is Conjunctivitis Treated 

Bacterial: As prescribed by child's physician. Antibiotic ointments, drops and oral medicine may 

be ordered if conjunctivitis is caused by a bacteria. 

Viral: No specific treatment other than supportive care. 

* How Can the Spread of Conjunctivitis Be Prevented/Limited in Child Care Center 

Teach the importance of proper hand washing. When washing hands, use soap, rubbing hands 

together for 20 seconds and rinse in running water 

- Children with possible conjunctivitis infection are to be removed from the center until 

symptoms resolved. 

- Children with pus-like drainage and/or fever and matted lids are indications of a bacterial 

infection. Child may return to center after receiving antibiotic treatment for 24 hours. 

- Frequent, thorough hand washing by children and staff. 

- Remind children and staff not to touch/rub their eyes or share towels

- Clean and disinfect toys, furniture, and other articles possibly contaminated with discharge 

from nose or throat secretions. 


- Notify parents of other enrolled children who may have been exposed of the illness. 

- Educate parents, staff and children about the infection, how it is spread, preventive measures 

and the need for good personal hygiene habits, especially handwashing. 

* Exclusion 

For bacterial conjunctivitis exclude child from school until 24 hours after antibiotic treatment 

begins or symptoms are gone.

NOTIFICATION OF CONJUNCTIVITIS 

(Pink-eye can be a bacterial or viral infection) 

Dear Parents: 

A case of “pink-eye” has been reported in your child’s classroom. 

Incubation period: ( the time between exposure to the disease and the appearance of 

symptoms) May be 1 to 3 days or up to 14 days for certain viral infections. 


Children are considered to be infectious until symptoms are gone. 


Include red eyes, watery or mucous discharge from eyes, itching, and burning. 

Treatment: 

If the infection is bacterial, you doctor may prescribe an antibiotic. It is extremely 

important to use all medications as prescribed by your doctor. 


This disease is usually spread by direct person-to-person contact by dirty hands, but may 

also be spread by respiratory droplets from coughing or sneezing. 


If your child has a conjunctivitis, he/she should be kept home until at least 24 hours after 

beginning an antibiotic or until the symptoms are gone. 

General preventative measures: 

Teach the importance of proper hand washing. When washing hands, use soap, 

rubbing hands together for 20 seconds and rinse in running water. Children should be 

advised not to share clothing, towels, make-up or eye medications. 


Notificación de Conjuntivitis 

(Conjuntivitis puede ser una infección causada por bacteria ó un virus). 


Un caso de Conjuntivitis ha sido reportado en el salón de su hijo (a). 


síntomas) Puede ser de 1 a 3 días o hasta 14 días dependiendo en el virus que causa la 

infeccione. 


Los niños son considerados contagiosos mientras tiene síntomas. 

Síntomas: Los ojos hinchados y rojos, con mucha picazón y lagrimas. 

Tratamiento: Antibióticos pueden ser recetados por su medico si la infección es causada 

por una bacteria. Es muy importante usar todo el medicamento que el médico le orden. 

Propagación: La enfermedad es transmitida por manos sucias, y también puede ser 

transmitida por góticas respiratorias transportadas por el aire durante el estornudo y/o tos. 

Control de la enfermedad: 

Si la infección de su niño es causada por una infección bacterial, su niño no puede 

regresar a su salón hasta que ya no tenga síntomas. Pero si puede regresar después de 

estar tomando antibióticos por 24 horas. 

Prevención: El primer paso es educar a su hijo (a) sobre la importancia del buen lavado 

de manos, antes de comer y después de usar el baño. Cuando se lavan las manos es muy 

importante usar jabón, usando mucha fricción por 20 segundos y enjuague las manos bajo 

agua corriente. Eduque a su hijo (a) sobre la importancia de no compartir peines, toallas 

y medicamentos para la vista. 



AND 


CROUP 

(Laryngotracheobronchitis) 

* What is Croup 

Croup is an inflammation or swelling of the voice box (larynx) and windpipe (trachea). When a 

child has croup, the airway just below the vocal cords becomes swollen and narrow. This makes 

breathing noisy and difficult. 


Two to 14 days. 

Period of Communicability:(Period person can give infection to another). 

Virus can be transmitted from one week before illness begins and for the duration of illness. 

* What are the Symptoms of Croup 

A barking cough with hoarseness which may follow a mild cold. May begin suddenly or slowly. 

There may be increasing difficulty breathing, loss of appetite and fatigue. 

* How is Croup Spread 

The typical virus (parainfluenza) that can cause croup is spread directly by contact with 

secretions from the mouth or by coughing and sneezing. Virus can also be spread indirectly by 

children’s or care-giver’s hands, disposable tissues, eating utensils or other articles freshly soiled 

by cough from an infected person (toys, table tops, etc). 

* How is Croup Treated 

There is no specific treatment for healthy children other than those to relieve symptoms and 

supportive care including rest and fluids. 

* How Can the Spread of Croup Be Prevented/Limited in Child Care Center 

Cover nose and mouth when coughing and sneezing, preferably with a tissue or upper arm. 

Dispose of contaminated tissues in a covered, washable plastic-lined waste container. 

- Wash hands frequently and thoroughly with soap and running water. 

- Clean and disinfect mouthed toys at least daily or more often if soiled or if many respiratory 

illnesses are occurring. Clean and disinfect eating and drinking utensils. 


- Inform parents of other enrolled children who may have been exposed to the illness 

* Exclusion 

- Exclude until child is fever free for at least 24 hours and able to comfortably and actively 

participate in child care activities and be cared for by staff.


AND 


CYTOMEGALOVIRUS INFECTION 

(CMV) 

* What Is Cytomegalovirus Infection 

Cytomegalovirus infection is caused by a virus and rarely produces symptoms of illness. 

Severely immunocompromized organ transplant recipients and neonatal infected babies may 

have severe illness. 


Unknown for person to person spread in households. 


Virus is excreted in urine, nasal secretions, and saliva for many months and may persist for 

several years following first infection. 

* What Are The Symptoms Of Cytomegalovirus Infection 

Most children and adults who are infected with the virus will have no symptoms. The few who 

develop symptoms will usually have mild flu-like illness (tired, achiness, sore throat, low-grade 

fever). Serious disease can occur when a child or adult with an impaired immune system is 

infected or when a developing fetus is infected. Pregnant women who practice good hygiene 

including frequent hand washing are at low risk of acquiring CMV. Caregivers who are 

pregnant or considering pregnancy should discuss being tested for CMV with their physician. 

Only 10% of babies infected before birth will have signs and symptoms of mental retardation. 

* How Is Cytomegalovirus Spread 

Transmission of CMV appears to require direct contact with virus-containing secretions. 

Urine, saliva, nasal secretions, blood and other body fluids are infected for a variable period of 

time following infection. The virus can be transmitted to a susceptible person when one of these 

infectious fluids makes contact with a break in the skin or with the mucous membrane of the eye, 

nose or mouth. CMV spreads easily in a child care setting, especially among children who lack 

control of body secretions 

* How is Cytomegalovirus Treated 

Antiviral drugs have shown to be helpful in some situations. Used only for severe disease. 

* How Can Spread of Cytomegalovirus Virus Infection Be Prevented/Limited In Child 

Care Center 

- Routinely clean and disinfect items contaminated with saliva, nasal secretions or urine 

- Careful hand washing of staff and children.


- Routine hygiene is the most effective method of preventing CMV transmission. 

- CMV circulation is most prevalent in children younger than 2 years of age. 

- Handle soiled diapers with care. Wear disposable gloves when changing diapers. Wash 

hands after each diaper change, assistance with toilet care, or contact with a child's saliva, 

nasal secretions or urine. Educate women of childbearing age about the potential risks of 

acquiring CMV infection and the important of proper hand washing before any activity that 

brings hands in contact with eyes, nose or mouth, e.g., eating, drinking, smoking, etc., 

minimize contact with children’s saliva, such as kissing on mouth or hands. 

- If caregivers of children younger than 2 years of age expect to become pregnant, CMV 

antibody testing and consultation with a physician can identify if they are immune to CMV; 

for those women without immunity, temporarily limiting contact with children younger than 

2 may reduce the risk. Contact with children that does not involve exposure to saliva or 

urine poses no risk of CMV transmission. 

* Exclusion 

No restrictions.


AND 


DIPHTHERIA 



* What is Diphtheria 

It is a disease caused by a bacteria that lives in the mouth, throat and nose of an infected person. 

It can be prevented by immunization of DTaP or Td. 


Usually 2-7 days, occasionally longer 


Period is variable, but usually two to four weeks until bacteria have disappeared from infected 

area. Carriers may be able to spread organisms for six months or more. 

* What are the Symptoms of Diphtheria 

Slight fever, swollen glands, sore throat with gray-white patches surrounding inflamed zones, 

chills. Proceeds to a gray membrane formation which obstructs the airway. Fatal up to 23%. 

* How is Diphtheria Spread 

Person-to-person spread is by sneezing or coughing or direct contact with respiratory tract or 

skin discharges of an infected person. It may spread by indirect contact with articles soiled by 

infected patient’s discharges from lesions; rarely spreads by contaminated objects and food.. 

* How is a Diphtheria Treated 

Effective antibiotic therapy and antitoxin. 

* How Can the Spread of Diphtheria be Prevented/Limited in a Child Care Center 

- All needed immunizations given according to schedule 

- Careful hand washing of staff and children. 

- Disinfection of mouthed toys 


- Only 0.001 cases per 100,000 population in the U.S. since 1980. Russian Epidemic 1990- 

97; Ecuador Epidemic 1993-94. 

- 

* Exclusion 

Child must be isolated and excluded from day care or school until two successive cultures from 

both nose and throat, taken not less than 24 hours apart, are negative for diphtheria. All 

susceptible contacts should be isolated.

LAKE COUNTY HEALTH DEPARTMENTAND 


ESCHERICHIA COLI (E. COLI 0157:H7 DIARRHEA) 

(Enterohemorrhagic E. coli (EHEC) 



* What Is Escherichia Coli infection 

E. Coli is a bacterial infection usually of the intestines. The bacteria (E. coli 0157:H7) are found 

in cattle and can be transmitted to humans through contaminated undercooked beef (especially 

ground beef) contaminated raw milk and contaminated water, fresh fruits, and vegetables. 

Incubation Period: (Time from exposure to infection to beginning of symptoms of illness). Ten 

hours to 6 days; averages 3 – 5 days. 

Period of communicability: (Period person can give infection to another). 

As long as the bacteria are in the stool or indirectly transferred from an infected person or 

animal. 

* What Are The Symptoms of E. Coli 0157:H7 Infection 

Diarrhea may range from mild and non-bloody to stools that are virtually all blood. Severe 

abdominal pain is typical; fever is usually absent. Any child with bloody diarrhea requires 

immediate medical attention. Some people infected with this bacteria may have only mild 

symptoms. 

* How Is E. Coli 0157:H7 Spread 

E. Coli 0157:H7 is spread by eating meat (especially ground beef) that is not cooked thoroughly, 

or by drinking unpasteurized milk or fruit juices. Fruits and vegetables that have been in contact 

with animal feces may transmit the germ. It also spreads easily from person to person. The 

stool of an infected person contains the bacteria and the bacteria can be spread to others if hands 

are not properly washed after having a bowel movement or changing diapers. The bacteria 

enters the body of another person when food, hands or objects (toys) contaminated with E. Coli 

bacteria are placed in the mouth. As with other intestinal infections, children in diapers in child 

care centers are at high-risk for spreading intestinal diseases. 

* How Is E. Coli 0157:H7 Infection Treated 

After physician’s diagnosis, treatment for E. Coli 0157:H7 infection is usually supportive. 

Antibiotics and diarrhea-stopping drugs are normally not recommended. Follow physician's 

orders. There may be serious complications from this disease. 

* How Can the Spread of E. Coli 0157:H7 Be Prevented/Limited in Child Care Center

- Cook all ground beef thoroughly until it is brown, not pink, in the inside. Heat kills 

bacteria. Heat to internal temperature of 155 o . 

- Do not drink unpasteurized milk or juice. Clean fresh fruits and vegetables well. 

- Wash hands thoroughly after using the toilet and after changing diapers. Always wash 

hands before preparing/eating foods. 

- 

- Clean and disinfect contaminated areas (toilets, faucets, door handles, etc.) when soiled 

but at least daily. Changing tables and potty-chairs must be cleaned and disinfected after 

each use. 

- Toys must be cleaned and disinfected when soiled but at least daily. Mouthed toys 

should be cleaned and disinfected after a child stops playing with the toy. 

- A child suspected of E. Coli 0157:H7 or with diarrhea must be removed from the center. 

- Inform parents of other enrolled child who may have been exposed to the illness. 

- Children who are not toilet trained should wear tight fitting rubber of plastic pants before 

entering public wading or swimming pools, water parks or beaches. Persons with 

diarrhea should not engage in recreational water activities. 

* Exclusion 

Exclude infected child/children until symptom free and 2 consecutive stool cultures are negative 

for E. coli 0157:H7.


AND 


FEVER 

* What is a Fever 

A fever is a body temperature that is higher than normal. It may be a sign that the body is 

fighting an infection. 


Variable, determined by the cause. 


Variable, determined by the cause. 

* What are the Symptoms of a Fever 

Oral temperature of 101 degrees F or greater – underarm (axillary) temperature of 100 degrees or 

more. 

* How is a Fever Spread 

Fever itself is not transmissible; the cause of the fever will determine the way it is transmitted. 

* How is a Fever Treated 

- The cause of fever needs to be identified and treated. The physician can recommend 

supportive care for fever also. Rest and usually extra fluid is recommended. 

* How Can the Spread of a Fever be Prevented/Limited in a Child Care Center 

- Careful hand washing and cleaning of toys. 

* Exclusion 

Child excluded due to fever may be readmitted when fever subsides, unless fever accompanies 

disease(s) for which there are other restrictions.


AND 


FIFTH DISEASE 

(ERYTHEMA INFECTIOSUM, PARVOVIRUS B19 INFECTION) 

(Note special precautions for Child Care Staff) 

* What is Fifth Disease 

Fifth Disease is a mild, contagious viral infection occurring in children, characterized by a 

distinctive rash. It tends to occur more in winter and spring. 


4 - 14 days, but as long as 21 days. 


Most infectious before onset of rash and probably not communicable after onset of rash. 

* What are the Symptoms of Fifth Disease 

Often the first symptoms are fever, fatigue, muscle aches and headache. This is followed by 

characteristic bright red rash on cheeks (slapped face appearance). A lace-like red rash occurs 

on chest and back and then it moves to arms and legs. This rash may fade and then reoccur for 

1 – 3 weeks. 

* How is Fifth Disease Spread 

This disease is spread by contact with the infected person’s respiratory secretions from coughing, 

sneezing and contaminated hands. 

* How is Fifth Disease Treated 

For most children, only supportive care for symptoms is needed. Make sure child is not too hot, 

is kept out of the sunlight and drinks enough fluids. 

* How Can the Spread of Fifth Disease be Prevented/Limited in Child Care Center 

Spread of Fifth Disease can be limited by frequent and complete hand washing by children and 

staff, by proper disposal of facial tissues containing respiratory secretions, by frequent cleaning 

and disinfecting of shared articles (e.g. toys, table tops, etc.) and by practicing good health 

habits. 


- Inform parents of other enrolled children who may have been exposed. 

- Educate parents, staff, and children about disease, how it is spread, prevention methods and 

the need for good personal hygiene habits. 

- Transmission may be limited by practicing good hand washing technique and proper disposal

of facial tissues containing respiratory secretions. Children should also avoid sharing eating 

utensils. When washing hands, use soap, rubbing hands together for 20 seconds and rinse in 

running water. 

* Exclusion 

Because children are no longer contagious when the rash appears, there are no restrictions. 

Exclude child if fever is present or if child does not feel well enough to participate in usual 

activities. 

* SPECIAL PRECAUTIONS 

Non-immune, pregnant women should avoid exposure to potentially infectious persons. 

Susceptible staff who are pregnant, or who might become pregnant and have continued close 

contact to children with this infection, should be advised of the potential for acquiring the 

infection and the risk to the fetus. These women need to discuss this issue with their physician. 

Women who are exposed to children either at home or at work are at increased risk of infection 

with this virus. Because of the widespread inapparent infections in both adults and children, all 

women are at some degree of risk of exposure, particularly those with school-aged children. In 

view of the high prevalence of this virus, the low incidence of ill effects on the fetus, and the fact 

that the avoidance of child care or teaching can only reduce but not eliminate the risk of 

exposure, routine exclusion of pregnant women from the workplace where this virus is occurring 

is not recommended.

______________________________________________________________________________________ 

Dear Parents: 

NOTIFICATION OF FIFTH DISEASE 

(A mild, contagious viral infection)* 

A case of fifth disease has been reported in your child’s school. 

Incubation period: (the time between exposure to the disease and the appearance of 

symptoms) Variable; 4 – 14, but as long as 21 days. 


Before the onset of the rash and probably not infectious after the onset of the rash. 


May consist of mild fever, fatigue and headache. 7 – 10 days later a bright red rash 

appears on the face (a “slapped cheek” appearance) and a lace-like rash may develop on 

the arms, legs, trunk and thighs. The rash may come and go over a period of a 1 - 3 

weeks. Heat and sunlight may aggravate the rash. 

Treatment: 

For most children only supportive care for symptoms is needed. Make sure child is not 

too hot, is kept out of the sunlight and is well hydrated. 


This disease is spread by contact with the infected person’s respiratory secretions from 

coughing, sneezing and contaminated hands. 


Transmission may be limited by practicing good hand washing technique and proper 

disposal of facial tissues containing respiratory secretions. Children should also avoid 

sharing eating utensils. When washing hands, use soap, rubbing hands together for 20 

seconds and rinse in running water. 

* Persons at risk include pregnant women, people with compromised immune systems 

and those with certain forms of anemia. If exposed, contact your doctor for further 

information. 


Notificación de la Quinta Enfermedad 

(Eritema Infectiosum). 


Un caso de Quinta enfermedad ha sido reportado en el salón de su hijo (a). 


síntomas) puede variar de 4 a 14 días, pero puede ser hasta 21 días. 


Los niños son considerados contagiosos antes de desarrollar el sarpullido. 

Síntomas: Fiebre baja, dolor de cabeza y fatiga. De 7 a 10 días después desarrollan una 

erupción de "cachete bofetada" distintiva. Una línea como de listón aparece en los brazos, 

piernas y en la cintura. La erupción puede ir y venir por un periodo de 1 a 3 semanas. El 

caliente y los rayos de sol pueden irritar la erupción. 

Tratamiento: Apoyo para los síntomas. Cuide que su hijo (a) no le dé calor, mantengan 

fuera de los rayos del solo y que tome muchos líquidos. 

Propagación: La enfermedad es transmitida por góticas respiratorias transportadas por el 

aire durante el estornudo y/o tos y por manos contaminadas. 

Prevención: El primer paso es educar a su hijo (a) sobre la importancia de el buen lavado 

de manos, y la propia disposición de pañuelos desechables (Kleenex). Los niños no deben 

compartir los utensilio de comer. Cuando se lavan las manos es muy importante usar 

jabón, usando mucha fricción por 20 segundos y enjuague las manos bajo agua corriente. 

Eduque a su hijo (a) sobre la importancia de no compartir peines, toallas y medicamentos 

para la vista. 

*Las personas de mas riesgo son las mujeres embarazadas, personas con el sistema 

inmune comprometido y ciertos tipos de anemia. Si usted ha sido expuesto por favor 

llame a sus medico para mas información. 


Fifth Disease


AND 


GASTROENTERITIS, VIRAL 

* What is Gastroenteritis 

Diarrheal disease with rapid beginning of illness. It may also include vomiting, nausea, fever or 

abdominal pain. 


Variable, usually one to 4 days. 


Variable, during diarrheal illness and for one to several days following resolution of symptoms. 

* What are the Symptoms of Gastroenteritis 

Stomach ache, nausea, vomiting, diarrhea, fever. 

* How is Gastroenteritis Spread 

Person-to-person via the fecal-oral route; also spread via food or drinks contaminated by an 

infected food handler and by contaminated water. 

* How is a Gastroenteritis Treated 

Unless caused by an identified bacteria, treatment is supportive. 

* How Can the Spread of Gastroenteritis be Prevented/Limited in a Child Care Center 

- Careful hand washing, cleaning, and disinfecting. 

* Exclusion 

Exclude child from school until clinical recovery, i.e., absence of diarrhea and fever for at least 

24 hours.


AND 


GIARDIASIS 

(Giardia lamblia) 


See: Illinois Reportable Disease list in front of section 

* What is Giardiasis 

Giardiasis is an infection that occurs in the intestinal tract and is caused by a parasite. 


One - 4 weeks. 


As long as the Giardia lamblia parasite is present in the stool. 

* What are the symptoms of Giardiasis 

Symptoms may be mild or absent. Signs and symptoms are gas, nausea and chronic, intermittent 

diarrhea. Weight-loss and bloating can occur with abdominal cramping and fatigue. Stools can 

be foul-smelling, frequent, pale and greasy. Children often do not have symptoms but are still 

infected with the parasite. The pattern is usually signs and symptoms for 2-3 days, then normal 

stools for 2-3 days, then signs and symptoms, etc. 

* How is Giardiasis Spread 

Giardia lamblia leaves the body of an infected person through the stool and enters the body of 

another person when hands, food, or objects contaminated with stool are placed in the mouth. 

The infected child/person who has the parasite may or may not have diarrhea. Giardiasis can 

also occur after drinking contaminated water from streams, creeks or improperly treated water 

found in foreign countries. As long as a child/person has Giardia lamblia in the stool (bowel 

movement) that child/person can serve as a possible source of disease spread (communicability). 

Infected preschool children with poor hand washing practices are the most common means of 

spread in Lake County. 

* How is Giardiasis Treated 

- Children with diarrhea or symptoms that suggest possible Giardiasis infection must be 

separated from the other children until a parent arrives to remove the child from the 

center. 

- Parents are advised to take their child to a physician for diagnosis and treatment. 

- The physician's treatment orders must be followed thoroughly. 

* How Can the Spread of Giardiasis be Prevented/Limited in a Child Care Center

- Thorough handwashing is the most important means of preventing the spread of 

Giardiasis. 

- Inform staff and parents of other enrolled children who may have been exposed of the 

illness. 

- Educate parents, staff and children about the disease. 

- Teach the importance of proper hand washing after using the bathroom, before eating, 

and after handling pets. When washing hands, use soap, rubbing hands together for 20 

seconds and rinse in running water. Adults should supervise children. Advise children 

not to share eating/drinking utensils or food and not to drink water from ponds, streams 

or lakes. 

* Exclusion 

Exclude child from school until clinical recovery, i.e., absence of diarrhea and fever for 24 

hours. Carriers who are food handlers or child care workers are prohibited from performing their 

job duties until three consecutive stool specimens are negative. 

No restrictions in general school population. Household contacts who are food handlers should 

be examined for trophozoites and cysts of Giardia lamblia and, if positive, should be restricted 

according to current IDPH rules and regulations. Household contacts who work in sensitive 

occupations also may be restricted according to current IDPH rules and regulations.

______________________________________________________________________________________ 

Dear Parents: 

NOTIFICATION OF GIARDIASIS 

(An intestinal infection caused by the Giardia organism) 

A case of giardia has been reported in your child’s classroom. 

Incubation period: ( the time between exposure to the parasite and the appearance of 

symptoms) Can be 1 to 4 weeks. 


During the entire period of infection, which can last for months. 


Can include chronic diarrhea, abdominal cramping and bloating, frequent loose and pale, 

greasy stools with a very foul odor, tiredness and weight loss. Symptoms will usually 

come and go over the course of the illness. Some children may not have symptoms and 

still be able to transmit the infection. 

Treatment: 

Antimicrobial medicine may be prescribed by your doctor. Fluid replacement when 

watery diarrhea is present is important. 


This organism leaves the body of an infected person through the stool and enters another 

person when dirty hands, food or objects are placed in the mouth. You can also get 

giardia from drinking unfiltered, contaminated water from ponds, streams or lakes. 


Child should be excluded from school until clinical recovery (absence of diarrhea for at 

least 24 hours). 

General preventive measures: 

Teach the importance of proper hand washing after using the bathroom, before 

eating, and after handling pets. When washing hands, use soap, rubbing hands together 

for 20 seconds and rinse in running water. Advise children not to share eating/drinking 

utensils or food and not to drink water from ponds, streams or lakes. 


Notificación de Giardia 

(Una Infección de la zona intestinal causada por el organismo de Giardia.) 


Un caso de Giardia ha sido reportado en el salón de su hijo (a). 


síntomas). Puede ser de 7 - 30 días ó mas. 

Periodo contagioso : (cuando la enfermedad puede ser trasmitida a otras personas) 

Durante la enfermedad la cual puede durar por meses. 

Síntomas: Diarrea crónica, dolores abdominales y gases. Perdida de peso, cansancio, 

excrementos frecuentes grasos con un olor desagradable. Los niños a veces no muestran 

síntomas pero todavía pueden trasmitir la enfermedad. 

Tratamiento: Es muy importante tomar muchos líquidos cuando la persona tiene diarrea 

y vómitos. Antibióticos pueden ser recetados por su medico. 

Propagación: Gérmenes infectados salen del cuerpo en la excreta y son transportadas por 

las manos de la persona infectada, luego entran en el cuerpo de otra persona cuando la 

persona infectada propaga los gérmenes tocando comidas ó objetos sin haberse lavado 

las manos después de usar el baño. Giardia también puede ser adquirida tomando agua 

contaminada de lagos y corrientes de agua que no ha sido filtrada. 

Control de la enfermedad: Los niños deben ser excluidos de las escuelas hasta que no 

tenga síntomas clínicos, tales como fiebre (calentura), vómitos y diarrea por 24 horas. 

Prevención: El primer paso es educar a su hijo (a) sobre la importancia de el lavado de 

manos, antes de comer y después de usar el baño. Cuando se lavan las manos es muy 

importante usar jabón, usando mucha fricción por 20 segundos y enjuague las manos bajo 

agua corriente. 



AND 


HAND, FOOT AND MOUTH DISEASE 

(COXSACKIE VIRUS DISEASE) 

(Enteroviral Vesicular Stomatitis with Exanthema) 

(Herpangina) 

(Enteroviral Vesicular Pharyngitis) 

* What is Hand, Foot and Mouth Disease 

Hand, foot and mouth disease is an infection of the mouth, palms of the hands, fingers and soles 

of the feet, caused by coxsackie virus. 

Incubation period: (Time from exposure to infection to beginning of symptoms of illness). 

Usually 3-6 days 


During illness and possibly longer, since viruses remain in the stool for several weeks. 

* What are the symptoms of Hand, Foot and Mouth Disease 

This disease usually starts suddenly with a sore throat and low grade fever that last 1-2 days. 

Small blisters containing clear fluid occur inside the mouth and throat, on the lips, fingers, hands 

and feet . These blisters break easily and can last for 7-10 days. 

* How is Hand, Food and Mouth Disease Spread 

Infectious germs leave the body of an infected person through the stool, saliva, and nasal 

discharges of an infected person and enter another person when contaminated hands, food or 

objects are placed in the mouth. Hand-foot-mouth disease is not transmitted to or from animals 

or pets; it is not associated with the similarly named disease that can cause serious illness in 

cattle. At least half of all children with this infection have no symptoms. 

* How is Hand, Foot and Mouth Disease treated 

There is no specific treatment. Call your medical provider with questions. 

* How Can the Spread of Hand, Foot and Mouth Disease be Prevented/Limited In Child 

Care Center 

- A child suspected of having Hand, Foot and Mouth Disease is to be removed from the 

center. 

- Inform parents of other enrolled children who have been exposed of the illness. Educate 

parents, staff and children about the disease, transmission, and prevention. 

- Encourage frequent, thorough handwashing by children and staff, especially after 

diapering/toileting, sneezing, coughing and/or blowing the nose.

- Clean and disinfect articles, (toys, tables, chairs, cots, sheets, doorknobs, etc.) that may 

be soiled with nose and throat discharges and/or stool of infected person, (diapering area, 

toilets, potty chairs). Dispose of tissues with nose/throat discharges, and diapers properly 

in a washable, plastic-lined, covered container. Wash hands thoroughly. 

* Other Comments/Suggestions. 

- Teach the important of basic hygiene measures such as covering the mouth when 

coughing or sneezing and frequent, proper hand washing before any activity that brings 

hands in contact with the mouth., e.g., eating, drinking, smoking, etc. Emphasize the 

importance of proper disposal of used tissues; prompt hand washing after handling 

articles soiled with oral secretions or discharges from the nose and immediately after 

diaper changing or toileting; and not sharing glasses, straws, water bottles, eating 

utensils, etc. 

* Exclusion 

Children with hand, foot and mouth disease should be excluded from school if fever is present. 

Children should be given plenty of rest and liquids.

NOTIFICATION OF HAND, FOOT & MOUTH DISEASE 

(A viral infection) 

Dear Parent: 

A case of hand, foot and mouth disease has been reported in your child’s classroom. This virus 

affects the mouth, palms of the hands, fingers and soles of the feet and is caused by the coxsackie 

virus. 


Usually 3 – 6 days. 


The person may be contagious during the illness and probably longer because the virus can be 

passed in the stool for several weeks after the symptoms are gone. 


This disease usually starts with a sore throat and low grade fever that lasts 1 – 2 days. Small 

blisters containing clear fluid occur inside the mouth and throat, on the lips, fingers, hands and 

feet. These blisters break easily and can last for 7 – 10 days. 

Treatment: 

There is not specific treatment but you should contact your doctor for evaluation and suggestions 

on alleviating symptoms. 

How is this disease spread: 

Infectious germs leave the body of an infected person through the stool, saliva, and nasal 

discharges of an infected person and enter another person when contaminated hands, food or 

objects are placed in the mouth. 


Children with hand, foot and mouth disease should be excluded from school if fever is present. 

Children should be given plenty of rest and liquids. 


Teach the importance of washing hands properly. When washing hands, use soap, rubbing 

hands together for 20 seconds and rinse in running water. Make sure children dispose of tissues 

properly. Children should be discouraged from sharing foods and eating/drinking utensils. 


Notificación de la Enfermedad de las Manos, Pies y Boca 

(Una infección virus). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de Manos, Pies y 

Boca. 


síntomas). Usualmente de 3 a 6 días. 


El niño puede ser contagioso durante la enfermedad y probablemente por mas tiempo. 

Por que el virus se queda en la excreta por varias semanas después de que desaparece los 

síntomas. 

Síntomas: La enfermedad usualmente comienza con dolor de garganta y fiebre 

(calentura) baja que dura de 1 a 2 días. Lesiones pequeñas que contienen un liquido claro 

salen dentro en la boca, garganta, los labios, dedos, manos y pies. Esta lesiones se 

revientan fácilmente y duran de 7 a 10 días. 

Tratamiento: No hay tratamiento especifico pero usted debe llamar a su medico para 

una evaluación y sugerencias para aliviar los síntomas. 

Propagación: El germen infectado sale del cuerpo por la excreta, saliva y descargos 

nasales de una persona infectada y entra en el cuerpo de otra persona cuando objetos 

contaminados esta puestos en la boca o comidas son cocinadas con la manos contaminas. 

Control de la Enfermedad: Los niños con la enfermedad de manos, pies y boca deben 

ser excluidos de la escuela hasta que no tengan fiebre. Los niños deben recibir mucho 

reposó y suficientes líquidos. 

Prevención: Educación sobre la importancia de el lavado de manos es el primer 

paso. Cuando se lavan las manos es muy importante usar jabón, usando mucha fricción 

por 20 segundos y enjuague las manos bajo agua corriente. Asegúrese que su niño 

deseche los kleenex faciales apropiadamente. También aconseje a sus niños en no 

compartir utensilios de tomar y comer. 



AND 


HEAD LICE 

(Pediculosis Capitis) 

* What is Head Lice 

It is caused by a very small insect (louse) which lives on human heads. The tan-colored insects 

lay eggs (nits) close to the scalp. The eggs are gray or white and very small (eye of needle size). 


Head lice live for about 30 days on a person. Eggs of lice usually hatch in 6-10 days. After 

another 10 days the hatched nits become adult head lice. 


As long as the lice or eggs/nits are present. 

* What are the Symptoms of Head Lice Infestation 

Severe itching and scratches on the scalp and neck. (This could lead to a secondary bacterial 

infection.) When looking for head lice: 

1). Check hair for crawling lice (usually only a few). 

2). Look for eggs (nits) glued/attached to the hair often behind the ears and at the hairline at 

the back of the neck, are very difficult to remove and are close to scalp. 

3). Scratch marks on scalp or back of neck. 

* How Is Head Lice Spread 

Head lice are spread from one person to another by direct contact with an infested person’s head 

or by contact with lice-infested items, such as hats, hairbrushes, combs, towels, and bedding. 

* How Is Head Lice Treated 

- Contact your physician, pharmacist, or school nurse for assistance in obtaining a 

shampoo that is specific for head lice. Follow the instructions carefully. After 

shampooing with a pediculicide (lice killing) shampoo, you must be sure to remove all 

the nits with either a fine-toothed comb or with your fingers. If any nits remain, they can 

hatch and your child can be reinfested, since the lice killing shampoo may not kill the 

nits. 

* How Can the Spread of Head Lice Be Prevented/Limited in Child Care Center 

- Follow cleaning recommendations found in IDPH Healthbeat. 

- Avoid sharing brushes, combs, hats, headgear (headphones/helmets), towels, bedding, 

pillows, etc. Coat hooks should be at least 12" apart. Avoid piling coats/jackets on top 

of each other. Instruct children to put hats or scarves in coat sleeves. Follow cleaning

- If a child/children in a child care center is/are diagnosed with head lice, all children in 

that classroom group should be screened for head lice or nits. Also, check sibling of the 

infected child/children in other classes or groups for head lice or nits. Exclude any 

child/children infected until day after treatment. 



infestation. Educate parents, staff and children about the disease, how it is spread and 

preventive measures. 

- Parents should check treated child/children's head daily for 2-3 weeks 

* Exclusion 

Exclude child from school at the end of day that the lice are discovered until the morning after 

the first shampoo, lotion or cream rinse pediculicide is properly applied.

head lice 

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HEAD LICE 

What are the symptoms of a head lice infestation 

The earliest and most common symptom of a head lice infestation is itching, 

particularly in the area behind the ears and at the nape of the neck. Intense scratching 

may lead to secondary bacterial infection. 

How are head lice spread 

Head lice can be passed from person to person through direct contact. But they also 

can be transferred indirectly among clothing items when coats, hats and scarves hang 

or are stored touching one another (in cloak rooms or when these items are placed 

against one another on coat hooks or racks). Head lice also can be spread when 

infested hair brushes or combs are shared or when infested bedding, towels or 

shower caps are shared. Once present in a home, school or institutional environment, 

head lice usually spread rapidly. 

There are many misconceptions about head lice. They do not transmit communicable 

diseases. They do not jump or fly; they can only crawl. Head lice depend completely 

on their host for nourishment; their only source of food is human blood. The 

prevalence of head lice infestation is no different in individuals with long hair than in 

those with short hair. Head lice seldom occur on eyebrows or eyelashes. They infest 

persons from all socioeconomic levels, without regard for age, race, sex or standards 

of personal hygiene. Animals are not a source of human lice. 

How long do head lice live 

The life span of an adult louse on a host ranges up to 30 days. During this time, the 

female head louse can deposit about 90 eggs. After incubating for seven to 10 days, 

the nits hatch and, after another 10 days, mature into adult head lice and the cycle 

begins again. Off the host, adult head lice can live about two to four days at 74 

degrees Fahrenheit (F) and one to two days at 86 degrees. Nits will remain alive off 

the host for up to 10 days; they will not hatch at or below room temperature (68 

degrees F). 

How are head lice infestations treated 

Both prescription and over-the-counter remedies are effective in treating head lice. 

But it is important that pregnant women and infants be treated under the direction of

head lice 


Page 2 of 3 

3/31/2005 

a physician because of concerns about potentially adverse effects. Be careful not to 

use topical preparations more frequently and over longer periods of time than 

directed. Overuse of these preparations may cause dermatitis or result in absorption 

of potentially toxic quantities of the drug. Since agents that kill lice may not kill nits 

completely even when used according to directions the U. S. Centers for Disease 

Control and Prevention (CDC) recommends that infested patients be treated twice. 

The interval between treatments should approximate the incubation period for nits 

(seven to 10 days) so the second application will kill any newly hatched parasites. 

Waiting longer than 10 days to apply a second treatment may allow some parasites to 

mature and lay more eggs. 

All persons who have head lice in a household should be treated. To treat an infested 

person-- 

• Remove all clothing; 

• Apply head lice medication according to label instructions (do not bathe before 

treatment), using a towel to protect the eyes; 

• Have the person bathe and put on clean clothing after treatment; and 

• Repeat treatment in seven to 10 days. 

Special fine-tooth combs (nit combs) are readily available and can be used to scrape 

nits and lice off the hair shaft. Combing out nits and lice after proper treatment is not 

necessary to eliminate infestation, but it may be used for cosmetic reasons or may be 

required by school "nit-free" policies or by health authorities. Parents and guardians 

should check treated children for lice and nits daily for two or three weeks after 

treatment. 

Should objects (e.g., clothing, furniture, etc.) be treated 

Objects that are able to harbor head lice and serve as vehicles of transmission should 

be treated. 

• Exposing lice and nits to temperatures above 125 degrees F for 10 minutes is 

lethal. Most personal articles of clothing and bedding can be disinfested by 

machine washing in hot water or machine drying for at least 20 minutes using 

the hot cycle. Be sure to allow time between loads for water to reheat to the 

disinfesting temperature. 

• Place non-washable personal articles of clothing or bedding in the dryer on 

high heat for at least 20 minutes, dry clean or seal non-washable fabrics in a 

plastic bag for a minimum of 10 days. 

• Place combs and brushes in a pan of water and heat on a stove to about 150 

degrees F for 10 minutes. If heating may damage combs or brushes, soak them 

for one hour in a phenol solution (e.g., Lysol®). To prevent the spread of head 

lice, do not share combs, brushes, hats, coats, towels or other articles that come 

in contact with the head, neck and shoulders. 

• Thoroughly vacuum or clean car seats, bus seats, and individual infant and car 

seats according to manufacturer's directions. 

• Fumigating rooms and using insecticidal sprays on furniture and carpets are 

not recommended to kill head lice; thorough vacuuming of houses and rooms

head lice 


Page 3 of 3 

3/31/2005 

inhabited by infested persons is sufficient. 

Use of product brand names® does not constitute product endorsement. 




Phone 217-782-4977 

Fax 217-782-3987 

TTY 800-547-0466 


NOTIFICATION OF HEAD LICE * 

(Small typically tan colored insect that lives on the head) 

Dear Parents: 

A case of head lice has been reported in your child’s classroom. There are three forms of lice, the 

nit (egg), the nymph, and the adult. Nits are found firmly attached to the hair shaft fairly close to 

the scalp and are white – yellow in color and oval shaped. They may look like dandruff, but are 

hard to remove. They take about 1 week to hatch. Nymphs are baby lice and mature into adults 

in about 7 days. They feed on blood. The adult is about the size of a sesame seed and is grayishwhite. 

They can live up to 30 days and feed on blood. 


6 to 10 days from laying to hatching of eggs. 


As long as the lice or eggs/nits are present. 


The lice cause severe itching usually on the back of the head by biting the scalp to feed. The 

itching is caused by an allergic reaction to the bite of the louse. Your child may have a tickling 

feeling of something moving in the hair, sores on the head caused by scratching, and irritability. 

Treatment: 

Contact your physician, pharmacist, or school nurse for assistance in obtaining a shampoo that is 

specific for head lice. Follow the instructions carefully. After shampooing with a pediculocide 

(lice killing) shampoo, you must be sure to remove all the nits with either a fine-toothed comb or 

with your fingers. If any nits remain, they can hatch and your child can be reinfested. 


Head lice are spread from one person to another by direct contact with an infested person’s head 

or by contact with lice-infested items, such as hats, hairbrushes, combs, towels, and bedding. 


Notify your school. Head lice must be treated with a special shampoo and all the nits must be 

removed. Wash all personal items such as hats, bedding, towels, combs, etc. in hot water and 

soap. If the articles cannot be washed, they should be dry-cleaned. Vacuum furniture, 

upholstery, carpeting, mattresses, and pillows. Anything that cannot be cleaned, like stuffed 

animals, should be put in a plastic bag and secured for two weeks. 


Encourage your child to wash his/her hands frequently, advise them not to share hats, combs, 

brushes, hair ribbons or pillows, to wash their combs and brushes regularly, and to report any 

itching. 

• The school maintains a “no nit” policy , which means that your child will not be allowed to 

return to school if there are any nits present in his/her hair. 


Notificación de Piojo 

(Un insecto pequeño de color bronceado que vive encima de la cabeza) 



síntomas). Puede tomara de 6 a 10 días durante el tiempo que el huevo de la liendre esté 

presente y hasta nacen las liendres. 

Periodo contagioso: (cuando la enfermedad puede ser trasmitida a otras personas). 

Mientras los piojos ó las liendres estén presentes. 

Síntomas: El síntoma más notable es que la persona infectada presenta una comezón 

persistente en la parte de atrás de la cabeza. Esta comezón es causada por la actividad de 

chupado de sangre realizada por el insecto. La comezón también es causada por una 

reacción alérgica al piojo. Su niño puede tener la sensación de que algo se esta moviendo 

en su cabello, llagas en la cabeza causada por estarse rascando y irritabilidad. 

Tratamiento: Llame a su medico, farmacista ó enfermera de la escuela para asistencia en 

obtener él champo correcto para los piojos. Siga las intrusiones cuidadosamente. Después de 

lavar el cabello con él champo de piojos, tendrá que remover todas las liendres con él peiné 

especial y usando sus dedos. Si no se remueven todas las liendres, los huevos volverán a 

empollar y su niño volverá a estar infestado. 

Propagación: Los piojos son propagados de persona-a- persona por contacto directo con la 

cabeza de una persona infestada. También con el contacto de artículos contaminados con 

piojos tales como sombreros, gorras, peines, cepillos, toallas y artículos de cama. 

Control de la Enfermedad: Notifique a escuela. Los piojos deben ser tratados con un 

champo especial y todas las liendres tendrán que ser removidas. Lave todos los artículos 

personales tales como gorras, toallas, cepillos y ropa de cama etc. en jabón y agua 

caliente. Los artículos que no pueden ser lavados deben de ser limpiados 

profesionalmente. Liempie los sofás, alfombras y almohadas con una aspiradora. 

Cualquier articulo que no pueda ser lavado, tales como peluches póngalos en una bolsa 

plástica y mantenga sellada apropiadamente por 2 semanas. 

Prevención: Anime a su niño a lavarse las manos frecuentemente y también usted debe 

advertir a su niño que no comparta peines, cepillos, sombreros, etc. Que le diga a usted si 

tiene picazón en la cabeza. 

* Si la escuela mantiene una regla que no se aceptan niños con liendres, esto significa 

que 

su niño no será aceptado en la escuela hasta que no tenga liendres. 



AND 


HEPATITIS A 

(INFECTIOUS HEPATITIS) 



* What is Hepatitis A 

Hepatitis A is a viral infection of the liver caused by the Hepatitis A virus (HAV). 


15-50 days average 25-30 days. 


Two weeks before onset of symptoms until the two weeks of illness following the onset of 

symptoms, or one week after onset of jaundice 

* What are the Symptoms of Hepatitis A 

The symptoms of Hepatitis A are low-grade fever, increased tiredness and sleeping, nausea and 

loss of appetite, abdominal discomfort, listlessness followed in a few days by dark colored 

urine, light colored stools and jaundice (yellowing of eyes and skin). In children, many 

infections are mild without symptoms and jaundice. Severity of illness increases with age. 

Hepatitis A can not be distinguished from other types of Hepatitis by symptom. A blood test 

must be done. 

* How is Hepatitis A Spread 

Hepatitis A is spread through person to person contact by the fecal/oral route. The infectious 

agent (virus) is found in the feces (stool) of an infected person. Virus enters another person when 

hands, food or objects contaminated with stool are placed in the mouth. The virus can survive 

on food and objects for a long time. 

* How is Hepatitis A Treated 

There is no specific therapy/treatment, other than supportive, for uncomplicated Hepatitis A 

infection. Rest, fluids and small nutritious meals. Avoid alcohol consumption. 

* How Can the Spread of Hepatitis A be Prevented/Limited in a Child Care Center 


illness. Latex, disposable gloves should be worn for each diaper change. Stress thorough 

hand washing after every diaper change, after using the toilet and preparing/handling/eating 

food. Review, reinstruct and supervise children and staff in proper handwashing techniques. 

The Lake County Health Department must be notified immediately so appropriate 

preventive immune globulin can be administered, if indicated, to staff and children. If 

administered within the first 2 weeks after exposure, spread of infection can be prevented or

limited. In Lake County, Hepatitis A is often diagnosed in children who have visited family 

in another country during summer. 

- Educate parents, staff and children about the infection, how it is spread, preventive measures 

and the need to practice good personal hygiene habits especially hand washing A vaccine for 

protection against Hepatitis A is available, but not administered to children under 2 years of 

age. It is not part of the Illinois routine childhood vaccination. Environmental cleaning is 

important because the virus which causes Hepatitis A may survive on objects for several 

weeks. Because infants, toddlers and young children require diapering and toileting 

assistance, explore the environment with their mouth and are careless about secretions, the 

risk in a child care center of spread and of an outbreak of Hepatitis A is great. It depends on 

the number of enrolled children less than 2 yrs. old and who are not toilet trained. If 

Hepatitis A infection occurs in a child care center, immune globulin may be recommended 

for children and staff, especially if diapered children attend the center. 

* Exclusion 

Exclude child from school during the two weeks of illness following onset of symptoms, or for 

one week after onset of jaundice. Cases who are food handlers or who work in sensitive 

occupations are prohibited from performing their job duties the two weeks of illness following 

the onset of symptoms, or one week after onset of jaundice.

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Hepatitis A 

What is hepatitis 

Hepatitis is an inflammation of the liver caused by certain viruses and other factors, 

such as alcohol abuse, some medications and trauma. Its various forms affect 

millions of Americans. Although many cases of hepatitis are not a serious threat to 

health, infection with certain hepatitis viruses can become chronic (long-lasting) and 

can sometimes lead to liver failure and death. 

How many kinds of viral hepatitis are there 

There are four major types of hepatitis, all caused by different viruses: hepatitis A, 

hepatitis B, hepatitis C and delta hepatitis. This “HealthBeat” focuses on hepatitis A. 

What is hepatitis A and how is it transmitted 

Hepatitis A, formerly known as infectious hepatitis, is caused by the hepatitis A 

virus. The virus enters through the mouth, multiplies in the body and is passed in the 

stool. It can be carried on the hands of an infected person who does not wash his or 

her hands thoroughly after using the toilet. The infection can be spread by direct 

contact with the hepatitis A virus or when another person consumes food or drink 

handled by an infected person who does not practice good hygiene, such as 

handwashing. In some cases, it can be spread to persons who ingest sewagecontaminated 

water. 

What are the symptoms of hepatitis A 

The symptoms of hepatitis A include fatigue, poor appetite, fever and vomiting. 

Urine may become darker. Jaundice may then appear. Symptoms can appear from 15 

to 50 days after exposure, but usually within 28 to 30 days of being exposed to the 

virus. 

The disease is rarely fatal, and most people recover in a few weeks without any 

complications. Infants and young children tend to have very mild or no symptoms 

and are less likely to develop jaundice than are older children and adults. Not 

everyone infected with the virus will have all of the symptoms. There are no longterm 

effects. Once an individual recovers from hepatitis A, he or she is immune for 

life and does not continue to carry the virus.

hepatitis a 


Page 2 of 3 

3/31/2005 

How contagious is hepatitis A 

Casual contacts — fellow classmates or work associates, for example — are 

generally not at risk. Because close personal contact in classrooms or offices is 

unlikely and because older children and adults typically practice good hygiene, the 

likelihood that hepatitis A will be transmitted in these settings is reduced. However, 

hepatitis A can be transmitted in child day-care settings, especially if good hygiene is 

not practiced after changing diapers. It also is due to the close personal contact 

among children, who are still learning to practice proper hygiene. 

The contagious period begins about two weeks before symptoms appear and 

continues up to one week after the onset of jaundice (a yellowing of the skin and 

whites of the eyes). Because of the delay in symptoms, a person can transmit the 

virus without realizing it. 

In Illinois, the incidence of hepatitis A has declined since 1990, when 1,726 cases 

were recorded, to 821 cases in 1998. 

How can hepatitis A be prevented 

The single most effective way to prevent the spread of the hepatitis A virus is careful 

handwashing after using the toilet. Also, infected people should not handle foods 

during the contagious period (about two weeks before symptoms appear and up to 

one week after onset of jaundice). 

Household members, day-care contacts or others in close personal contact with an 

infected person should call a doctor or their local health department to obtain a shot 

of immune globulin, which reduces the chances of becoming ill. In normal working 

and classroom situations (except day-care centers), contacts do not need to receive 

immune globulin. 

What is the proper handwashing technique 

Wet hands with soap and warm water. Rub hands for 10 to 20 seconds, making sure 

you clean under fingernails. Rinse under warm water. Dry hands on a paper towel or 

your own clean towel. In washrooms where paper towels are available, use a paper 

towel to turn off the water faucet and throw the towel away. 

How is hepatitis A treated 

No special medicines or antibiotics are used to treat a person once symptoms appear. 

Generally, bed rest is all that is needed. 

Is there a vaccine to prevent hepatitis A 

In 1995, a hepatitis A vaccine was licensed for use in the United States. This vaccine 

is recommended for persons who plan to travel to countries where hepatitis A occurs 

frequently, those who have blood clotting disorders or chronic liver disease, men 

who have sex with men and illegal drug users. Current guidelines call for a two-shot 

series with an interval between the doses of between six and 18 months, depending

hepatitis a 


Page 3 of 3 

3/31/2005 

on the brand of vaccine used and the age of the person receiving the vaccine. Please 

check with your physician. 

After receiving the full series of vaccinations, a person should develop long-term 

immunity. Research suggests immunity could last as long as 20 years. 




Phone 217-782-4977 

Fax 217-782-3987 

TTY 800-547-0466 


NOTIFICATION OF HEPATITIS “A” 

(A viral infection that affects the liver) 

Dear Parents: 

A child in our school has been diagnosed as having Hepatitis “A”. The last day this child was 

infectious was _______________________. 

Hepatitis “A” is passed from person to person, especially in young children who may not have 

perfect hygiene. Symptoms of Hepatitis may include abdominal pain, fatigue, diarrhea, loss of 

appetite, vomiting, whitish-colored stools, tea-colored urine, or jaundice (yellowing of the skin or 

the whites of the eyes). Children may often be infected and have either no symptoms or very mild 

ones. 

A fact sheet on Hepatitis “A” is enclosed with this letter. If your child or any family member 

shows any of the symptoms of Hepatitis “A” in the next 2 months, contact your doctor and the 

school as soon as possible. One of the best ways to prevent infection with Hepatitis “A” is 

through proper hand washing. When washing hands, use soap, rubbing hands together for 20 

seconds and rinse in running water. Hands should be washed after going to the bathroom, after 

helping others go to the bathroom and before preparing food. 


Notificación de Hepatitis A 

(Un virus que afecta el hígado). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de Hepatitis A. El 

ultimo día que este niño era contagioso fue ___________________________________. 

El virus de Hepatitis A es transmitido de persona-a-persona, especialmente en los niños 

que no tienen buena higiene. Los niño pueden estar infectados y a veces no demostrar 

síntomas ó tener síntomas leves. La enfermedad afecta a los adultos severamente. Los 

síntomas de Hepatitis A pueden incluir cansancio, falta de apetito, fiebre, nausea, 

oscurecimiento de la orina y aveces ictericia (el amarillento color de la piel y de la parte 

blanca de los ojos). 

Un tema de salud sobre Hepatitis A esta incluido con esta carta. Si su niño ó cualquier 

miembro de la familia muestra algún de síntomas en los próximos 2 meses por favor 

llame a su medico y a la escuela lo mas pronto posible. La manera mas eficaz de prevenir 

la enfermedad es el buen lavado de manos. Cuando se lavan las manos es muy importante 

usar jabón, usando mucha fricción por 20 segundos y enjuague las manos bajo agua 

corriente. Las manos deben ser lavadas antes de comer, después de usar el baño y antes 

de prepara comidas. 

Si su medico tiene cualquier pregunta, puede llamar el programa de Enfermedades 

Comunicables de el Departamento de Salud del Condado de Lake al (847) 360-6423. 



AND 


HEPATITIS B 

(Serum Hepatitis) 



* What Is Hepatitis B 

Hepatitis B is a viral infection of the liver caused by the Hepatitis B Virus (HBV). 


45 -160 days, average 60 - 90 days. There are many factors that could make the incubation 

period shorter or longer. 


Infectious for many weeks before onset of symptoms and through course of illness (could be up 

to 6 months). Some persons become chronic carriers and are infectious for life. 

* What Are The Symptoms of Hepatitis B 

Symptoms of Hepatitis B are nausea, vomiting, fatigue, and loss of appetite, abdominal and joint 

pain, dark urine, light stools and jaundice. Fever may be absent or mild. Half of all acute cases 

do not have symptoms. 

* How Is Hepatitis B Spread 

Hepatitis B virus is found in the blood and body fluids (semen, saliva and vaginal fluids) of 

persons with Hepatitis B. Contact with even small amounts of infected blood can cause 

infection. Sharing needles, having sex with an infected person, and getting infected blood into 

an infected person’s cuts/abrasions can all transmit the disease. Infected mothers also give the 

illness to their newborn infants through blood exposure at birth. 

* How Is Hepatitis B Treated: 

Antiviral treatment for 1 year which is frequently unsuccessful and not used with children. 

Vaccinate all children and staff with the 3 dose series which is 90-95% effective. 

* How Can the Spread of Hepatitis B Be Prevented/Limited In Child Care Center 

- Reduce the risk of disease transmission through consistent use of standard precautions 

(glove use, hand washing) whenever there’s the chance of contact with blood or body 

fluids. 

- Discourage sharing of possible blood-contaminated objects: toothbrushes, razors, towels, 

etc. 

- Clean and disinfect blood and body fluid spills. Any surface/object contaminated with

lood and/or body fluids must be cleaned,(soap/detergent and water), rinsed, then 

disinfected. (See Cleaning and Disinfecting Procedures.) 

- Disposable latex or vinyl gloves must be worn when cleaning/disinfecting 

surfaces/objects contaminated with blood or body fluids (especially saliva). Hepatitis B 

is a very hardy virus and can survive up to 1 month in dried secretions on surfaces. 


- Educate parents and staff about the illness, how it is spread, preventive measures, and the 

need to practice good personal hygiene habits, especially handwashing. 

* Hepatitis B Vaccine 

- Hepatitis B is vaccine – preventable. Since July 1997, all children entering a child care 

center are required to provide documentation of 3 doses of Hepatitis B vaccine. 

* Exclusion 

Risk of hepatitis B transmission in child care is very small.


AND 


HERPES SIMPLEX VIRUS – TYPE I 

Oral Herpes (Cold Sores/Fever Blisters) 

* What is Oral Herpes 

Oral Herpes (Herpes Simplex Virus - type 1) is a viral infection that is commonly acquired for 

the first time in early childhood. In some susceptible people, the virus can reactivate 

periodically causing cold sores. 


2 to 14 days. 


One week to several weeks. 

* What are the Symptoms of Oral Herpes/Cold Sores Infection 

Cold sores (blisters) may appear on the face, in the mouth, and lips. These fluid-filled, painful 

lesions will crust and heal within a few days. Children may have no symptoms. There may also 

be a fever and a runny nose. 

* How is Oral Herpes Spread 

Oral Herpes (cold sores) is spread through direct contact with infected saliva or with fluid from 

lesions. 

* How is Oral Herpes Treated 

The child's physician should be contacted 

* How Can the Spread of Oral Herpes be Prevented/Limited in a Child Care Center 

- Educate parents, staff and children about the infection, how it is spread, preventive 

measures and the need to practice good personal hygiene habits especially handwashing. 

Prevent children from sharing bottles, glasses, pacifiers, water fountain, etc. Frequent, 

thorough hand washing (see Hand washing procedure) by infected child/person and 

caregivers is important. Clean and disinfect toys used by an infected child before 

returning toys for common use. Inform parents of other enrolled children who may have 

been exposed of the illness. 

* Exclusion 

Children diagnosed with Herpes Simplex Type I infection with blisters in the mouth and who do 

not have control of mouth secretions, who are biters, or who mouths toys other children may put 

in their mouths should be excluded from child care until blisters are gone.


AND 


HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION/AIDS 


* What Is HIV Infection/AIDS 

Human Immunodeficiency Virus infection leads to failure of the human immune system that 

leaves the body with decreased ability to fight infections and cancers. There can be a long 

period without symptoms. This is followed by a shorter time when the infected person develops 

infections/symptoms and progresses to acquired immunodeficiency syndrome or AIDS. 


Variable; infection of children to development of antibodies is 12-18 months up to 5 years or 

longer. 


Presumed to begin early after onset of HIV infection and extend probably throughout life. 

* What Are The Symptoms of HIV Infection 

Early symptoms in children- 

Failure to grow or to gain weight, chronic diarrhea without a specific cause, liver and spleen 

enlargement, lymph gland swelling, chronic yeast infections (mouth and skin), pneumonia and 

other bacterial, viral, fungal and parasitic infections that healthy children do not pick up. 

Early symptoms in Adults- 

No symptoms or may become ill with a fever, night sweats, sore throat, general tiredness, 

swollen lymph glands and a skin rash lasting a few days to a few weeks. These early symptoms 

then go away but the virus remains in the body. This causes increasing loss of immune functions 

that results in the body becoming unable to fight off infections to which we are all normally 

exposed. 

* How Is Human Immunodeficiency Virus/AIDS Spread 

Only blood, semen, vaginal fluids and breast milk have been found to transmit the virus. 

Children acquire the virus from their infected mothers during pregnancy or at the time of birth 

though the risk of this has been greatly decreased with use of antiviral medications. Adult 

infection usually comes from sexual contact or by sharing needles with an infected person. May 

also be transmitted through organ transplantation or transfusion of infected blood or blood 

components. The risk of HIV transmission in the child care center is extremely low. 

* How Is Human Immunodeficiency Virus/AIDS Treated 

Many antiviral medications are used to treat HIV.

* How Can The Spread of Human Immunodeficiency Virus/AIDS Be 

Prevented/Limited in Child Care Center 

- There have been no reported cases of HIV infection transmission in a child care center. 

No exclusion is necessary. 

- Consistent use of standard precautions. 

- Careful hand washing.


AND 


IMPETIGO 

* What Is Impetigo: 

Impetigo is a skin infection caused by either staphylococcus or streptococcus bacteria. It is 

contagious (catching). Impetigo is common in young children. 


Varies from7-10 days 


As long as the blisters continue to drain or until the infected child has been treated with an 

antibiotic for at least a full 24 hours and is fever free. 

* What are the Symptoms of Impetigo 

Impetigo looks like a small grape-like path of tiny blisters. The blisters break and the skin 

become red and moist. A yellow or brown crust forms over the broken blisters. The blisters 

may be very itchy and are usually found on the face around the nose and mouth, but it can spread 

to other parts of the body. An individual can develop impetigo from his or her own nasal 

discharge. Encourage your child not to scratch or rub the blisters because this can lead to a 

secondary infection. 

* How is Impetigo Spread 

The bacteria that cause impetigo are spread person-to-person through contact with the fluid 

from the draining blister or by contact with a person who has the bacteria in nasal discharges, but 

has no symptoms. 

* How is Impetigo Treated 

This disease is usually treated with an antibiotic cream/ointment applied to the blisters. The 

doctor may order an oral antibiotic. 

* How Can the Spread of Impetigo be Prevented/Limited in Child Care Center 

- Children with possible Impetigo infections are to be removed from the center. Parents 

are advised to take the child to a physician for diagnosis and treatment. 

- Clean and disinfect any item that may have been in contact with the infected child (cot 

sheet, toys, etc.). 

- Remind all children and staff to wash their hands frequently and thoroughly and never to 

pick or touch any sore. 


- Sometimes the blisters/sores may need to be covered to prevent spread to other parts of

the child's body or to others if the child touches or picks at the blisters/sores. Keep 

children's fingernails short. 

- At home, don't allow others to use infected child's towel, wash cloth. Wash all towels, 

bedding, and clothes that touch the infected areas with detergent and bleach (if possible). 

- Notify parents of other enrolled children who may have been exposed of the infection. 

Educate parents, staff and children about the infection, how it is spread, and prevention 

measures including good personal hygiene practices. 

- Gloves must be worn when applying antibiotic ointment to affected areas. Wash hands 

after removing gloves. 

* Contact the Doctor Again If: 

- The Impetigo is not cleared up after one week of treatment or other symptoms occur. 

Exclusion 

Until the child has been treated with antibiotics for at least 24 hours and is fever free.

NOTIFICATION OF IMPETIGO 

(A bacterial skin infection) 

Dear Parents: 

A case of impetigo has been diagnosed in your child’s classroom. 


Varies, from 7 – 10 days. 


As long as the blisters continue to drain or until the infected child has been treated with 

an antibiotic for at least a full 24 hours and is fever free. 


Impetigo looks like a small, grape-like patch of tiny blisters. The blisters break and the 

skin becomes red and moist. A yellow or brown crust forms over the broken blisters. He 

blisters may be very itchy and are usually found on the face around the nose and mouth, 

but it can spread to other parts of the body. Encourage your child not to scratch or rub 

the blisters because this can lead to a secondary infection. 

Treatment: 

This disease is usually treated with an antibiotic cream/ointment applied to the blisters. 

Your child may receive an oral antibiotic. 


The bacteria that cause impetigo are spread person-to-person through contact with the 

fluid from the draining blister or by contact with a person who has the bacteria in nasal 

discharges, but has not symptoms. 


An infected child should be excluded from school for 24 – 48 hours after beginning 

antibiotic treatment. Teach the importance of proper handwashing. Wash hands using 

soap, rubbing together for at least 20 seconds and rinsing under running water. Clean and 

sanitize any item that may have been in contact with the child, such as toys, sheets, etc. 

Cover all blisters (sores) to prevent spread of the disease to other parts of the child’s body 

as well as preventing the spread of disease to other children. 


The most effective method of prevention is to wash hands thoroughly and often. A 

doctor should evaluate any suspected disease as soon as possible. 


Notificación de el Impétigo 

(Una infección causada por bacteria en la piel) 


Un caso de Impétigo ha sido reportado en el salón de su hijo (a). 


síntomas) Puede ser de 7 a 10 días. 


Los niños son considerados contagiosos mientras las ronchas broten liquido. Hasta que 

el niño este tomando un antibiótico por 24 horas y no tenga calentura. 

Síntomas: El Impétigo aparece como racimo de uvas. Las lesiones brotan y la piel se 

pone roja y irritada. Una costra de color amarillenta ó de color café se forma sobre las 

lesiones. Las lesiones puede aparecer alrededor de la cara, nariz ó boca y otras partes del 

cuerpo. Usualmente causan mucha picazón. No deje que su hijo se rasque por que puede 

causar una infección secundaria. 

Tratamiento: Esta enfermedad es usualmente tratada con cremas antibióticas aplicadas 

directamente a las lesiones. Su hijo(a) puede tomar antibióticos orales. 

Propagación: La enfermedad es transmitida de persona-a-persona por el contacto de las 

lesiones que contiene fluidos. También por secreciones nasales de una persona que tenga 

la bacteria, pero que no tiene síntomas. 

Control de la Enfermedad: Cualquier niño infectado debe ser excluido de la escuela de 

24 a 48 horas. Después de haber comenzado tratamiento con antibióticos por mas de 1 

día puede regresar. El primer paso es educar a su hijo (a) sobre la importancia de el buen 

lavado de manos . Cuando se lavan las manos es muy importante usar jabón, usando 

mucha fricción por 20 segundos y enjuague las manos bajo agua corriente. Lave y 

desinfecte cualquier articulo del niño tales como juguetes, etc. Cubra todos las lesiones 

para evitar que se rieguen a otras partes de cuerpo, y a otras personas. 

Prevención: El método mas efectivo es el buen lavado de manos. Un doctor debe evaluar 

a sus hijo (a) si usted sospecha que tiene la enfermedad. 



AND 


INFLUENZA 

* What is Influenza 

Respiratory disease caused by a virus. 


Usually 1-3 days. 


From the day before signs or symptoms occur and for up to 7 days after onset of symptoms in 

children. 

* What are the Symptoms of Influenza 

Rapid onset of fever, chills, headache, muscle aches, sore throat and dry cough. Some children 

have very mild symptoms. 

* How is Influenza Spread 

By direct contact with droplets of respiratory secretions from nose or cough (influenza virus 

persists for hours in dried mucus), or through airborne spread in crowded, enclosed spaces. 

* How is Influenza Treated 

For children who have no health problems, only flu symptoms are treated. Encourage rest and 

fluids. There are antiviral medications that may be used. 

* How Can the Spread of Influenza be Prevented/Limited in a Child Care Center 

- CDC now recommends influenza vaccine for children 6 – 23 months of age, their 

families and other caregivers. 

- Good hand washing of child, parents and staff is important. Cover cough with tissue or 

sleeve. Dispose carefully of tissues. 

. 

* Exclusion 

Exclude child from day care or school until clinical recovery, i.e., absence of fever and child is 

able to participate in activities of child care program.


AND 


MEASLES 



* What is Measles 

A highly contagious viral rash disease. 


About 10 days, but 10 days for fever, 14 days for rash, range of 8 – 18 days. 


Highly communicable from 1 – 2 days before the beginning of initial symptoms to 4 days after 

the appearance of the rash. 

* What are the Symptoms of Measles 

Begins with abrupt, high fever, cough, red eyes, eye sensitivity to light, and runny nose. After 3 

to 4 days, the red, blotchy rash, which usually begins on the face and then covers entire body; 

rash lasts 4 to 7 days. Deep red, raised pimples begin at hairline then spread down neck, trunk, 

abdomen, then out to arms, legs, hands and feet and become merged. 

* How is Measles Spread 

Measles is one of the most highly contagious infectious diseases and is primarily spread from 

person-to-person by droplets or direct contact with throat and nasal secretions of infected 

persons or by indirect contact with articles soiled by infected patient’s nasal and throat 

secretions. 

* How is Measles Treated 

- Vitamin A supplements and bed rest and fluids. 

* How Can the Spread of Measles be Prevented/Limited in a Child Care Center 

- All children need to be immunized according the schedule with MMR (Measles, Mumps, 

Rubella), vaccine after one year of age in order to be in out of home child care. In Illinois, 

all school children must have 2 doses. 

- A child with fever must be removed from the center. Children with suspected measles must 

remain home first 5 days of rash. 

- Inform parents of other enrolled children and staff who have been exposed to this illness. 

Educate parents, staff and children about the illness, how it is spread, prevention methods 

and the need to practice good personal hygiene. Exclude anyone who has not had vaccine

for 2 weeks after last rash onset. Vaccinate those un-immunized children within 72 hours 

of exposure. 

- Frequent, thorough hand washing by children and staff, frequent cleaning and disinfecting 

of shared items, (toys, water fountain, equipment, table tops, etc.) and practicing good 

health habits (rest, play, exercise, proper nutrition, etc.) will help keep children healthy 

and limit spread of disease. 

* Exclusion 

Child must be isolated and excluded from school until four days after the appearance of the rash. 

DCFS child care licensing regulations say “until 4 days after disappearance of the rash.”


AND 


MENINGITIS 

(BACTERIAL) 



* What is Bacterial Meningitis 

Meningitis is an inflammation of the covering membrane of the brain and spinal cord caused by 

a bacteria. There are many causes and types of meningitis. 


Varies from 1-10 days, commonly 3-6 days. 


The infected person is contagious until the bacteria are no longer present in the secretions from 

the nose and mouth. The bacteria will usually disappear within 24 hours of starting treatment 

with an appropriate medicine to which the bacteria is sensitive. It is not that easily spread except 

to very close household contacts. 

* What Are the Symptoms of Bacterial Meningitis 

Sudden onset of high fever, headache, stiff neck (except in infants), nausea, often vomiting, a 

purplish-red rash in some cases, confusion or difficulty awakening from sleep are common, 

especially in children. In infants, poor feeding, extreme listlessness, irritability and sometimes 

vomiting may be the only symptoms present. 

* How is Bacterial Meningitis Spread 

By direct and immediate contact with nose and throat secretions of a person carrying the 

bacteria, e.g., kissing on the mouth, drinking from a shared glass or straw, sharing eating 

utensils, coughing or sneezing directly into the face of another person, etc. 

* How is Bacterial Meningitis Treated 

Bacterial meningitis can be treated with effective antibiotics. It is important, however, that 

treatment be started as early as possible in the course of the disease. Close personal contacts 

(those who have had contact with the infected person’s oral secretions within 7 days of 

symptoms) may be treated as well. Meningitis can only be diagnosed by having a spinal tap test 

at a hospital or emergency room. 

* How Can Meningitis Be Prevented/Limited in Child Care Center 

- Exclude child with fever until cause identified.

- Children in child care are required to receive the HIB vaccine (protection against the 

Haemophilus influenzae type b organism) according to current schedule for immunizations, 

beginning at 2 months of age to 4 years, or as recommended by the child’s physician. 

- Inform parents of other enrolled children that their child may have been exposed to a serious 

contagious disease. This must be done as soon as possible especially for the classmates and 

teachers of the sick child. Educate parents, staff and children about the disease. 

- Clean and disinfect objects possibly soiled with nose and throat secretions and excretions 

(toys, tables, chairs, doorknobs, eating utensils, etc.) Enforce & monitor frequent, thorough 

handwashing by children and staff. 

* Exclusion 

Bacterial – Exclude child from school until clinical recovery, i.e., absence of fever and able to 

participate in school activities.

________________________________________________________________________ 

NOTIFICATION OF PRESUMPTIVE BACTERIAL MENINGITIS 

(A bacterial infection of the tissue that surrounds the brain and spinal cord) 

Dear Parents: 

A person in your child’s school has been diagnosed with presumptive bacterial meningitis. This 

disease can be severe and result in brain damage, hearing loss, or learning disabilities. Some 

types of bacteria can be treated with antibiotics and this can help prevent these types from 

spreading and infecting others. This disease is not as contagious as the common cold or the flu 

and is not spread by casual contact or by simply breathing the air where a person with meningitis 

has been. 

Incubation period:(the time between exposure to the disease and the appearance of symptoms) 

Varies from 2 – 10 days, commonly 3 – 6 days. 

Contagious period:(when the disease can be transmitted to another person) 

The infected person is contagious until the bacteria are no longer present in the secretions from 

the nose and mouth. The bacteria will usually disappear within 24 hours of starting treatment 

with an appropriate medicine to which the bacteria is sensitive. 


Sudden onset of high fever, intense headache, nausea, vomiting, stiff neck, sensitivity to light, 

confusion, sleepiness, and possibly rash. Your doctor should be notified immediately if these 

symptoms develop. 

Treatment: 

Bacterial meningitis can be treated with a number of effective antibiotics. It is important, 

however, that treatment be started as early as possible in the course of the disease. Close personal 

contacts (those who have had contact with the infected person’s oral secretions within 7 days of 

symptoms) may be treated as well. 

How is this disease spread: 

This disease is usually spread through contact with oral secretions i.e.: by coughing, kissing, 

sharing food or beverages, etc. Someone who has direct contact with a person’s oral secretions 

would be at increased risk of acquiring this disease (such as a boyfriend or girlfriend). 


Antibiotics may be prescribed for close contacts of an infected person. Children are excused 

from school until the bacteria are no longer present in their nose and mouth secretions. They 

should not return to school until they are feeling ready and healthy enough to participate in a full 

day of school activities. 


Teach the importance of proper handwashing and disposal of soiled articles. Vaccines are 

available against several types and strains of meningitis, but not all are vaccine preventable. 


Notificación de Meningitis Bacterial 

(Una infección causada por una bacteria en los tejidos que cubren el celebro y médulaespinal). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de Meningitis Bacterial. 

Esta enfermedad es severa y afecta el celebro causando daño y perdida de audición. Algunos 

tipos de bacteria pueden ser tratados con antibióticos y esto puede prevenir infectar a otras 

personas. Esta enfermedad no es tan contagiosa como un catarro ó el flu y no es transmitida por 

contacto casual ó por simplemente aspirar el mismo aire de una persona infectada. 

Periodo de Incubación: (el tiempo de exposición de la enfermedad y la apariencia de síntomas). 

Varia de 2-10 días, usualmente 3 a 6 días. 


La persona es contagiosa mientras la bacteria este presente en la secreciones de la nariz y la boca 

. La bacteria usualmente desaparece en dentro de 24 horas después de haber comenzado un 

medicamento, cual sea sensitivo a la bacteria. 

Síntomas: Los mas comunes son fiebre (calentura) alta, dolor de cabeza intenso, el cuello duro, 

sensibilidad a la claridad, confusión, nausea y vómitos, posiblemente comezón. Si su niño 

muestra estos síntomas usted debe notificar a su medico inmediatamente. 

Tratamiento: Se usan varios antibióticos efectivos para tratar esta enfermedad. Es muy 

importante, que comience tratamiento lo mas pronto posible. Contactos cercanos (personas que 

hayan besado a la persona infecta durante los 7 día antes de los síntomas) necesitaran recibir 

tratamiento . 

Propagación: La bacteria es transportados por secreciones orales, tales como tocidura, 

besándose, compartiendo comida ó bebidas. Una persona que tiene contacto directo con la 

secreciones de una persona infectada esta en riesgo de adquiere esta enfermedad (novio, mejor 

amiga /o). 

Control de la Enfermedad: Antibióticos pueden ser recetados para los contactos de la persona 

infectada. Los niños serán excluidos de la escuela hasta que la bacteria no este presente en la 

secreciones de la nariz y boca. No deben regresar a la escuela hasta que se sienta en buena salud 

y pueda participar en la actividades escolares. 

Prevención: El método mas preventivo es lavándose las manos y la disposición apropiada de 

artículos tales como pañales. Hay vacunas disponibles para los varios tipos de esta enfermedad, 

pero no todos los tipos de esta enfermedad pueden ser prevenidos con una vacuna. 



AND 


MENINGITIS 

(VIRAL) 



* What is Meningitis 

Meningitis is an inflammation of the covering membrane of the brain and spinal cord caused by 

a virus. There are many causes and types of meningitis. 




Variable, determined by causative agent. 

* What Are the Symptoms of Viral Meningitis 

The more common symptoms are sudden onset of fever, severe headache, stiff neck, sensitivity 

to light, drowsiness or confusion, and nausea and vomiting. If your child exhibits these 

symptoms, your doctor should be notified immediately to determine the cause of the meningitis. 

* How is Viral Meningitis Spread 

A small number of cases are transmitted by insects such as mosquitoes or ticks. usually the 

person has a common intestinal or cold virus which has entered the blood brain barrier. 

* How is Meningitis Treated 

Antibiotics are not used to treat viral illnesses and therefore have no benefit in preventing viral 

meningitis. Most people will recover completely on their own, but doctors often recommend bed 

rest, plenty of fluids and medicine (do not give aspirin products unless specifically told to by 

your doctor) to relieve fever and headache. No treatment is needed for household or close 

contacts. 

* How Can Meningitis Be Prevented/Limited in Child Care Center 

- Educate parents, staff and children about the disease. 

- Teach the importance of proper hand washing and disposal of soiled articles. Teach 

importance of basic hygiene, especially covering the mouth when coughing or sneezing; not 

sharing glasses, straws, eating utensils; disposing of used tissues properly; washing hands 

after handling soiled tissues and after toileting. Prophylactic antibiotics are of no value.

- Clean and disinfect objects possibly soiled with nose and throat secretions and stool (toys, 

tables, chairs, doorknobs, eating utensils, etc.) 

- Closely observe all remaining children and staff for any possible early signs of illness. 

* Exclusion 

Viral – Children should be excused from school until they are no longer symptomatic., i.e., no 

sneezing, coughing or runny nose. They should not return to school until they are feeling ready 

and healthy enough to return to a full day of school activities.

NOTIFICATION OF VIRAL MENINGITIS 

(A viral infection of the tissue that covers the brain and spinal cord) 

Dear Parents: 

A student in your school has been diagnosed with viral meningitis. This disease is relatively common, but 

rarely serious. The viruses responsible are usually the Enteroviruses that cause the common “stomach flu” 

with nausea, vomiting, and diarrhea. 


Usually 3 – 7 days. 


Viral meningitis cannot be transmitted from person to person directly, but the causative virus may infect 

another person resulting in GI or respiratory illness. 


The more common symptoms are sudden onset of fever, severe headache, stiff neck, sensitivity to light, 

drowsiness or confusion, and nausea and vomiting. If your child exhibits these symptoms, your doctor 

should be notified immediately to determine the cause of the meningitis. 

Treatment: 

Antibiotics are not used to treat viral illnesses and therefore have no benefit in preventing viral meningitis. 

Most people will recover completely on their own, but doctors often recommend bed rest, plenty of fluids 

and medicine (do not give aspirin products unless specifically told to by your doctor) to relieve fever and 

headache. No treatment is needed for household or close contacts. 


Viruses are usually spread through direct contact with saliva, sputum or nasal secretions. This can happen 

by shaking hands with an infected person and rubbing your eyes, mouth, or nose. 

It can also be found in the stool of an infected person. Infected mosquitoes or ticks cause a small number 

of cases. 


Because most people who are infected with enteroviruses do not become sick, it can be difficult to prevent 

the spread of the virus. As with most other diseases, it is essential to teach the importance of proper 

handwashing. Children should be excused from school until they are no longer symptomatic, i.e., no 

sneezing, coughing or runny nose. They should not return to school until they are feeling ready and healthy 

enough to return to a full day of school activities. 


The most effective method of prevention is to wash hands thoroughly and often. This should be done 

after toileting, changing diapers, and preparing food or eating. Washing surfaces with a dilute bleach 

solution (made by mixing 1 capful of household bleach with 1 gallon of water) can be a very effective way 

to inactivate the virus. 


Notificación de Meningitis Aséptica 

(Una infección viral en los tejidos que cubren el celebro y médula espinal ). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de meningitis Aséptica. 

Esta enfermedad es común y raramente peligrosa. Los virus responsables por causar esta 

enfermedad son los que causan el "Flu" con nausea, vómitos y diarrea. 


síntomas). De 3 a 7 días usualmente. 


La enfermedad de meningitis viral no puede ser transmitido de persona-a-persona. Pero el 

virus que causa la enfermedad puede infectar a otras personas causando infección 

respiratorias y problemas gastrointestinales. 

Síntomas: Los mas comunes son fiebre repentina, dolor de cabeza, el cuello duro, 

sensibilidad a la claridad, confusión, nausea y vómitos. Si su niño muestra estos síntomas 

usted debe notificar a su medico inmediatamente. 

Tratamiento: No se usan antibióticos para tratar esta enfermedad. La majoria de la gente se 

recuperan por si mismos, pero los médicos recomiendan mucho descanso y que tomen 

bastante líquidos. No le medicamentos que contengan aspirina amenos que sea indicado por 

su medico para aliviar los dolores de cabeza. Los miembros de la familia no necesitan 

ningún tipo de medicación. 

Propagación: Los virus usualmente son transportados por saliva o secreciones nasales. Esto 

también ocurrir tocando las manos de una persona infectada y pasándose las manos por los 

ojos, boca o nariz. También puede estar en la excreta de una persona infectada. En ciertos 

casos en mosquitos o garrapatas infectadas. 

Control de la Enfermedad: Como la majoria de la gente infectada no muestra síntomas, el 

difícil prevenir la enfermedad. Lo esencial es enseñare a sus niños la importancia del lavado 

de manos. Los niños debe ser excluidos hasta que no tengan síntomas tales como tos y 

mococidas. No deben regresar a la escuela hasta que se sientan bien y estén saludables y 

puedan ir a la escuela todo el día. 

Prevención: El método mas preventivo es lavándose las manos bien y a menudo. Esto debe 

ser hecho después de cambiar pañales, usar el bano y antes de preparar la comida. Lavando 

las superficie con una solución de cloro (un tapa de cloro a un galón de agua) puede ser una 

forma efectiva de inactivar el virus. 


Viral Meningitis


AND 


MOLLUSCUM CONTAGIOSUM 

* What is Molluscum Contagiosum 

Molluscum Contagiosum is a viral disease of the skin. 


Between 2 and 7 weeks, but may be as long as 6 months. 


Unknown, but probably as long as lesions persist. 

* What are the symptoms of Molluscum Contagiosum 

The lesions are smooth, waxy in appearance, usually few in number often with a central core. 

Color may be white, yellow, flesh colored or translucent. Children usually have lesions on the 

face, trunk or extremities. 

* How is Molluscum Contagiosum Spread 

Molluscum Contagiosum virus is usually spread by direct contact and possibly by clothes 

personal articles. 

* How is Molluscum Contagiosum treated 

Removal of the central core of each lesion usually results in recovery from the disease. 

* How Can the Spread of Molluscum Contagiosum be Prevented/Limited In Child Care 

Center 

- Frequent, thorough handwashing by staff and children. 

- Parents are advised to take the child to a physician for diagnosis and treatment. 

- Notify parents of other enrolled children who may have been exposed of the illness. 

Educate parents, staff and children about the infection, how it is spread, preventive 

measures and the need for good personal hygiene habits, especially handwashing. 

* Exclusion 

None.


AND 


MONONUCLEOSIS 

* What is Infectious Mononucleosis 

Infectious Mononucleosis is a viral infection (Epstein-Barr Virus) that is generally mild in 

children. 


30 to 50 days. 


Children may be infectious for up to a year or longer. 

* What are the Symptoms of Infectious Mononucleosis 

Children may have no symptoms or they may have fever, sore throat and tonsils, tiredness, 

tender swollen lymph nodes in the neck, enlarged abdominal organs such as the liver or spleen, 

and/or jaundice (yellowing of the skin or the whites of the eyes). 

* How is Infectious Mononucleosis Spread 

This disease is spread from person-to-person in saliva from the mouth or throat of an infected 

person. Children may be infected by sharing eating or drinking utensils or by kissing an infected 

person. 

* How is Infectious Mononucleosis Treated 

There is no specific treatment. Physician's recommendations should be followed. 

* How Can the Spread of Infectious Mononucleosis be Prevented/Limited in Child Care 

Center 

- Inform parents of other enrolled children who may have been exposed, of the illness. 

Educate parents, staff and children about the disease, and importance of hand washing. 

- Teach the importance of basic hygiene measures such as covering the mouth when 

coughing or sneezing and frequent, proper hand washing before any activity that brings 

hands in contact with the mouth., e.g., eating, drinking, smoking, etc. Emphasize the 

importance of proper disposal of used tissues and prompt hand washing after handling 

articles soiled with respiratory secretions; discourage the sharing of glasses, straws, water 

bottles, eating utensils, etc. Due to risk of rupture of the spleen, contact sports should be 

avoided until permission is given by the physician. 

* Exclusion 

Children should be excluded from school when feeling ill and if unable to tolerate general school 

activities.

NOTIFICATION OF MONONUCLEOSIS 

(A mildly contagious viral infection) 

Dear Parents: 

A case of mononucleosis has been reported in your child’s classroom. 

Incubation period: ( the time between exposure to the disease and the appearance of symptoms) 

From 30 – 50 days. 


Children may be infectious for up to a year or longer. 


Children may have no symptoms or they may have fever, inflamed throat and tonsils, 

tiredness, tender swollen lymph nodes in the neck, enlarged abdominal organs such as the 

liver or spleen, and/or jaundice (yellowing of the skin or the whites of the eyes). 

Treatment: 

There is no specific treatment. This is a viral infection and, therefore, antibiotics will not 

help. You should consult your doctor if you suspect your child may have this disease. 


This disease is spread from person-to-person in saliva from the mouth or throat of an 

infected person. Children may be infected by sharing eating or drinking utensils or by 

kissing an infected person. 


Children should be excluded from school when feeling ill and if unable to tolerate general 

school activities. 


Teach the importance of proper hand washing. Maintain good health habits, ie: good 

nutrition, exercise, and plenty of rest. Discourage children from sharing eating/drinking 

utensils. 


Notificación de Mononucleosis 

(Una leve infección causada por un virus contagioso). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de Mononucleosis. 


síntomas). De 30 - 50 días. 


Los niños puede ser infecciosos por un año ó mas. 

Síntomas: Los niños a veces no tienen síntomas y si le dan síntomas los mas comunes 

son fiebre, dolor de garganta y amígdala, hinchazón del hígado y a veces ictericia (el 

amarillento color de la piel y de la parte blanca de los ojos). 

Tratamiento: No hay tratamiento especifico. Esta enfermedad es causada por un virus y 

los antibióticos no trabajan. Debe llamar a su medico si usted sospecha que su niño tiene 

esta enfermedad. 

Propagación: Esta enfermedad se transmite de persona-a-persona por la boca ó garganta 

de una persona infectada. Los niños puede ser infectados si comparten utensilios de 

comer y tomar, ó por besar a una persona infectada. 

Control de la Enfermedad: Los niños deben ser excluidos de la escuela hasta que se 

sientan bien y puedan participar todo el día en actividades escolares. 

Prevención: Educación sobre la importancia de el lavado de mano. Mantenga hábitos 

saludables tales como, nutrición, ejerció y bastante descanso. También aconseje a sus 

niños en no compartir utensilios de tomar y comer. 



AND 


MUMPS 



* What is Mumps 

Mumps is a viral disease that usually causes swelling of the glands that make saliva, though not 

all swelling of these glands is caused by mumps. 

Incubation Period: (Time from exposure to infection to beginning of symptoms.) 

From 12 - 26 days, commonly 16 - 18 days. 


From 1 – 2 days before onset to symptoms to 5 days after developing swelling but occasionally 

is from 7 days before to 9 days after swelling develops. 

* What are the Symptoms of Mumps 

Fever, pain and swelling of one or more salivary glands causing jaw tenderness. 

* How is Mumps Spread 

Person-to-person spread by droplet, airborne or direct contact with patient’s throat or nasal 

secretions. 

* How is Mumps Treated 

* How Can the Spread of Mumps be Prevented/Limited in a Child Care Center 

- Required by all child care is the measles, mumps and rubella immunization. 

- Practice careful hand washing by staff, children and families. Disinfection of shared toys 

and tables. 

- Exclude child from school. 


- Inform other parents of mumps illness and educate them about this disease. 

. 

* Exclusion 

Child must be isolated and excluded from school until 9 days after the onset of swelling.


AND 


PERTUSSIS 

(Whooping Cough) 



* What is Pertussis 

Pertussis causes inflammation and narrowing of airways. It is a bacteria. 


Commonly 7 – 10 days, almost uniformly within 6 days and not exceeding 21 days. 


Highly communicable from the beginning of respiratory symptoms to 2 weeks after onset of 

coughing spasms in patients not treated with antibiotics. When treated with appropriate 

antibiotics, the communicable period is reduced to 5 days or less after the onset of treatment. 

* What are the Symptoms of Pertussis 

Initial upper respiratory symptoms feature an irritating cough that develops into a violent, 

spasmodic cough within 1 to 2 weeks. The patient may develop the characteristic “whoop” 

during the coughing spasms. The symptoms, if left untreated, may last 1 to 2 months. 

* How is Pertussis Spread 

Person-to-person spread by droplet or direct contact with airborne respiratory secretions or by 

indirect contact with articles soiled by infected patient’s nose and throat discharges. 

* How is Pertussis Treated 

After diagnosis by physician, treatment with appropriate antibiotic, often erythromycin. 

* How Can the Spread of Pertussis be Prevented/Limited in a Child Care Center 

- Pertussis immunization according to current schedule is required for child care admission. 

- Careful hand washing, cover of cough. 

- Disinfection of tables and articles used by ill child. 

* Exclusion 

Inform other parents and staff of illness. Educate them concerning illness. Child must be 

isolated and excluded from school until at least 5 days after the start of antibiotic therapy.

Dale Galassie, MA, MS 

Executive Director 

Pertussis Fact Sheet 

Starting 2004 reported cases of pertussis (or whooping cough) have increased in Lake County 

along with several other counties in the state and southeast Wisconsin. 

What is Pertussis (Whooping Cough) 

Pertussis is a highly contagious bacterial infection that causes coughing and gagging with 

little or no fever. An infected person has cough episodes that may end in vomiting or cause 

a “whoop” sound when the person breathes in. Adults usually have 2 to 3 coughing spells 

per day children often have 10 or more coughing spells per day. 

Potential complications: 

‣ Pertussis is most dangerous to infants less than 1 year old who may develop 

pneumonia, convulsions, and rarely, brain damage or death. 

‣ Serious complications are less likely in older children and adults. 

What does it look like 

‣ Symptoms appear between 5 to 21 days (average 7-10) after exposure to an 

infected person. 

‣ Pertussis usually starts with cold symptoms (runny nose, sneezing, mild occasional 

non productive cough) for several days followed by episodes of severe coughing 

lasting at least 7 days and can last 1-2 months. 

‣ Paroxysms (coughing fits) may be followed by high pitch whooping noise as the 

person struggles to inhale air, more common in small children. 

‣ Vomiting or gagging may occur after severe coughing spells, 

‣ Cough is worse at night and often sleep is disturbed. 

‣ The person will look and feel healthy between coughing episodes. 

‣ Immunized school children, adolescents and adults have milder symptoms than 

young children. 

‣ Cough medications do not help. 

How is it spread 

‣ Pertussis is spread through droplets from the mouth and nose when an infected 

person coughs, sneezes or talks. 

‣ They are most contagious during the early “cold” stage. 

‣ Older children, adolescents, adults and parent who may be harboring the disease in 

their nose or throat can spread the infection to infants and young children in the 

household or by babysitting. 

‣ Many cases occur in adults and older children because protection from the vaccine 

lasts only 5 to 10 years after the last dose.

‣ Persons treated with antibiotics are contagious until the first 5 days of appropriate 

antibiotic treatment have been completed otherwise they may be contagious up to 

21 days since the cough began. 

What to do 

‣ See a physician if you have any of the following 

o A cough lasting more than 7 days 

o Prolonged coughing spells, which may leave you short of breath 

o A cough that gets worse at night and may interfere with sleep 

o Coughing fit ending in gagging or vomiting 

o Develop a cough of any duration after being in close contact with a 

Pertussis case within the past 3 weeks. 

‣ Persons with suspected pertussis should stay home and avoid contact with others 

until 5 days of antibiotic treatment have been completed at which time they are no 

longer contagious. 

‣ Drink plenty of fluids to avoid dehydration (loss of fluids). 

Prevention: 

‣ While there is no lifelong protection against pertussis, immunization is the best 

preventive measure. Pertussis vaccine is given in combination with diphtheria and 

tetanus (DTaP) in five doses given at 2, 4, 6 months of age, 15-18 months of age 

and 4-6 years of age. 

‣ If you live or have close contact with someone who has pertussis, you should 

contact your health care provider who will prescribe an antibiotic to prevent 

pertussis. 

‣ If the exposure was more then 21 days antibiotics are not needed. 

‣ Monitor for cough illness for up to 21 day following an exposure. 

‣ When coughing cover your mouth or cough into your elbow. 

‣ Wash hands frequently. 

Who Else Needs Treatment (Close contacts of the person 

with Pertussis) 

‣ ALL HOUSEHOLD MEMBERS 

‣ Caregivers/babysitters 

‣ Co-workers who work together in close proximity in a confined space 

‣ Babysitting jobs 

‣ Close friends including boyfriend/girlfriend 

‣ Bus/ car pool seat-mates 

‣ Regular after-school care/ play groups 

For additional information you may contact Lake County Health Department 

Communicable Disease Program at (847) 377-8130 or visit the following educational web 

sites. 

www.whoopingcough.net/symptoms.htm 

www.cdc.gov/nip/disease/pertussis/default.htm 

www.immunize.org/pertussis/index.htm. 

www.pertussis.com

Notification of Pertussis 

(Whooping Cough) 

Dear Parent: 

A suspected case of Pertussis has been reported in your child's classroom and/ or school. 

Incubation period: (time from exposure to infection to beginning of symptoms of illness). 

Incubation period is 6 to 21 days, commonly 7 to 10 days. 

Contagious period: (Period person can give infection to another). 

The person is contagious just before onset of cough until 3 weeks of coughing unless 

treated with the appropriate antibiotic. 


Begins with upper respiratory symptoms, like a common cold with an increasingly 

irritating cough. In one to two weeks the cough develops a characteristic "whoop" in 

young children and occurs in spasms sometimes followed by vomiting. Symptoms may 

last up to one to two months and reoccur up to 6 months. 

Treatment: 

Pertussis is usually treated with antibiotics. People in close contact with children or 

adults with pertussis usually need to be treated with antibiotics. 


The method of transmission is person-to-person, spread by droplet or direct contact with 

airborne respiratory secretions or by indirect contact with articles soiled by the infected 

persons' nose and throat discharges. 


Cases must be excluded from school until at least 5 days after starting appropriate 

antibiotic therapy. Please keep your child at home and consult medical care if they 

display any symptoms. Your doctor can diagnose the disease in a few days by 

ordering a PCR test on a nasal-pharyngeal swab 


Pertussis immunity from the vaccine wanes starting 2-3 years after the last dose is given 

by (Kindergarten). If your child's immunity is compromised by an illness, consult your 

doctor immediately. 

All people over 10 years old are susceptible to the disease. In adults it presents as a bad 

cough at night lasting more than 1 week, which "over the counter" medication does not 

seem to help. 


Notificación de Tos ferina 

(Una tos convulsiva) 

Estimados Padres, 

Un niño en el salón de clases y en la escuela de su hijo/(a) ha sido diagnosticado con la 

enfermedad de tos ferina. 


síntomas) El periodo de incubación es de 6 a 21 días comúnmente de 7 a 10 días. 


La persona es contagiosa antes de que comience la tos y hasta por tres semanas con tos a 

menos que reciba tratamiento. 

Síntomas: Problemas respiratorios, que comienzan como un catarro con una tos 

constante, que de una a dos semanas es acompañada por espasmo que a veces son 

acompañados con vómitos. Estos síntomas pueden durar de uno a dos meses, y ocurrir de 

nuevo por 6 meses. 

Tratamiento: La tos ferina es usualmente tratada con antibióticos. Las personas que 

viven en el mismo hogar y los mejores amigos también necesitan ser tratadas con 

antibióticos. 

Propagación: El método de transmisión es de persona a persona con contacto de 

descargas de gotitas respiratorias en el aire o tocando secreciones de nariz, garganta, piel 

y ojos y artículos contaminados por descargos de nariz y garganta. 

Control de la enfermedad: Las personas infectadas deben de ser excluidas de la escuela 

por 5 días después de haber tomado los antibióticos. Por favor mantenga a su hijo/(a) en 

su casa si demuestran síntomas de esta enfermedad y llame a su medico privado. Su 

medico puede diagnosticar la enfermedad en par de días si ordena que su hijo/(a) reciba 

un examen de PCR. 

Medidas Preventivas: La inmunidad de la vacuna de tos ferina empieza a desminuir 

después de 2-3 anos de haber recibido los refuerzos para la entrada a Kindergarten. Si su 

hijo/(a) tiene problemas con su sistema inmune, llame a su medico inmediatamente. 

Todas las personas sobre 10 anos de edad son susceptibles a esta enfermedad, en los 

adultos esta enfermedad aparece como una tos fuerte de noche que dura mas de una 

semana, y no se alivia con medicamentos para la tos. 



AND 


PINWORMS 

(ENTEROBIASIS) 

* What are Pinworms 

Pinworms disease is a common intestinal infection, especially in children, caused by a tiny 

parasite which lives in the human large intestine. 


One to 2 months or longer from the time of ingesting pinworm egg until an adult worm migrate 

to anal area. 


As long as eggs are being discharged on perianal area. Eggs may remain infective for up to two 

weeks outside of the body. 

* What are the symptoms of Pinworm infection 

There may be anal itching which can be severe. Other symptoms include irritability, 

nervousness, restlessness and difficulty sleeping during the night. These symptoms are due to 

the female pinworm crawling out of the anus at night to lay eggs. The child may also have a 

secondary infection from scratching the skin. 

* How are Pinworms Spread 

Pinworms are spread by direct transfer of infective eggs by hand from the anus (rectum) to the 

mouth of the same or another person or indirectly through clothing, bedding, food or other 

articles contaminated with parasite eggs. By not washing hands properly, an infected person can 

spread the worms to food or other items after scratching the anal (rectal) area or handling 

contaminated pajamas, underwear or bedding. Eggs can also be spread through the air if bedding 

or clothing are shaken. 

* How is a Pinworm Infection Treated 

There is medication to treat pinworm infection which a physician prescribes. Usually the whole 

family receives treatment. Further infection can be prevented by careful hand washing after 

using the toilet and before eating and by washing all bedding and clothing in hot water. 

* How Can the Spread of Pinworms Infection be Prevented/Limited in a Child Care 

Center 

- Inform only parents of other enrolled children who may have been exposed of the illness. 

- Educate parents, staff, and children about the infection stressing proper, careful 

handwashing after using the toilet and before eating or preparing food.

- Infected individuals shower and change underwear and clothes daily. Night clothes and 

bed linens should be washed with soap and hot water each morning. 

- Teach the importance of proper hand washing after using the toilet and before eating or 

preparing foods. Do not share common food bowls with other people, i.e., popcorn, chips, 

etc. Discourage nail biting and keep nails trimmed and short. 

* Exclusion 

A child with a possible pinworm infection should be excused from school until treatment is 

started. An infected child may attend school while undergoing treatment

NOTIFICATION OF PINWORMS 

(An intestinal infection caused by a parasite) 

Dear Parents: 

A case of pinworms(enterobiasis) has been diagnosed in your child’s classroom. This is a 

common intestinal infection caused by a tiny worm, which lives in the human large intestine. 

Incubation period:(the time between exposure to the disease and the appearance of symptoms) 

One to 2 months or longer. 

Contagious period:(when the disease can be transmitted to another person) 

The infected child can pass the parasites as long as eggs are being discharged on the area around 

the anus. Eggs may remain infective for up to two weeks outside of the body. 


There may be anal itching which can be severe. Other symptoms include irritability, 

nervousness, restlessness and difficulty sleeping during the night. These symptoms are due to the 

female pinworm crawling out of the anus at night to lay eggs. The child may also have a 

secondary infection from scratching the skin. 

Treatment: 

One dose of oral Vermox, which may be repeated in 14 days. The entire household is usually 

treated. 


Direct transfer of eggs from the stool of one infected person to another spreads pinworms when 

contaminated hands, food or objects are placed in the mouth. The eggs can also be transferred 

from one person to another indirectly through clothing, bedding or other articles contaminated 

with parasite eggs. Shaking out bedding and clothing may spread eggs. 


A child with a possible pinworm infection should be excused from school until treatment is 

started. An infected child may attend school while undergoing treatment. Infected individuals 

should shower and change underwear and clothes daily. Night clothes and bed linens should be 

washed with soap and hot water each morning. 


Teach the importance of proper handwashing after using the toilet and before eating or 

preparing foods. Do not share common food bowls with other people, i.e: popcorn, chips, etc. 

Discourage nail biting and keep nails trimmed and short. 


Notificación de Lombriz Intestinal 

(Una infección intestinal causada por un parásito). 


Un caso de lombriz intestinal ha sido reportado en el salón de su hijo (a). Esta es una 

infección intestinal común, la cual es causada por un pequeño gusano, el cual vive en el 

intestino grande. 

Periodo de Incubación: (el tiempo entre exposición a la enfermedad y la apariencia de 

síntomas). Puede ser de 4 a 8 semanas. 

Periodo contagioso : (cuando la enfermedad puede ser trasmitida a otras personas). 

El niño infectado puede trasmitir los parásitos mientras los huevos sean descargados por 

la área alrededor del ano. Los huevos se mantiene vivos fuera del cuerpo hasta por 2 

semanas. 

Síntomas: Puede causar comezón severo en el ano. Otros síntomas incluyen irritabilidad, 

nerviosidad, inquietud y dificultada durante la noche. Estos síntomas son causados por la 

lombriz femenina saliendo del ano de noche para depositar sus huevos. El niño puede 

recibir una infección secundaria por estar rascando su piel. 

Tratamiento: El tratamiento consiste de una pastilla oral de Vermox, la cual puede ser 

repetida en 14 días. Usualmente los otros miembros de la familia son tratados a la misma 

vez. 

Propagación: Contacto directo con los huevos en la excreta de una persona infectada a 

otra persona causa que las lombriz se propaguen. Los huevos de la lombriz también 

pueden ser trasmitidos por ropa de cama y otros artículos contaminados. Sacudiendo la 

ropa de cama causa que los huevos se rieguen. 

Control de la enfermedad: Los niños infectados deben ser excluidos de la escuela hasta 

que comienzan tratamiento. Cuando el niño comienza tratamiento puede regresar a la 

escuela. Las personas infectadas deben ducharse y cambiarse de ropa diariamente. La 

ropa usada para dormir de noche y la ropa de cama debe ser lavada diariamente con agua 

caliente y jabón. 


manos. Qué no compartan envases que contengan comidas tales como papitas, palomitas, 

etc. Enseñe a sus niños a no morderse las uñas. 



AND 


RASH ILLNESS 

* What is Rash Illness 

See attached chart of childhood Rash Illnesses. 


Variable; dependent on the causative agent. 

Period of Communicability: 

Variable, determined by causative agent. 

* What are the Symptoms of Rash Illness 

Variable signs may be present. To begin identifying possible causes of the rash, it is important 

to acquire a detailed description of the rash (e.g., color; raised or level with skin; clear or 

pustular vesicles or pockets; smooth or sandpaper texture; spotted, diffuse, lace-like or slapped 

cheek appearance; blanched on touch; initial location and spread on body; discomfort due to 

itching, pain, etc.) 

Accompanying symptoms – such as fever, headache, swollen glands – may be present. Runny 

nose or eyes, cough, sore throat, strawberry tongue, malaise, anorexia, nausea, vomiting, and 

joint pain also help to further define possible causes/ 

* How is Rash Illness Spread 

Variable, depended on the causative agent. 

* How is Rash Illness Treated 

Variable, depended on the causative agent. 

* How Can the Spread of Rash Illness be Prevented/Limited in a Child Care Center 

- Ensure child has received all required immunizations. 

- Careful hand washing and disinfection of tables, shared toys. 

* Exclusion 

Exclude child until seen by a medical provider and given diagnosis.


AND 


RESPIRATORY SYNCYTIAL VIRUS 

(R.S.V.) 

* What is Respiratory Syncytial Virus Infection 

A viral infection that is the most frequent cause of lower respiratory disease (bronchitis and 

pneumonia) in infants and children. It can also affect older children and the elderly. 


2 to 8 days. 4 to 6 days is most common. 


Shortly prior to and for duration of active disease. A young child with RSV may be infectious for 

3 days to 4 weeks after symptoms subside. 

* What are the Symptoms of Respiratory Syncytial Virus Infection 

Fever and one or more other symptoms, such as chills, headache, body aches, malaise and loss of 

appetite, either alone or in combination with runny nose, sore throat, swollen glands, bronchitis 

or pneumonia, are usually present. Infants sometimes have gastrointestinal disturbances. Signs 

and symptoms usually subside in two to five days without complications; however, some 

infections may be complicated by sinus infection, ear infection, or less commonly, by bacterial 

pneumonia. 

* How is Respiratory Syncytial Virus Infection Spread 

RSV is spread through direct contact with respiratory secretions such as breathing them in after 

an infected person coughs or sneezes; indirectly by hands, soiled tissues and handkerchiefs, 

eating and drinking utensils, and other articles and environmental surfaces contaminated by 

respiratory discharges from an infected person. 

* How is Respiratory Syncytial Virus Infection Treated 

Symptomatic and supportive therapy. Antiviral drugs have been used for hospitalized infants. 

* How Can the Spread of Respiratory Syncytial Virus Infection Be Prevented/Limited in 

a Child Care Center 

- Inform parents of other enrolled children who may have been exposed of the illness. Educate 

parents, staff and children about the infection, how it is spread, preventive measures and the 

need to practice good personal hygiene habits, especially hand washing. Because the virus 

may persist on environmental surfaces for at least several hours and for 1/2 hour or more on 

the hands, cleaning and disinfection of environmental surfaces (toys, tables, chairs, 

highchairs, strollers, etc.) must be done frequently and thoroughly. 

- Thorough, frequent hand washing is the single best way to reduce the spread of R.S.V. 

especially after wiping a nose, coughing or sneezing. Cover the mouth when

- coughing/sneezing. Wash hands immediately. Dispose of soiled tissues properly, in a 

washable, plastic-lined, covered container. Wash hands immediately. 

* Exclusion 

Until fever is gone and child is well enough to actively and comfortably participate in center 

activities.


AND 


RINGWORM 

Ringworm of the Scalp (Tinea Capitis) 

and Body (Tinea Corporis) 

* What is Ringworm of the Scalp 

Ringworm of the scalp is an infection caused by a fungus. Ringworm of the scalp is common in 

children. 


Unknown. 


As long as infected lesions are present. Fungus can persist on contaminated items or materials 

for long periods. 

* What does Ringworm of the Scalp Look Like 

Ringworm of the scalp can have round or irregularly shaped, raised areas that can be red or dry 

and flaky. There may be hair loss at the sight of the rash and there may be black spots; caused 

by hairs that have been broken off. Ringworm of the body may start as small red spots. As they 

grow larger, the center begins to clear, creating the appearance of a ring. This “ring” may have 

raised borders that are red and scaly. The rash may itch or burn. 

* How is Ringworm of the Scalp Spread 

By direct skin or scalp contact or indirect contact with items or materials contaminated with 

fungus from skin, scalp or hairs e.g. theater seats, barber clippers, combs, brushes, hats, and 

clothing. The same fungi that infects humans can also infect animals such as dogs and cats and 

infections can be acquired from pets and farm animals. However, animals account for less than 

10 percent of cases; some animals, especially cats, may be unapparent carriers. 

* How is Ringworm of the Scalp Treated 

Ringworm of the scalp or body is usually treated by antifungal medications (oral and 

creams/ointments) prescribed by a physician. The physician may order other treatments. 

* How Can Spread of Ringworm of the Scalp be Prevented/Limited in Child Care 

Center 

- Notify parents of other enrolled children who may have been exposed, of the infection. 

Educate parents, staff and children how the infection is spread, preventive measures and 

need for good personal hygiene habits. Inspect household contacts and pets. 

- Remove headwear (hats, scarves, wigs, etc.) from play/dress up area. Clean and disinfect. 

Children should not share hats, combs, towel or personal items.

- Cover skin lesions. 

- Teach importance of not sharing towels, clothing, combs, brushes, hair accessories, hats and 

coats; store clothing items and coats so that these items are separate from one another; teach 

proper hand washing procedures. Pets with skin rashes should be evaluated by a 

veterinarian. 

* Exclusion 

Exclude child from school until after treatment begins.

NOTIFICATION OF RINGWORM (TINEA) 

(A fungal infection of the skin, scalp and fingernails) 

Dear Parents: 

A case of ringworm has been diagnosed in your child’s classroom. This is a fungal infection and 

is not caused by a “worm” or parasite. 


Unknown. 


This infection can be transmitted as long as the fungus remains on the skin lesion. When the 

lesion starts to shrink, the child is no longer infectious. 


Ringworm of the scalp can have round or irregular shaped, raised areas that can be red or dry and 

flaky. There may be hair loss at the sight of the rash and there may be black spots caused by hairs 

that have been broken off. 

Ringworm of the skin may start as small, round red spots. As they grow larger, the center begins 

to clear, creating the appearance of a “ring”. This “ring” may have raised borders that are red and 

scaly and the rash may itch or burn. 

Treatment: 

If the fungal infection is on the scalp your child may require oral medication. If the skin is the 

site of the infection you may need to use an anti-fungal cream or ointment. If your child has any 

skin rash, you should contact your doctor for an evaluation. 

How this disease is spread:. 

Ringworm is spread by direct contact with a person or animal infected with the fungus. It can 

also be spread by contact with surfaces contaminated with the fungus; like clothing, towels, 

combs, or bed linens. 


All skin lesions must be covered. If it cannot be covered, the child should be excluded from 

school until after treatment has started. Consult your doctor as soon as possible if you suspect 

ringworm, because fungi require a long treatment time. 


Teach proper hand washing and dry skin thoroughly after washing. Children and adults 

should be advised not to share personal items, such as hair care articles, clothes, towels, etc. If 

there are any animals in the household with a rash they should be evaluated by your veterinarian. 


Notificación de Tiña 

(Un hongo que causa infección en la piel, cuero cabelludo y las uñas). 


Un caso de tiña ha sido reportado en el salón de su hijo (a). Esta infección es causada por 

un hongo, no es causada por un gusano. 

Periodo de Incubación: (el tiempo entre exposición a la enfermedad y la apariencia de 

síntomas). Desconosido. 


Esta infección puede ser trasmitida mientras el hongo este en la heridas. Cuando las 

heridas comienzan a disminuir, el niño ya no es contagioso. 

Síntomas: La tiña del cuero cabelludo empieza en la forma de un barro rojo y aveces 

descarozo. Pueden salir puntos negros en la área de la infección causados por la perdida 

de cabello. Tiña en el cuerpo aparece como heridas rojas ó lesiones rosados, llanos ó 

elevados. Según va creciendo las heridas el centro se despeja, creando la apariencia de 

un anillo. Esta heridas puede causar comezón y ardor. 

Tratamiento: Si el hongo esta en el cuero cabelludo puede necesitar un antibiótico oral. 

Si el hongo esta en la piel puede necesitar una crema antibiótica. Si su hijo (a) tiene algún 

tipo de sarpullido en el cuerpo llame a su medico para una evaluación. 

Propagación: Tiña es trasmitido por contacto directo con una persona ó animal 

infectado. También puede ser trasmitido por superficies contaminadas con el hongo tales 

como; ropa, toallas, peines y ropa de cama. 

Control de la enfermedad: La lesiones deben ser cubiertas. Si las lesiones no pueden ser 

cubiertas el niño debe ser excluido de la escuela hasta que comience el tratamiento. 

Consulte con su medico si usted sospecha que su hijo(a) tiene tiña, porque las 

infecciones causadas por hongo requieren un largo tiempo de tratamiento. 


manos y secar bien sus manos después de lavarlas. Los niños y adultos no deben 

compartir artículos personales tales como cepillos, ropa y toallas etc. Si hay algún animal 

en su casa con algún tipo de sarpullido en su cuerpo este bebe ser evaluado por un 

veterinario. 



and 


ROSEOLA 

(EXANTHEM SUBITUM/SIXTH DISEASE) 

* What is Roseola 

Roseola is a viral infection that is usually seen in children under 4 years, most commonly before 

2 years of age. 


Between 9 – 10 days. 


Unknown. 

* What are the Symptoms of Roseola 

Usually starts with a high fever that starts abruptly and lasts 3 – 4 days. The child may be 

irritable, have swelling around the eyes and develop a pink rash that starts on the body and 

spreads to face, arms and legs. Seizures may occur due to high fever. 

* How is Roseola Spread 

The way this disease is spread is unknown. 

* How is Roseola Treated 

Specific treatment for Roseola will be determined by your child’s physician based on your 

child’s age, overall health, medical history, extent of the disease, your child’s tolerance for 

specific medications, procedures or therapies, expectations for the course of the disease, and 

your opinion or preference. Increased fluid intake – acetaminophen for fever (DO NOT GIVE 

ASPIRIN) 

* How Can the Spread of Roseola be Prevented/Limited in Child Care Center 

- Because the period of communicability and transmission methods are not completely known, 

definite preventive measures are difficult to establish. 

- Frequent, complete handwashing; frequent, thorough cleaning and disinfecting of toys, 

tables, other shared items; exclusion of ill children and good health practices, (rest, proper 

nutrition, exercise, play, etc.) will help promote healthy children and decrease illnesses. 

- Inform parents of other enrolled children who may have been exposed of the illness. 

- Educate parents, staff and children about disease, and the need to practice good personal 

hygiene. 

* Exclusion 

Until child has been fever free for at least 24 hours and is able to comfortably and actively 

participate in center activities.

NOTIFICATION OF ROSEOLA 

(A viral infection that is usually seen in children under 4 years, commonly before 2 years of age) 

Dear Parents: 

A case of roseola has been reported in your child’s classroom. This virus causes a fever 

usually followed by a rash. 


symptoms) Usually 9 – 10 days after exposure to the disease. 


This infection is most contagious during the time that the child has a high fever. 


Roseola usually starts with a high fever that starts abruptly and lasts for 3-4 days. The 

child may be irritable, have swelling around the eyes and develop a pink rash that starts 

on the body and spreads to face, arms and legs. This disease is most common in children 

under the age of 3. 

Treatment: 

Do not give aspirin without direct order of physician. May give other medication to 

address fever as recommended by physician. Increase fluids. 


The way this disease is spread is unknown. 

General preventative measures: 

Careful hand washing and keeping child out of school when fever is present. 


Notificación de Roséola 

( Una infección causada por un virus que ocurre usualmente in los niños menores de 4 

anos de edad, pero que es más común en antes de los 2 anos de edad) 


Un caso de roséola ha sido reportado en el salón de su niño(a). Este virus puede causar 

calentura usualmente acompañado por salpullido. 


síntomas) Usualmente de 9 – 10 días después de haber sido expuesto a la enfermedad. 


Esta infección es contagiosa mientras el niño tiene calentura alta. 

Síntomas: Los síntomas comienzan con fiebre alta que comienza de momento y dura de 3 

a 4 días. El niño puede sentirse incomodo, hinchazón alrededor de los ojos y salpullido 

que comienza en el cuerpo y se propaga a la cara, brazos y piernas. Esta enfermedad es 

mas común en los niños menores de 3 años. 

Tratamiento: No se recomienda administrar aspirina a su niño sin antes consultar a su 

medico. Su medico recomendara el tratamiento adecuado para reducir la fiebre. Aumente 

la cantidad de líquidos. 

Propagación: No se ha establecido como esta enfermedad se propaga. 

Prevención: Educación sobre la importancia del lavado de manos es el primer paso. 

Cuando se lavan las manos es muy importante usar jabón, usando mucha fricción por 15 

segundos y enjuague las manos bajo agua corriente. También mantenido los niños fuera 

de la escuela cuando tienen fiebre. 



AND 


ROTAVIRUS ENTERITIS 

* What Is Rotavirus Enteritis 

Rotavirus enteritis is a viral infection in the intestinal tract. 


2 - 4 days. 


The symptoms of this infection last 4-6 days though the virus can be present in the stool for up to 

21 days. 

* What Are The Symptoms of Rotavirus Enteritis 

There is a range of symptoms from mild to severe. The symptoms include fever which usually 

decreases after the first couple of days, nausea and vomiting, abdominal pain, diarrhea which is 

usually watery and frequent, dehydration which is lack of fluids in the system. Symptoms of 

dehydration include sleepiness, irritability, thirst, pale color to skin, eyes appear sunken, soft 

spot in baby’s head feels sunken, decreased or absent tears, decreased urine and fewer wet 

diapers, dry mouth. 

* How Is Rotavirus Enteritis Spread 

It is probably spread person-to-person through oral fecal contact. The virus is taken in the mouth 

from a contaminated object or person. This can happen with poor hand washing or from 

contaminated food or water. The virus can live on toys, doorknobs, and hard surfaces for quite 

some time. 

* How Is Rotavirus Enteritis Treated 

There is no medication that cures rotavirus. It is very important to call your child’s doctor if you 

have any questions or if you notice any signs of dehydration. 

* How Can The Spread of Rotavirus Enteritis Be Prevented/Limited in a Child Care 

Center 

- Inform staff and parents of other enrolled children who may have been exposed to the illness. 

Educate parents, staff and children about the disease, how it is spread, preventive measures 

including frequent, thorough hand washing, cleaning and disinfecting of toys, equipment, 


nutrition, etc.) to keep children healthy and to decrease their chances for acquiring illnesses. 

- Clothe children to cover diapers to decrease transmission of the infection. 

Special care needs to be taken when diapering and/or assisting children with toileting.

Hand washing by staff and children after each diapering and toileting, cleaning and 

disinfecting of changing surfaces and potty chairs after each use and proper disposal of soiled 

diapers and clothes will help prevent the spread of rotavirus. 

- Toys must be cleaned and disinfected when soiled with body secretions as often as necessary 

but at least daily. Studies show that fecal contamination of the environment (toys, bedding, 

surfaces, etc.) is highest in infant/toddler areas. Rotavirus germs survive on environmental 

surfaces for periods ranging from hours to weeks. 

* Exclusion 

Children may be excluded from day care until 24 hours after diarrhea and fever ends and child is 

able to participate in the child care activities.

NOTIFICATION OF ROTAVIRUS 

(A viral infection in the intestinal tract) 

Dear Parents: 

A case of rotavirus has been diagnosed in your child’s classroom. This is a viral disease 

that causes severe diarrhea. 


symptoms) After coming in contact with virus, it may take 2 - 4 days for symptoms to 

develop. 


This symptoms of this infection last 4-6 days though the virus can be present in stool for 

up to 21 days. 


There is a range of symptoms from mild to severe. The symptoms include fever which 

usually decreases after the first couple of days, nausea and vomiting, abdominal pain, 

diarrhea which is usually watery and frequent, dehydration which is lack of fluids in the 

system. Symptoms of dehydration include sleepiness, irritability, thirst, pale color to 

skin, eyes appear sunken, soft spot in baby’s feels sunken, decreased or absent tears, 

decreased urine and fewer wet diapers, dry mouth. 

Treatment: 

There is no medication that cures rotavirus. It is very important to call your child’s 

doctor if you have any questions or if you notice any signs of dehydration. 


It is spread person to person through oral fecal contact. The virus is taken in the mouth 

from a contaminated object or person. This can happen with poor hand washing or from 

contaminated food or water. The virus can live on toys, doorknobs, and hard surfaces for 

quite some time. 


Children may be excluded from day care until 24 hours after diarrhea ends. 


Proper handling and disposal of dirty diapers is important even after the child no longer 

has symptoms. Proper hand washing and hygiene is very important. Cleaning hard 

surfaces, toys and doorknobs is important as well. 


Notificación de Rota virus 

(Una infección en los intestinos causada por un virus) 


Un caso de rota virus ha sido reportado en el salón de su niño(a). Este virus causa diarrea 

severa. 


síntomas) Puede tomar hasta 2 – 4 días para que aparezcan los síntomas después de haber 

esta en contacto con el virus. 


Los síntomas de esta infección duran de 4 a 6 días, pero el virus puede estar presente en 

él excremento hasta 21 días. 

Síntomas: Los síntomas varían de leves a severos incluyendo fiebre que desminue 

después de varios días, nausea, dolor de estomago, diarrea aguada y frecuente, y también 

deshidratación debido a perdida de líquidos en el cuerpo. Los síntomas de deshidratación 

incluyen cansancio, irritabilidad, sed, palidez, ojos sumidos, la mollera hundida en los 

bebes, falta de las lagrimas, poca orina en los pañales orinados, y sequedad en la boca. 

Tratamiento: No hay tratamiento para el rota virus. Pero es muy importante que llame a 

su medico si tiene preguntas o sí usted nota síntomas de deshidratación. 

Propagación: Esta enfermedad se propaga de persona a persona mediante bacteria que 

entra en la boca por medio de excremento. El virus es transmitido en la boca por objetos 

que han sido contaminadas. Esto ocurre cuando las personas no se lavan las manos 

apropiadamente después de usar el baño o por agua o comida contaminad. El virus puede 

sobrevivir en superficies tales como mesas, juguetes y las maniguetas de las puertas por 

mucho tiempo. 


tenga diarrea por 24 horas. 

Prevención: Educación sobre la importancia del lavado de manos es el primer paso. 

Cuando se lavan las manos es muy importante usar jabón, usando mucha fricción por 15 

segundos y enjuague las manos bajo agua corriente. También la disposición apropiada de 

pañales sucio aunque el niño ya no tenga síntomas y la limpieza de superficies tales como 

mesas, juguetes y las maniguetas de las puertas. 



AND 


RUBELLA 

* What is a Rubella 

Usually a mild viral rash illness. 


From 14 – 23 days, usually 16 - 18 days. 


For about 1 week before and 14 days after onset of rash. Is very contagious. 

* What are the Symptoms of Rubella 

Mild disease with low-grade fever, feeling sick, swollen glands, runny nose, pink eye precedes 

the rash, which lasts for 2 to 3 days. 

* How is Rubella Spread 

Person-to-person spread by droplet or direct contact with nasopharyngeal secretions or by 

indirect contact with articles soiled by patient’s nose and throat discharges or urine or feces. 

* How is Rubella Treated 

There is no treatment to cure Rubella. Supportive care of rest and fluids along with any 

medication recommended by physician to relieve symptoms. 

* How Can the Spread of Rubella be Prevented/Limited in a Child Care Center 

- Inform and educate staff, parents about Rubella how it is spread, preventive measures 

including frequent, thorough hand washing, cleaning and disinfection of toys, equipment, 

commonly shared items and the need to practice good health habits (rest, play, exercise, 

good nutrition.) 


When a pregnant woman is exposed to measles, it is very important that she is or had been tested 

for Rubella antibodies. She should discuss this exposure with her physician as soon as possible. 

. 

* Exclusion 

Child should be isolated from school or workplace for 7 days after rash onset. All suspect 

children should undergo both measles and rubella IgM testing to rule out measles and/or rubella. 

Congenitally infected children should be considered infectious for up to 1 year.


AND 


SALMONELLOSIS 



* What Is Salmonellosis 

Salmonellosis is a bacterial infection in the intestinal tract. 


6 - 72 hours, usually 12 - 48 hours. 


Extremely variable, usually several days to several weeks. A temporary carrier state 

occasionally continues for months in infants and immune compromised individuals. 

* What Are the Symptoms of Salmonellosis 

Sudden onset of one or more of these symptoms: headache, abdominal pain, fever, diarrhea, 

nausea, and sometimes vomiting. Children may have no symptoms and still transmit infection. 

* How Is Salmonellosis Spread 

Infectious germs leave the body through the stool of an infected person and enter another person 

when dirty hands, food or objects are placed in the mouth. Salmonella can be found in 

undercooked poultry and eggs, as well as unwashed raw fruit and vegetables. Reptiles, like 

turtles, snakes and iguanas may also carry this bacteria. 

* How Is Salmonellosis Treated 

- A child/children with symptoms that suggest possible Salmonellosis infection must be 

separated from other children until a parent arrives to remove the child from the center. 

- Parents are advised to take their child to a physician for diagnosis and treatment. 

- Fluid replacement when diarrhea or vomiting is present is important. Antibiotics will 

probably not be used unless complications arise. Antibiotics often cause temporary carrier 

state for weeks to months. 

* How Can the Spread of Salmonellosis Be Prevent/Limited in a Child Care Center 

- Inform staff and parents of other enrolled children who may have been exposed, of the illness. 


including frequent, thorough hand washing, cleaning and disinfecting of toys, equipment,


nutrition etc.) to keep children healthy and to decrease their chances for acquiring illnesses. 

- Cook all food derived from animal sources thoroughly, particularly poultry, pork, egg 

products and meat dishes. Do not use dirty or cracked eggs. Use only pasteurized milk, milk 

products and egg products. Refrigerate prepared foods promptly in small containers. 

- Studies show that fecal contamination of the environment (toys, bedding, surfaces etc.) is 

highest in infant/toddler areas. Toys must be cleaned and disinfected when soiled with body 

secretions, especially stool, as often as necessary but at least daily. 

- Limit the serving of snacks and treats prepared in the children’s homes. Dairy products and 

liquid formula must be refrigerated to prevent the growth of bacteria, including salmonella. 

Avoid foods made with raw eggs including homemade ice cream and raw eggs. 

- Teach the importance of proper hand washing after using the bathroom, changing diapers or 

having diaper changed, before eating and after handling pets. Wash, peel or cook all raw 

fruits and vegetables before eating. When washing hands, use soap, rubbing hands together 

for 20 seconds and rinse in running water. 

* Exclusion 

Child should be excluded from school until clinical recovery (absence of fever, vomiting, and 

diarrhea for at least 24 hours).

NOTIFICATION OF SALMONELLOSIS 

(An intestinal disease produced by the Salmonella bacteria) 

Dear Parents: 

A case of Salmonellosis has been reported in your child’s classroom. 


symptoms) 6 to 72 hours, usually 12 – 48 hours. 


During the illness and up to several weeks after. 


Sudden onset of one or more of these symptoms: headache, abdominal pain, fever, 

diarrhea, nausea, and sometimes vomiting. Children may have no symptoms and still 

transmit infection. 

Treatment: 

Fluid replacement when diarrhea or vomiting is present is important. Antibiotics will 

probably not be used unless complications arise. 


Infectious germs leave the body through the stool of an infected person and enter another 

person when unwashed hands, food or objects are placed in the mouth contaminated with 

this germ. Salmonella can be found in undercooked poultry and eggs, as well as 

unwashed raw fruits and vegetables. Turtles, snakes and iguanas may also carry this 

bacteria. 


Child should be excluded from school until clinical recovery (absence of fever, vomiting, 

and diarrhea for at least 24 hours). 


Teach the importance of proper hand washing after using the bathroom, before 

eating and after handling pets. Wash, peel or cook all raw fruits and vegetables before 

eating. When washing hands, use soap, rubbing hands together for 20 seconds and rinse 

in running water. 


Notificación de Salmonela 

(Una enfermedad de la zona intestinal causada por el organismo de Salmonela.) 


Un caso de Salmonela ha sido reportado en el salón de su hijo (a). 


síntomas). De 6 a 72 horas, usualmente 12 – 48 horas. 


Durante la enfermedad y varias semanas después de haber tenido la enfermedad. 

Síntomas: Diarrea leve ó severa, dolor de cabeza, fiebre (calentura), dolores abdominales 

y a veces vómitos. Los niños aveces no muestran síntomas pero pueden trasmitir la 

enfermedad. 

Tratamiento: Es muy importante tomar muchos líquidos cuando la persona tiene diarrea 

y vómitos. Antibióticos pueden ser recetados por su medico solamente si hay 

complicaciones. 

Propagación: Gérmenes infectuosas salen del cuerpo por medio del excremento fecal de 

la persona infectada que no se lava las manos y entran al cuerpo de la otra persona al 

tocar comida ó objectos contaminados con la gérmene. Salmonela pueda encontrarse en 

carnes y huevos no cosinados completamente, asi como en frutas y legumbres no lavadas 

y crudas. Tortugas, culebras y iguanas pueden tambien transportar esta bacteria. 


tenga ningún síntoma clínico. (tales como fiebre (calentura), vómitos y diarrea por 24 

horas). 

Prevención: El primer paso es la educación sobre la importancia de el lavado de manos 

después de usar el baño, antes de comer y después de jugar con animales domésticos. 

Lave, pele ó cocine vegetales ó frutas antes de comer. Cuando se lavan las manos es muy 

importante usar jabón, usando mucha fricción por 20 segundos y enjuagar las manos bajo 

agua corriente. 


Salmonella


AND 


SCABIES 

* What is Scabies 

Human scabies, caused by a mite, is a common, wide-spread, contagious skin disease. 


4-6 weeks before onset of itching after initial exposure. If the child has had the infection before, 

the itching may begin in 1-4 days. 


Scabies can be transmitted until mites and eggs are destroyed by treatment; a second treatment 

application is often recommended one week following the first treatment. 

* What Are The Symptoms of Scabies Infestation 

This mite causes intense itching, particularly at night. There may be a red rash and gray or 

white, thread-like lines, that are caused by the insect burrowing into the skin. The rash is usually 

found in between the fingers, the elbows, at the belt-line, on the abdomen, thighs and buttocks. 

In infants, the rash could be on the head, neck, palms of hands, and soles of feet. 

* How is Scabies Spread 

The mites are usually spread by direct skin-to-skin contact with an infected person. 

* How is Scabies Treated 

- A child with possible scabies infestation is to be removed from the center. Parents are 

advised to take their child to a physician for diagnosis and treatment. 

- Parents must follow exactly the instructions provided by the physician and by the product 

(cream or lotion) to be used for treatment. Household contacts may be treated at the same 

time as the child, to prevent reinfestation. 

- Bedding and clothing worn next to the skin during the 48 hours prior to treatment, should be 

laundered in a washer with hot water and dried in a dryer. Clothing that cannot be laundered 

should be placed in a bag, sealed and stored for a week. The parasites do not live more than 

3-4 days without skin contact. 

* How Can The Spread of Scabies Be Prevented/Limited in Child Care Center 

- Notify parents of other enrolled children who may have been exposed to the infested child of 

the disease. Educate parents, staff and children about the disease, how it is spread, prevention 

methods and the need to practice good personal hygiene habits, especially handwashing.

- Remove dress-up clothing, bedding, stuffed animals. Wash in hot water and dry at hottest 

setting of dryer. If item cannot be laundered, place it in a plastic bag, seal and store for one 

week. 

- Reinforce/reinstruct hand washing procedure for staff and children 

- DO NOT USE TREATMENT PRODUCT MORE OFTEN THAN DIRECTED. The 

medication can be harmful, if overused. 

* Exclusion 

Until morning after first treatment.

NOTIFICATION OF SCABIES 

(A disease of the skin caused by a small insect called a mite) 

Dear Parents: 

A child in your classroom has been diagnosed with scabies. This infestation can cause severe 

itching which can lead to bacterial infections from scratching with dirty hands. 


Four to six weeks before onset of itching after initial exposure. If the child has had the infection 

before, the itching may begin in one to four days. 

Contagious period: ( when the disease can be transmitted to another person) 

The mites can be transmitted to other people until all the mites and the eggs are destroyed by 

treatment. 


This little parasite causes intense itching, particularly at night. You may have a red rash and gray 

or white, thread-like lines, that are caused by the insect burrowing into the skin. The rash is 

usually found in between the fingers, the elbows, at the belt-line, on the abdomen, thighs and 

buttocks. 

Treatment: 

Your doctor will prescribe medication. The medication prescribed will be either a lotion or cream 

to be applied to the body. All members of the family will need to be treated. Follow your 

doctor’s instructions very carefully. You may need to use the medication a second time before 

the mites are all dead. Consult with your doctor if you think the medication did not work the first 

time. 


The mites are usually spread by direct skin-to-skin contact with an infected person. But the mites 

can live for as long as 4 days on bedding and clothing. 


If you suspect scabies, notify your doctor immediately. Bedding and clothing worn next to the 

skin during the 4 days before symptoms should be washed in hot water and dried, using the hot 

cycle. Articles that cannot be laundered, such as stuffed animals, should be removed and stored 

in plastic bags for at least a week to avoid a re-infestation. Children diagnosed with scabies may 

not return to school until morning after the first treatment. 


Encourage your child to wash his hands frequently, to shampoo regularly and to wear clean 

clothes daily. Advise children not to share or exchange clothing items. 



Notificación de Sarna 

(Una enfermedad de la piel, causada por un ácaro de la sarna). 

Un caso de Sarna ha sido reportado en el salón de su hijo (a). Esta enfermedad puede causar 

mucha comezón y una infección secundaria cuando una persona se rasca con las mano sucias. 

Periodo de Incubación: (el tiempo de exposición de la enfermedad y la apariencia de síntomas). 

Puede ser de 4 a 6 semanas después de ser expuestos y antes de que comienze el picazón en un 

niño infectado por la primer vez. Si el niño ha tenido la enfermedad anteriormente, el picazón 

puede comenzar de 1 a 4 días. 

Periodo contagioso : (cuando la enfermedad puede ser trasmitida a otras personas). Mientras 

todos los ácaros de sarna y sus huevos sean destruidos con tratamiento la enfermedad puede ser 

transmitida. 

Síntomas: Una comezón persistente majormente en la noche. Se manifiestan por lo general en 

forma de líneas elevadas de color blanco grisáceo, causadas por el ácaro. Las lesiones que se 

encuentran más comúnmente ocurren entre los dedos, en las muñecas y los codos. Otros sitios 

comunes son la línea de la faja, muslos, áreas genitales y nalgas. Las lesiones cutáneas son 

causadas por una reacción alérgica al ácaro. 

Tratamiento: 

Su medico recetara medicación, la cual puede ser una loción ó crema aplicadas directamente a el 

cuerpo. Todos los miembros de la familia necesitaran tratamiento. Siga la instrucciones de su 

medico cuidadosamente. Tal vez necesitara usar el medicamento mas de una vez para destruir 

todos los ácaros. Llame a su medico si usted cree que el medicamento no fue efectivo la primera 

vez. 

Propagación: La enfermedad es transmitida de persona-a-persona por el contacto con una 

persona infectada. Los ácaros puede vivir hasta por 4 días en la ropa de cama y de vestir. 

Control de la Enfermedad: La ropa interior y otras fuentes potenciales de infestación empleadas 

durante los últimos días, deben lavarse (en agua caliente) y secarse en un secadora de ropas. Los 

artículos personales de un caso infectado pueden ser sellados en una bolsa plástica durante 10 

días. Los ácaros no sobrevivirán lejos del huésped por más de uno ó dos días. Los niños 

diagnosticados con sarna pueden regresar a la escuela e la mañana despues de ponerle el primer 

tratamiento. 

Prevención: Anime a su niño que se lave las manos frecuentemente. Cambie su ropa diariamente 

y se lave el cabello a menudo. No deje que su niño comparta artículos de vestir. 



AND 


SHIGELLOSIS 



* What Is Shigellosis 

Shigellosis is a bacterial infection of the intestinal tract. 


1 - 7 days, usually 2 - 4 days. 


During the illness and up to four weeks after illness. 

* What Are The Symptoms of Shigellosis 

Watery, often bloody, diarrhea. High fever, nausea, vomiting, abdominal cramps. Mild 

infections can occur with watery or loose stools for several days with few, if any other 

symptoms. Children may be infected and show no symptoms. Children under 2 years old often 

have very high fevers and seizures. 

* How Is Shigellosis Spread 

It is spread very easily. Only 1 – 10 germs will make you sick. Infectious germs leave the body 

through the stool of an infected person and enter another person when dirty hands, food or 

objects are placed in the mouth. Children 2 – 4 years old are at highest risk of contracting 

disease. 

* How Is Shigellosis Treated 

- A child/children with symptoms that suggest possible Shigellosis infection must be separated 

from other children until a parent arrives to remove the child from the center. 

- Parents are advised to take their child to a physician for diagnosis by stool culture and 

treatment. 

- Do not take anti-diarrheal agents (likely to make illness worse). Antibiotics may be used after 

a culture is completed by the doctor or health care facility. Fluid replacement when watery 

diarrhea and vomiting are present is important. 

* How Can The Spread of Shigellosis Be Prevented/Limited in a Child Care Center 

- Very careful hand washing.

- Separate any staff or child with diarrhea. Also keep diapered children separate. If attendee or 

staff is diagnosed with Shigella, actively identify anyone else with diarrhea or if having 

symptoms. 

- Inform staff and parents of other enrolled children who may have been exposed of the illness. 


including frequent, thorough handwashing, cleaning and disinfecting of toys, equipment, 


nutrition, etc.) to keep children healthy and to decrease their chances for acquiring illnesses. 

- Special care needs to be taken when diapering and/or assisting children with toileting. Hand 

washing by staff and children after each diapering and toileting, cleaning and disinfecting of 

changing surfaces and potty chairs after each use, and proper disposal of soiled diapers and 

clothes will help prevent the spread of Shigellosis 

- Toilets (seats, flush handles, etc.) must be cleaned and disinfected as necessary but at least 

daily. Studies show that fecal contamination of the environment (toys, bedding, surface, 

etc.) is highest in infant/toddler areas. 

- Toys must be cleaned and disinfected when soiled with body secretions, especially stool, as 

often as necessary but at least daily. 

* Exclusion 

- Until child has been treated with antibiotics for at least 24 hours and stool returns to normal 

form. No diarrhea. Child must be able to comfortably and actively participate in center 

programs. Those children who show Shigella in their stools but who do not have symptoms 

need to be treated but they do not need to be excluded. 

- Staff members ill with Shigellosis must be excluded, examined by a physician and treatment 

followed. Staff member who is diarrhea free may not return to work until the Lake County 

Health Department determines the staff member is free from Shigellosis by means of stool 

examinations, the number of tests is set by the Illinois Department of Public health 

regulations. 

- Household contacts who are food handlers or who work in sensitive occupations shall be 

examined for shigellosis and, if positive, shall be restricted according to current IDPH rules 

and regulations for the control of communicable diseases.

NOTIFICATION OF SHIGELLOSIS 

(An intestinal disease produced by the Shigella organism) 

Dear Parents: 

A case of shigellosis has been reported in your child’s classroom. 


symptoms) One to seven days. 


During the illness and up to four weeks after illness. 


Sudden onset of fever, nausea, diarrhea (sometimes with blood and mucus), cramps, and 

occasionally vomiting. Children can be asymptomatic and still transmit infection. 

Treatment: 

Antibiotics may be used after a culture is completed by the doctor or health care facility. 

Fluid replacement when watery diarrhea and vomiting are present is important. 


Infectious germs leave the body through the stool of an infected person and enter another 

person when dirty hands, food or objects are placed in the mouth. 


Child should be excluded from school until clinical recovery (absence of fever, vomiting 

and diarrhea for at least 24 hours). 


Teach the importance of proper hand washing. When washing hands, use soap, 

rubbing hands together for 20 seconds and rinse in running water. 


Notificación de Shigelosis 

(Una Infección de la zona intestinal causada por el organismo de Shigela.) 


Un caso de Shigelosis ha sido reportado en el salón de su hijo (a). 


síntomas). De uno a siete días. 

Periodo contagioso:(cuando la enfermedad puede ser trasmitida a otras personas) 

Durante la enfermedad y hasta cuatro semanas después de haber tenido la enfermedad. 

Síntomas: Diarrea suave ó severa (con rastros de sangre o moco en la excreta), a menudo 

con fiebre, dolores abdominales y a veces vómitos. Los niños aveces no muestran 

síntomas pero todavía pueden ser contagiosos. 

Tratamiento: Ciertos antibióticos pueden ser recetados por su medico. Es muy 

importante remplazar los líquidos cuando la persona tiene diarrea y vómitos. 

Propagación: Germenes infectados salen del cuerpo en la excreta y son transportadas por 

las manos de la persona infectada luego entran en el cuerpo de otra persona cuando la 

persona infectada propaga los germenes tocando comidas ó objetos sin haberse lavados 

las manos después de usar el baño. 


tenga síntomas clínicos. (tales como fiebre (calentura), vómitos y diarrea por 24 horas). 



por 20 segundos y enjuague las manos bajo agua corriente. 



AND 


SHINGLES (HERPES ZOSTER) 

* What Is Shingles 

Singles is the result of a reactivation of infection with the varicella zoster virus, the virus that 

causes chickenpox. A person is usually infected with this virus early in life. 


Can be within days after experiencing chickenpox, but usually will not occur until years after the 

initial outbreak. 


The infected person may be contagious until blisters are covered with scabs. 

* What Are the Symptoms of Shingles 

The infected person may have pain in the area 48-72 hours before a lesion (or blister-like area) 

appears. The virus will generally show up in a particular spot and not all over the body, like 

chickenpox. The area may continue to be painful until the lesions have healed. Children usually 

do not experience any pain or discomfort. 

* How Is Shingles Spread 

The fluid in shingles lesions contains virus that can be spread to another person through direct 

contact with the fluid when the lesions are not crusted over, or by contact with articles freshly 

soiled with the fluid from shingles lesions. 

* How Is Shingles Treated 

The symptoms of shingles are treated with non-aspirin pain relievers for discomfort. Other 

antiviral medications may be used. Your doctor should be notified so that he can evaluate and 

diagnose the child and rule out other diseases. 

* How Can the Spread of Shingles Be Prevented/Limited in a Child Care Center 

- Inform parents and staff about the illness especially those children/adults who are most 

susceptible to infection, i.e. those who have never had chickenpox disease Educate parents, 

staff and children about the disease, how it is spread, prevention methods and the need for 

good personal hygiene habits. 

- When a pregnant woman or a person with a weak immune system who has not had 

chickenpox is exposed to shingles, she/he should contact a physician for possible treatment. 

- Aspirin should not be given to any child due to risk for a complication known as Reye 

Syndrome, which can be fatal. Wash hands carefully and make sure children do not share 

eating/drinking utensils, clothing or tissues. A vaccine is available for chickenpox and you 

should consult with your doctor for more information. 

* Exclusion 

If the rash cannot be covered.

NOTIFICATION OF SHINGLES 

(A viral infection in the chickenpox family) 

Dear Parents: 

A case of shingles has been reported in your child’s classroom. This disease only occurs in 

people who have had chickenpox and is a reappearance of a previous chickenpox infection. It 

most frequently occurs in people over 60 years old. Shingles in childhood is usually a mild, selflimiting 

illness unless the child is immuno compromised. Exposure to the infected person may 

cause chickenpox, but will not cause another person to have shingles. 

Incubation period: (the time between exposure to the disease and the appearnace of symptoms) 

Can be within days after experiencing chickenpox, but usually will not occur until years after the 

initial outbreak. 


The infected person may be contagious until the blisters are covered with scabs. A child who has 

not had chickenpox may develop it if exposed to someone with shingles. 


The infected person may have pain in the area 48-72 hours before a lesion (or blister-like area) 

appears. The virus will generally show up in a particular spot and not all over the body, like 

chickenpox. The area may continue to be painful until the lesions have healed. Children usually 

do not experience any pain or discomfort. 

Treatment: 

There is usually no treatment for shingles. However, your doctor should be notified so that he 

can evaluate and diagnose the child and rule out other diseases. 


This virus is spread by direct contact with an infected person’s moist lesions. Direct contact with 

articles contaminated with the fluid from the lesions (blisters) or tissues with respiratory 

secretions can spread it. 


Blisters should be covered until dry to reduce the risk of infecting other people. If unable to 

cover blisters, especially on the face, consider keeping child home longer. If child removes 

covering from blisters, consider keeping child home longer. 


Wash hands carefully and make sure children do not share eating/drinking utensils, clothing or 

tissues. A vaccine is available for chickenpox and you should consult with your doctor for more 

information. 


Notificación de Zoster de Herpes (Ripias) 

(Una infección de la familia de varicela causada por un virus). 


Un caso de zoster de herpes (ripias) ha sido reportado en el salón de su hijo (a). Esta enfermedad 

usualmente ocurre en personas que han tenido varicela anteriormente y es un reaparencia de la 

enfermedad. Ocurre frecuentemente en personas de 60 años. La enfermedad es usualmente leve 

en niñez. Mientras el niño no tenga un sistema inmune comprometido. 

Periodo de Incubación: (el tiempo de exposición de la enfermedad y la apariencia de síntomas) 

A veces ocurre días después de haber tenido varicela. Pero es más común que ocurra años 

después de haber tenido la enfermedad. 


La persona infectada puede ser contagiosa hasta que se sequen las lesiones. Un niño que nunca 

ha tenido varicela, si es expuesto a zoster de herpes (ripias) le puede dar varicela. 

Síntomas: La persona infectada puede tener dolor alrededor del área por 48-72 horas antes de que 

la lesión este presente. El virus generalmente sale solamente en un lugar y no sobre todo el cuerpo 

como la varicela. Puede haber dolor en el área hasta que la lesión se haga secado. Usualmente el 

niño no siente dolor o molestia. 

Tratamiento: Usualmente no hay tratamiento para esta enfermedad. Pero, su medico debe ser 

notificado para que su niño sea evaluado y su medico pueda diagnosticar la enfermedad de su 

niño. 

Propagación: Este virus es trasmitido por contacto directo con las lesiones de la persona 

infectada. Tocando artículos contaminados con fluido de las lesiones ó pañuelos desechables 

(kleenex) con secreciones respiratorias. 

Control de la enfermedad: Las ampollas deben de estar cubiertas para reducir el riesgo de 

infectar a otras personas. Si no se pueden cubrir las ampollas, especialmente las de la cara, 

considere dejar a su hijo(a) en casa por mas tiemp. Si su hijo(a) se quita la envoltura de las 

ampollas considere dejar a su hijo(a) en casa por mas tiempo. 

Prevención: Lave sus manos y asegúrese que los niños no compartan utensilios de tomar y 

comer ó ropa. Hay una vacuna disponible para la varicela. Para mas información llame al medico 

de su niño. 



AND 


STREPTOCOCCAL INFECTIONS 

(STREPTOCOCCAL PHARYNGITIS, SCARLET FEVER) 

* What are Streptococcal Infections 

Streptococcal pharyngitis (strep throat) and scarlet fever are infections caused by streptococci 

organisms, usually group A streptococcus. 




If left untreated, your child could be contagious for 10 days to several weeks or months. If 

treated with an antibiotic, your child will no longer be contagious 24 hours after starting to take 

the medication. 

* What are the Symptoms of Streptococcal Pharyngitis (Strep Throat) and Scarlet Fever 

Scarlet fever occurs most commonly in association with a strep throat infection.. Scarlet fever 

producing strains of bacteria cause a fine, red rash that appears one to three days after onset of 

sore throat. Symptoms may include sudden start of fever, headache, sore throat, nausea, 

vomiting and abdominal pain. Tonsils may be swollen, red and painful. If your child has these 

symptoms you should consult your doctor as soon as possible. 

* How are these Streptococcal Infections Spread 

Person-to-person by direct contact with nasal secretions; by ingesting of food contaminated by 

an infected food handler’s nasal secretions or streptococci present on skin; rarely by contact with 

articles handled by an infected person. 

* How are these Streptococcal Infections Treated 

After your doctor determines a positive throat culture, antibiotic treatment is started. It is 

extremely important to take all medication as prescribed until gone. 

* How Can the Spread of Streptococcal Infections Be Prevented/Limited in Child Care 

Center 

- A child with fever must be removed from the center. 

- Inform parents of other enrolled children and staff who may have been exposed, of the 

illness. Educate parents, staff and children about the illness, how it is spread, prevention 

methods and the need to practice good personal hygiene. 

- Frequent, thorough hand washing by children and staff, frequent cleaning and disinfecting of 

shared items, (toys, water fountain, equipment, table tops, etc.) and practicing good health

habits (rest, play, exercise, proper nutrition, etc.) will help keep children healthy and limit 

spread of disease. Children should be advised not to share eating/drinking utensils or food. 

- If not treated, streptococcal infections can lead to scarlet fever, rheumatic fever, skin, 

bloodstream, ear infections and pneumonia. 

- Teach importance of covering mouth when coughing or sneezing. 

* Exclusion 

The infected child should be excluded from school until he/she has been on antibiotics for at 

least 24 hours and is feeling ready and healthy enough to return to a full day of school activities.

NOTIFICATION OF STREP THROAT 

(A bacterial infection from Streptococcal Group A organism) 

Dear Parents: 

A case of strep throat has been reported in your child’s classroom. 


symptoms) Usually 2 – 5 days. 


If left untreated, your child could be contagious for 10 days to several weeks or months. 

If treated with an antibiotic, your child will no longer be contagious 24 hours after 

starting to take the medication. 


Symptoms may include fever, headache, sore throat, nausea, vomiting and abdominal 

pain. Tonsils may be swollen, red and painful. If your child has these symptoms you 

should consult your doctor as soon as possible. 

Treatment: 

After your doctor determines a positive throat culture, antibiotic treatment is started. It is 



Strep throat is usually spread by direct person-to-person contact from nose and throat 

secretions, and rarely by contaminated food. 


The infected child should be excluded from school until he/she has been on antibiotics for 

at least 24 hours and is feeling ready and healthy enough to return to a full day of school 

activities. 


Teach the importance of proper handwashing. When washing hands, use soap, 

rubbing hands together for 20 seconds and rinsing in running water. Children should be 

advised not to share eating/drinking utensils or food. 


Notificación de Estreptococo 

(Una infección bacteria del grupo A de estreptococo ). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de Estreptococo. 




Si su niño no es tratado, puede estar contagios por 10 días hasta varias semanas ó meses. 

Si su niño es tratado con antibiótico, no será contagios 24 horas después de haber 

comenzado el antibiótico. 

Síntomas: Los mas comunes son fiebre repentina, dolor de cabeza, dolor de garganta, 

nausea, vómitos y dolor abdominal. Si su niño muestra estos síntomas usted debe 

notificar a su medico inmediatamente. 

Tratamiento: Después que su medico determine que la cultura es positiva, su niño debe 

comenzar tratamiento. Es importante que su niño se tome todo su medicamento. 

Propagación: El estreptococo usualmente es transportados por contacto directo de 

person-a-persona ó por saliva o secreciones nasales y raramente por comida contaminada. 

Control de la Enfermedad: Los niños puede regresar a la escuela después de haber 

estado tomando un antibiótico por 24 horas y hasta que se sientan bien y estén saludables 

y puedan ir a la escuela todo el día. 



por 20 segundos y enjuague las manos bajo agua corriente. También aconseje a sus niños 

en no compartir utensilios de tomar y comer. 


NOTIFICATION OF SCARLET FEVER 

(A bacterial strep infection with a rash) 

Dear Parents: 

A case of scarlet fever has been reported in your child’s classroom. 




If left untreated, your child could be contagious for 10 days to several weeks or months. If 

treated with an antibiotic, your child will no longer be contagious 24 hours after starting to take 

the medication. 


Symptoms will include the appearance of fine, pink rash that feels like sandpaper, most often 

found on the neck, chest, and underarms, inside elbow, groin and inner surfaces of the thighs. 

Typically the rash will not be found on the face, but there may be flushing of the cheeks. 

Other symptoms may include fever, sore throat, nausea, vomiting and abdominal pain. Tonsils 

may be swollen, red and painful. As the child recovers, he may have peeling of the skin on his 

hands and feet. If your child has these symptoms, you should consult your doctor as soon as 

possible. 

Treatment: 

After evaluation and diagnosis by your doctor, antibiotic treatment will be started. It is 



Scarlet fever is usually spread by direct person-to-person contact from nose and throat secretions, 

and rarely by contaminated food. 


The infected child should be excluded from school until he/she has been on antibiotics for at least 

24 hours and is feeling healthy enough to return to a full day of school and activities. (Your child 

may need more than 24 hours on an antibiotic before returning to school.) 


Teach the importance of proper hand washing. When washing hands, use soap, rubbing hands 

together for 20 seconds and rinsing in running water. Children should be advised not to share 

eating/drinking utensils or food. 


Notificación de Fiebre Escarlatina 

(Una infección bacteria de estreptococo con ronchas). 


Un niño en nuestra escuela ha sido diagnosticado con la enfermedad de fiebre escarlatina. 




Si su niño no es tratado, puede estar contagios por 10 días hasta varias semanas ó meses. 

Si su niño es tratado con antibiótico, no será contagios 24 horas después de haber 

comenzado el antibiótico. 

Síntomas: Los síntomas incluyen comezón con la sensación de una lija comúnmente se 

encuentra en el cuelo, pecho, codos, arcillas y la parte interior de los muslos. Típicamente 

el comezón no se encuentra en la cara, pero los cachetes aparecen de color rosados. 

Otros síntomas son fiebre repentina, dolor de cabeza, dolor de garganta, nausea, vómitos 

y dolor abdominal. Sus amígdalas puede estar hinchadas, rojas y causa dolor. Según el 

niño se recupera, empieza a perder la piel en sus pies y manos. Si su niño muestra estos 

síntomas usted debe notificar a su medico inmediatamente. 

Tratamiento: Después que su medico evalué su niño, el comenzar tratamiento con 

antibióticos. Es importante que su niño se tome todo su medicamento. 

Propagación: El fiebre escarlatina usualmente es transportados por contacto directo de 

person-a-persona ó por secreciones nasales y de la garganta, raramente por comida 

contaminada. 

Control de la Enfermedad: Los niños puede regresar a la escuela después de haber 

estado tomando un antibiótico por 24 horas y hasta que se sientan bien y estén saludables 

y puedan ir a la escuela todo el día ( A veces los niños necesitan mas de 24 horas). 



por 20 segundos y enjuague las manos bajo agua corriente. También aconseje a sus niños 

en no compartir utensilios de tomar y comer. 



AND 

COMMUNITY HEALTH SERVICES 

THRUSH 

(CANDIDIASIS) 

(Diaper Rash) 

* What is Thrush 

Thrush is a yeast infection in the mouth and throat of babies. It may also cause a diaper rash. 


Unknown. 


Rarely contagious. 

* What Are The Symptoms Of Thrush 

Mouth: lesions appear as creamy white, slightly raised-patches that may begin on the tongue or 

inside the cheek. Diaper rash: babies with oral yeast infections may also develop a bright red 

diaper rash caused by the same organism. 

* How Is Thrush Spread 

Babies usually are infected with thrush from contact with this during birth. 

* How Is Thrush Treated 

A physician needs to examine and diagnose the lesions and then prescribe appropriate treatment. 

* How Can The Spread Of Thrush Be Prevented/Limited In Child Care Center 

- Clean and disinfect mouthed toys when soiled but at least daily. 

- Careful hand washing. 

* Exclusion 

None.


AND 


TUBERCULOSIS (TB) 



* What is Tuberculosis 

Tuberculosis (TB) is an infection, often of the lungs, caused by the bacteria Mycobacterium 

tuberculosis. 


The bacteria can be carried in the body for many years remaining dormant without active 

disease. 


Generally infants and young children with active TB are not contagious. Transmission of 

infection can occur in adults until proper antibiotics are given. 

* What are the Symptoms of Tuberculosis 

Chronic cough, lack of appetite, weight loss, fever, growth delay, fatigue, night sweats and 

chills. 

* How is Tuberculosis Spread 

Infection in children is nearly always the result of close contact with an adult who has TB. It is 

spread by tiny airborne droplets that are expelled from the lungs. 

* How is Tuberculosis Treated 

Specific medications for TB prescribed by physician. Treatment regimens can be 9 months or 

longer. 

* How Can the Spread of Tuberculosis be Prevented/Limited in a Child Care Center 

- Mantoux skin testing with PPD is the standard method for identifying infected persons. 


- With rare exception, childhood TB is non-contagious; child may remain in school, even if 

a person at home has active TB. 

- Close contacts to a person with TB (family members) may be placed on a preventative 

medicine. 

- Educate teachers and parents.

- Cooperate with health department or physician in skin testing and/or x-rays of selected 

contacts. 

* Exclusion 

May return when child is approved to return by local health department officials and considered 

noninfectious to others.

CHILDREN FROM DEVELOPING NATIONS 

Ross A. Pennie, MC, FRCPC 

Infectious Risks 

Children from developing nations often come from regions where sanitation is poor and 

diseases are transmitted by food and drink contaminated by pathogenic organism. 

Overcrowding and malnutrition may lead to increased incidence of other diseases, such 

as tuberculosis. 

There are several organisms that a previously infected child can continue to carry and 

excrete for prolonged periods after the acute symptoms have resolved. In a child care 

center or preschool, it is these organisms, excreted for prolonged periods, that pose a risk 

of child-to-child transmission. 

Common Infections 

Pathogenic organisms potentially carried for prolonged periods by children from 

developing nations are: 

Bacteria 

Parasites 

Salmonella 

Protozoa 

Shigella 

Cryptosporidium 

Camphlobacter jejuni 

Giardia lamblia 

Mycobacterium tuberculosis 

Entamoeba histolytica 

Viruses 

Dientamoeba fragilis 

Hepatitis A virus 

Plasmodia (malaria) 

Hepatitis B virus 

Worms 

Hepatitis C virus 

Cytomegalovirus 

HIV 

However, most of the organisms listed above are not transmissible directly from one 

child to another. The reason varies with the organism but may be because to life cycle 

requires an intermediate animal host, the eggs must mature in the soil before they are 

contagious, or the organism must be transferred very directly through sexual activity or 

infected blood or needles. Therefore, common tropical organisms readily transmissible 

in a child care center are: 

Bacteria 

Viruses 

Salmonella 

Cytomegalovirus 

Shigella 

Hepatitis A 

C. jejuni 

Mycobacterium tuberculosis 

Parasites 

Protozoa 

Giardia lamblia 

Entamoeba histolytica 

Worms

Infection Control 

Special Infection Control Needs. The organisms of concern are all transmissible by the 

fecal-oral route (except for cytomegalovirus and M. tuberculosis). Therefore, infection 

control should focus on good personal hygiene, good hand washing, the preparation of 

food by staff who do not care for children in diapers, and the exclusion of children with 

diarrhea. These measure are not special and are recommended for every child care center 

or preschool, regardless of whether it is attended by children from developing nations. 

Children with tuberculosis are not contagious unless they are obviously ill with 

symptoms such as chronic cough and weight loss. A chronically ill child from a 

developing country should therefore be evaluated by a physician before the child enters 

the care center or school. 

Risks to Healthy Children 

Healthy children are at theoretical risk of infection from the short list of enteric pathogens 

listed above. Practically speaking, the organisms most commonly transmitted are 

Salmonella, Shigella, and Giardia lamblia. The risk of infection can be reduced by the 

routine use of good personal hygiene as discussed above. 

Exclusion from Child Care or Preschool Attendance 

Children from developing nations should be excluded from child care or preschool 

attendance when they have an unexplained chronic illness or when they have acute 

diarrhea. A child who repeatedly bites should be excluded until it is certain that he or she 

carries neither hepatitis B virus nor HIV. 

Recommendations for Personnel 

Child care and preschool personnel should understand that there is little likelihood that a 

child from a developing country will pass along a dangerous disease to other children. 

Routines of good personal hygiene and the exclusion of children with diarrhea should be 

established to minimize the transmission of gastrointestinal disease. 

Any child who appears to be chronically unwell should be evaluated by a doctor who has 

been informed that the child may have a disease endemic to the tropics and be 

investigated accordingly. 

Parental Advice 

Parents may find the following information helpful: 

• Children get diarrhea in child care centers and preschools regardless of whether there 

are children there from developing nations 

• Parents should make certain that there is good personal hygiene practiced in the child 

care center or preschool before enrolling their child. 

• Foreign children in the child care or preschool setting are at minimal risk of 

spreading serious disease to other children

Immunization Information

Recommended Childhood and Adolescent Immunization Schedule UNITED STATES •2005 

Age 

Birth 1 

Vaccine 

month 

Hepatitis A 8 HepB #1 

Hepatitis B 1 

Diphtheria, 

Tetanus, Pertussis 2 

Haemophilus 

influenzae type b 3 

Inactivated Poliovirus 

Measles, Mumps, 

Rubella 4 

Varicella 5 

Pneumococcal 6 

Influenza 7 

2 

months 

HepB #2 

4 

months 

6 

months 

DTaP DTaP DTaP 

Hib 

IPV 

Hib 

IPV 

Hib 

PCV PCV PCV 

Vaccines below red line are for selected populations 

12 

months 

HepB #3 

Hib 

IPV 

MMR #1 

PCV 

15 

months 

Varicella 

Influenza (Yearly) 

DTaP 

18 

months 

24 

months 

PCV 

4–6 

years 

DTaP 

IPV 

MMR #2 

11–12 

years 

HepB Series 

Varicella 

PPV 

Td 

Influenza (Yearly) 

Hepatitis A Series 

MMR #2 

13–18 

years 

Td 

This schedule indicates the recommended ages for routine administration of currently 

licensed childhood vaccines, as of December 1, 2004, for children through age 

18 years. Any dose not administered at the recommended age should be administered 

at any subsequent visit when indicated and feasible. 

Indicates age groups that warrant special effort to administer those vaccines 

not previously administered. Additional vaccines may be licensed and recommended 

during the year. Licensed combination vaccines may be used whenever any 

components of the combination are indicated and other components of the vaccine 

Department of Health and Human Services 


are not contraindicated. Providers should consult the manufacturers' package inserts 

for detailed recommendations. Clinically significant adverse events that follow 

immunization should be reported to the Vaccine Adverse Event Reporting System 

(VAERS). Guidance about how to obtain and complete a VAERS form are available at 

www.vaers.org or by telephone, 800-822-7967. 

Range of recommended ages 

Preadolescent assessment 

Only if mother HBsAg(–) 

Catch-up immunization 

The Childhood and Adolescent Immunization Schedule is approved by: 

Advisory Committee on Immunization Practices www.cdc.gov/nip/acip 

American Academy of Pediatrics www.aap.org 

American Academy of Family Physicians www.aafp.org

Footnotes 

Recommended Childhood and Adolescent Immunization Schedule 

UNITED STATES • 2005 

1. Hepatitis B (HepB) vaccine. All infants should receive the first dose of HepB 

vaccine soon after birth and before hospital discharge; the first dose may also be 

administered by age 2 months if the mother is hepatitis B surface antigen (HBsAg) 

negative. Only monovalent HepB may be used for the birth dose. Monovalent or 

combination vaccine containing HepB may be used to complete the series. Four 

doses of vaccine may be administered when a birth dose is given. The second 

dose should be administered at least 4 weeks after the first dose, except for 

combination vaccines which cannot be administered before age 6 weeks. The third 

dose should be given at least 16 weeks after the first dose and at least 8 weeks 

after the second dose. The last dose in the vaccination series (third or fourth dose) 

should not be administered before age 24 weeks. 

Infants born to HBsAg-positive mothers should receive HepB and 0.5 mL of 

hepatitis B immune globulin (HBIG) at separate sites within 12 hours of birth. The 

second dose is recommended at age 1–2 months. The final dose in the 

immunization series should not be administered before age 24 weeks. These 

infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 

9–15 months. 

Infants born to mothers whose HBsAg status is unknown should receive the 

first dose of the HepB series within 12 hours of birth. Maternal blood should be 

drawn as soon as possible to determine the mother's HBsAg status; if the HBsAg 

test is positive, the infant should receive HBIG as soon as possible (no later than 

age 1 week). The second dose is recommended at age 1–2 months. The last dose 

in the immunization series should not be administered before age 24 weeks. 

2. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) 

vaccine. The fourth dose of DTaP may be administered as early as age 

12 months, provided 6 months have elapsed since the third dose and the child is 

unlikely to return at age 15–18 months. The final dose in the series should be given 

at age ≥4 years. Tetanus and diphtheria toxoids (Td) is recommended at 

age 11–12 years if at least 5 years have elapsed since the last dose of tetanus and 

diphtheria toxoid-containing vaccine. Subsequent routine Td boosters are 

recommended every 10 years. 

3. Haemophilus influenzae type b (Hib) conjugate vaccine. Three Hib 

conjugate vaccines are licensed for infant use. If PRP-OMP (PedvaxHIB ® or 

ComVax ® [Merck]) is administered at ages 2 and 4 months, a dose at age 

6 months is not required. DTaP/Hib combination products should not be used for 

primary immunization in infants at ages 2, 4 or 6 months but can be used as 

boosters after any Hib vaccine. The final dose in the series should be administered 

at age ≥12 months. 

4. Measles, mumps, and rubella vaccine (MMR). The second dose of MMR 

is recommended routinely at age 4–6 years but may be administered during any 

visit, provided at least 4 weeks have elapsed since the first dose and both doses 

are administered beginning at or after age 12 months. Those who have not 

previously received the second dose should complete the schedule by age 

11–12 years. 

5. Varicella vaccine. Varicella vaccine is recommended at any visit at or after age 

12 months for susceptible children (i.e., those who lack a reliable history of 

chickenpox). Susceptible persons aged ≥13 years should receive 2 doses 

administered at least 4 weeks apart. 

6. Pneumococcal vaccine. The heptavalent pneumococcal conjugate 

vaccine (PCV) is recommended for all children aged 2–23 months and for 

certain children aged 24–59 months. The final dose in the series should be given at 

age ≥12 months. Pneumococcal polysaccharide vaccine (PPV) is 

recommended in addition to PCV for certain high-risk groups. See MMWR 

2000;49(RR-9):1-35. 

7. Influenza vaccine. Influenza vaccine is recommended annually for children 

aged ≥6 months with certain risk factors (including, but not limited to, asthma, 

cardiac disease, sickle cell disease, human immunodeficiency virus [HIV], and 

diabetes), healthcare workers, and other persons (including household members) in 

close contact with persons in groups at high risk (see MMWR 2004;53[RR-6]:1-40). 

In addition, healthy children aged 6–23 months and close contacts of healthy 

children aged 0–23 months are recommended to receive influenza vaccine because 

children in this age group are at substantially increased risk for influenza-related 

hospitalizations. For healthy persons aged 5–49 years, the intranasally 

administered, live, attenuated influenza vaccine (LAIV) is an acceptable alternative 

to the intramuscular trivalent inactivated influenza vaccine (TIV). See MMWR 

2004;53(RR-6):1-40. Children receiving TIV should be administered a dosage 

appropriate for their age (0.25 mL if aged 6–35 months or 0.5 mL if aged ≥3 years). 

Children aged ≤8 years who are receiving influenza vaccine for the first time 

should receive 2 doses (separated by at least 4 weeks for TIV and at least 6 weeks 

for LAIV). 

8. Hepatitis A vaccine. Hepatitis A vaccine is recommended for children and 

adolescents in selected states and regions and for certain high-risk groups; consult 

your local public health authority. Children and adolescents in these states, regions, 

and high-risk groups who have not been immunized against hepatitis A can begin 

the hepatitis A immunization series during any visit. The 2 doses in the series 

should be administered at least 6 months apart. See MMWR 1999;48(RR-12):1-37.

The tables below give catch-up schedules and minimum intervals between doses for children who have delayed immunizations. 

There is no need to restart a vaccine series regardless of the time that has elapsed between doses. Use the chart appropriate for the child’s age. 

Vaccine 

Recommended Immunization Schedule 

for Children and Adolescents Who Start Late or Who Are More Than 1 Month Behind 

UNITED STATES • 2005 

CATCH-UP SCHEDULE FOR CHILDREN AGED 4 MONTHS THROUGH 6 YEARS 

Minimum 

Minimum Interval Between Doses 

Age for 

Dose 1 Dose 1 to Dose 2 Dose 2 to Dose 3 Dose 3 to Dose 4 Dose 4 to Dose 5 

Diphtheria, 

Tetanus, Pertussis 

Inactivated 

Poliovirus 

Hepatitis B 3 

Measles, Mumps, 

Rubella 

Varicella 

Haemophilus 

influenzae type b 5 

6 wks 

6 wks 

Birth 

12 mo 

12 mo 

6 wks 

4 weeks 4 weeks 6 months 6 months 1 

4 weeks 4 weeks 4 weeks 2 

4 weeks 8 weeks 

(and 16 weeks after first dose) 

4 weeks 4 

4 weeks 

if first dose given at age

Vaccine 

CATCH-UP SCHEDULE FOR CHILDREN AGED 7 YEARS THROUGH 18 YEARS 

Minimum Interval Between Doses 

Dose 1 to Dose 2 Dose 2 to Dose 3 Dose 3 to Booster Dose 

Tetanus, 

Diphtheria 

Inactivated 

Poliovirus 9 

Hepatitis B 

Measles, 

Mumps, Rubella 

Varicella 10 

4 weeks 6 months 



(and 16 weeks after first dose) 

4 weeks 

4 weeks 

6 months 8 

if first dose given at age

Lake County Health Department Community Health 

Immunization Clinics 

NOTE: For directions to clinics, please call the appropriate phone number. For any 

questions on immunizations, please call the Lake County Health Department and 

Immunizations program at (847) 377-8470 or (847) 377-8480 

Memorial United 

Methodist Church 

2935 Sheridan Road 

Zion 

2 nd Saturday 

9:00 a.m.-11:00 a.m. 

(847) 872-6062 

Victory Memorial Hospital 

1324 North Sheridan Road 

Waukegan 

3 rd Tuesday 

4:00 p.m.-6:00 p.m. 

(847) 360-4127 

Lake County Health 

Department 

2303 Dodge Avenue 

Waukegan 

All children, walk-in 

(847) 377-8470 

Monday thru Friday 

1:00pm –3:00pm 


Department 

VFW Post 4551 

75 North Avenue 

Antioch 

3 rd Wednesday 

4:00 p.m.-6:00 p.m. 

(847) 377-8470 


Department 

American Legion Hall 

111 East Main Street 

(Rt. 134) 

Round Lake Park 

2 nd Wednesday 

9:00 a.m.-11:00 a.m. 

(847) 377-8470 

Condell Acute Care 

Center 

2 E. Rollins Road 

Round Lake Beach 

4 th Tuesday 

4:00 p.m.-6:00 p.m. 

(847) 377-8470 

Condell Medical Center 

Allen Conference Center 

801 S. Milwaukee 

Libertyville 

2 nd Tuesday 

4:00 p.m.-6:00 p.m. 

(847) 362-2905 ext. 1444 

Foglia YMCA 

1025 McHenry Road 

Lake Zurich 

1 st Tuesday 

4:00 p.m.-6:00 p.m. 

(800) 323-8622 

(Sponsored by Good 

Shepherd Hospital) 

Varicella (Chicken 

Pox) vaccine is 

available at this 

location only 

Lake Forest Hospital 

Patient Services and 

Health Education Center 

660 N. Westmoreland 

Road 

Lake Forest 

4 th Saturday 

9:00 a.m.-11:00 a.m. 

(847) 234-6112 

Highland Park Hospital 

718 Glenview Avenue 

Highland Park 

4 th Friday 

9:00 a.m.-11:00 a.m. 

(847) 480-2630 

11/04

El Condado del Departamento de Salud 

Clinicas Para Vacunas 

NOTA: Para direcciones a las clinicas, por favor llame al numero apropiado de la clinica. 

Para cualquier pregunta acerca de las vacunas, por favor llame al : 

El Departamento del Condado de Salud (847) 377-8470 

Memorial United 

Methodist Church 

2935 Sheridan Road 

Zion 

Segundo Sabado 

9:00 a.m.-11:00 a.m. 

(847) 872-6062 

Victory Memorial Hospital 

1324 North Sheridan Road 

Waukegan 

Tercer Martes 

4:00 p.m.-6:00 p.m. 

(847) 360-4127 


Department 

2303 Dodge Avenue 

Waukegan 

Lunes a Viernes 

1:00 -3:00 de la tarde 

para ninos hasta 18 

anos 

(847) 377-8470 


Department 

VFW Post 4551 

75 North Avenue 

Antioch 

Tercer Miercoles 

4:00 p.m.-6:00 p.m. 

(847) 377-8470 


Department 

American Legion Hall 

111 East Main Street 

(Rt. 134) 

Round Lake Park 

Segundo Miercoles 

9:00 a.m.-11:00 a.m. 

(847) 377-8470 

Condell Acute Care 

Center 

2 E. Rollins Road 

Round Lake Beach 

Cuarto Martes 

4:00 p.m.-6:00 p.m. 

(847) 377-8470 

Condell Medical Center 

Allen Conference Center 

801 S. Milwaukee 

Libertyville 

Segundo Martes 

4:00 p.m.-6:00 p.m. 

(847) 362-2905 ext. 1444 

Foglia YMCA 

1025 McHenry Road 

Lake Zurich 

Primer Martes 

4:00 p.m.-6:00 p.m. 

(800) 323-8622 

(Patrocinado por Good 

Shepherd Hospital) 

La vacuna de Varicela 

esta disponible 

solamente en este sito 

Lake Forest Hospital 

Patient Services and 

Health Education Center 

660 N. Westmoreland 

Road 

Lake Forest 

Cuarto Sabado 

9:00 a.m.-11:00 a.m. 

(847) 234-6112 

Highland Park Hospital 

718 Glenview Avenue 

Highland Park 

Cuarto Viernes 

9:00 a.m.-11:00 a.m. 

(847) 480-2630 

El Condado del Departamento de Salud, 3010 Grand Avenue, Waukegan, (847) 377-8480 

11/04

THE LAKE COUNTY HEALTH DEPARTMENT IMMUNIZATION CLINICS 2005 

2303 Dodge, Waukegan IL 

847-377-8470 

VARICELLA (CHICKENPOX) VACCINE IS ONLY AVAILABLE AT THE LAKE COUNTY HEALTH DEPARTMENT 

ALL CLINICS ARE WALK-IN (FIRST COME, FIRST SERVED) 

IMMUNIZATION RECORDS ARE REQUIRED AT ALL CLINICS 

IMMUNIZATIONS ARE $8.00 EACH 

WE WILL BE CLOSED ON ALL NATIONAL HOLIDAYS 

YMCA (LAKE ZURICH) CONDELL HOSP. ROUND LAKE (AML) MEMORIAL UMC (ZION) VICTORY HOSP 

1 ST TUE 4-6PM 2 ND TUE 4-6PM. 2 ND WED 9-11AM 2 ND . SAT 9-11AM 3 RD TUES. 4-6PM 

JAN 4, 2005 JAN 11, 2005 JAN 12, 2005 JAN 8, 2005 JAN 18, 2005 

FEB 1, 2005 FEB 8, 2005 FEB 9, 2005 FEB 12, 2005 FEB 15, 2005 

MAR 1, 2005 MAR 8, 2005 MAR 9, 2005 MAR 12, 2005 MAR 15, 2005 

APR 5,02005 APR 12, 2005 APR 13, 2005 APR 9, 2005 APR 19, 2005 

MAY 3, 2005 MAY 10, 2005 MAY 11, 2005 MAY 14, 2005 MAY 17, 2005 

JUN 7, 2005 JUNE 14, 2005 JUNE 8, 2005 JUNE 11, 2005 JUNE 21, 2005 

JULY 5, 2005 JULY 12, 2005 JULY 13, 2005 JULY 9, 2005 JULY 19, 2005 

AUG 2, 2005 AUG 9, 2005 AUG 10, 2005 AUG 13, 2005 AUG 16, 2005 

SEPT 6, 2005 SEPT 13, 2005 SEPT 14, 2005 SEP 10, 2005 SEPT 20, 2005 

OCT 4, 2005 OCT 11, 2005 OCT 12, 2005 OCT 8, 2005 OCT 18, 2005 

NOV 1, 2005 NOV 8, 2005 NOV 9, 2005 NOV 12, 2005 NOV 15, 2005 

DEC 6, 2005 DEC 13, 2005 DEC 14, 2005 DEC 10, 2005 DEC 20, 2005 

.ANTIOCH (VFW) CACC - RL HIGHLAND PARK LAKE FOREST LAKE COUNTY 

3 RD WED. 4-6-PM 4 th TUE 4-6 PM 4 TH FRI 9-11AM 4 TH SAT.9-11 AM HEALTH DEPARARTMENT 

JAN 19, 2005 JAN 25, 2005 JAN 28, 2005 JAN 22, 2005 

FEB 16, 2005 FEB 22, 2005 FEB 25, 2005 FEB 26, 2005 MONDAY - FRIDAY 

MAR 16, 2005 MAR 22, 2005 MAR 25, 2005 MAR 26, 2005 1 – 3 PM 

APR 20, 2005 APR 26, 2005 APR 22, 2005 APR 23, 2005 

MAY 18, 2005 MAY 24, 2005 MAY 27,2005 MAY CANCELLED 

JUNE 15, 2005 JUNE 28, 2005 JUNE 24, 2005 JUNE 25, 2005 

JULY 20, 2005 JULY 26, 2005 JULY 22, 2005 JULY 23, 2005 

AUG 17, 2005 AUG 23, 2005 AUG 26, 2005 AUG 27, 2005 

SEPT 21, 2005 SEPT 27, 2005 SEPT 23, 2005 SEPT 24, 2005 

OCT 19, 2005 0CT 25, 2005 OCT 28, 2005 OCT 22, 2005 

NOV 16, 2005 NOV 22, 2005 NOV CANCELLED NOV CANCELLED 

DEC 21, 2005 DEC 27, 2005 DEC CANCELLED DEC CANCELLED

El Condado del Departamento de Salud 

Clinicas de Vacunas del 2005 

2303 Dodge, Waukegan IL 

847-377-8470 

La Vacuna de la Varicella esta disponible solamente en la clinica de Waukegan 

TODAS LAS CLINICAS SON SIN CITAS (SE ATIENDEN SEGUN LLEGUEN) 

EN TODAS LA CLINICAS SE REQUIRE EL RECORD DE VACUNAS 

CADA VACUNA CUESTA $8.00 

ESTAMOS CERRADOS LOS DIAS DE FIESTA NACIONALES 

YMCA (LAKE ZURICH) CONDELL HOSP. ROUND LAKE (AML) MEMORIAL UMC (ZION) VICTORY HOSP 

1 ST MARTES 4-6PM 2 ND MARTES 4-6PM. 2ND MIERCOLES 9-11AM 2 ND . SABADO 9-11AM 3 RD MARTES. 4-6PM 

ENE4, 2005 ENE 11, 2005 ENE 12, 2005 ENE 8, 2005 ENE 18, 2005 

FEB 1, 2005 FEB 8, 2005 FEB 9, 2005 FEB 12, 2005 FEB 15, 2005 

MAR 1, 2005 MAR 8, 2005 MAR 9, 2005 MAR 12, 2005 MAR 15, 2005 

ABR 5,02005 ABR 12, 2005 ABR 13, 2005 ABR 9, 2005 ABR 19, 2005 

MAY 3, 2005 MAY 10, 2005 MAY 11, 2005 MAY 14, 2005 MAY 17, 2005 

JUN 7, 2005 JUN 14, 2005 JUN 8, 2005 JUN 11, 2005 JUN 21, 2005 

JUL 5, 2005 JUL 12, 2005 JUL 13, 2005 JUL 9, 2005 JUL 19, 2005 

AGO 2, 2005 AGO 9, 2005 AGO 10, 2005 AGO 13, 2005 AGO 16, 2005 

SEPT 6, 2005 SEPT 13, 2005 SEPT 14, 2005 SEPT 10, 2005 SEPT 20, 2005 

OCT 4, 2005 OCT 11, 2005 OCT 12, 2005 OCT 8, 2005 OCT 18, 2005 

NOV 1, 2005 NOV 8, 2005 NOV 9, 2005 NOV 12, 2005 NOV 15, 2005 

DIC 6, 2005 DIC 13, 2005 DIC 14, 2005 DIC 10, 2005 DIC 20, 2005 

.ANTIOCH (VFW) CACC - RL HIGHLAND PARK LAKE FOREST EL CONDADO DEL 

3 RD MIERCOLES. 4-6-PM 4 th MARTES 4-6 PM 4 TH VIERNES 9-11AM 4 TH SABADO.9-11 AM DEPARTAMENTO DE 

ENE 19, 2005 ENE 25, 2005 ENE 28, 2005 ENE 22, 2005 SALUD 

FEB 16, 2005 FEB 22, 2005 FEB 25, 2005 FEB 26, 2005 (EN WAUKEGAN) 

MAR 16, 2005 MAR 22, 2005 MAR 25, 2005 MAR 26, 2005 

ABR 20, 2005 ABR 26, 2005 ABR 22, 2005 ABR 23, 2005 LUNES A VIERNES 

MAY 18, 2005 MAY 24, 2005 MAY 27,2005 MAY CANCELADO 1 PM A 3 PM 

JUN 15, 2005 JUN 28, 2005 JUN 24, 2005 JUN 25, 2005 

JUL 20, 2005 JUL 26, 2005 JUL 22, 2005 JUL 23, 2005 

AGO 17, 2005 AGO 23, 2005 AGO 26, 2005 AGO 27, 2005 

SEPT 21, 2005 SEPT 27, 2005 SEPT 23, 2005 SEPT 24, 2005 

OCT 19, 2005 0CT 25, 2005 OCT 28, 2005 OCT 22, 2005 

NOV 16, 2005 NOV 22, 2005 NOV CANCELADO NOV CANCELADO 

DIC 21, 2005 DIC 27, 2005 DIC CANCELADO DIC CANCELADO

Standard Precautions

STOP 

DISEASE 

WASH YOUR HANDS PROPERLY 

1. Wet hands and apply soap. 

Use warm running water; 

liquid soap is best. 

2. Rub hands together vigorously for 

at least 10 seconds, scrubbing all 

surfaces. 

3. Rinse hands well under running water 

until all the soil and soap are gone. 

4. Dry hands with a fresh paper 

towel. 

5. Turn off water with a paper towel— 

not with your clean hands. 

6. Discard the used paper towels 

in a lined, foot-pedal canister. 

Rev. 01/03 



STOP 

DISEASE 

CLEANING AND DISINFECTING 

• Make a fresh bleach solution every day using: 

• 1 tablespoon bleach in 1 quart water 

-OR- 

• 1/4 cup bleach in 1 gallon water. 

• Clean off any visible soil with soap and water. 

• Disinfect by spraying with bleach solution. 

Wipe disinfectant over the surface with a paper 

towel. Leave glistening wet—do not dry off. 

• Allow to air dry for 2 minutes. 

Rev. 01/03 



STOP 

DISEASE 

GLOVING 

1. Put on a clean pair of gloves. 

2. Provide appropriate care. 

3. Remove each glove carefully. Grab 

the first glove at the palm and strip 

the glove off. Touch dirty surfaces 

only to dirty surfaces. 

4. Ball up the dirty glove in the 

palm of the other gloved hand. 

5. With the clean hand, strip the glove off from 

underneath at the wrist, turning the glove inside 

out. Touch clean surfaces only to clean surfaces. 

6. Discard the dirty gloves immediately 

in a step can. Wash your hands. 

Rev. 01/03 



First Aid/Choking 

Poster

The First Aid/Choking Poster is available from the 

American Academy of Pediatrics. 

Please call 847.434.4000 to order.

Health Promotion

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ILLINOIS DEPARTMENT OF PUBLIC HEALTH 

Reptiles include iguanas, turtles, snakes and 

lizards. As with many other animals, reptiles 

may carry Salmonella bacteria, which can be 

shed in their feces. Unwashed hands can carry 

the bacteria directly or indirectly to the mouth. 

When ingested, the bacteria can cause diarrheal 

illness, which may be serious in some people. 

Always wash your hands thoroughly after you 

handle your pet reptile, its cage, its litter, its food 

and anything it has touched. 

Keep your pet reptile and its equipment out of the kitchen or 

any area where food is prepared. Kitchen sinks should not be 

used to bathe reptiles or wash their dishes, cages or aquariums. 

If a bathtub is used for these purposes, it should be cleaned 

thoroughly and disinfected with bleach. 

Do not nuzzle or kiss your pet reptile. 

Keep reptiles out of homes where there are children 

under 5 years of age or people with weakened 

immune systems. Children under 5 years of age 

or people with weakened immune systems should 

avoid contact with reptiles. 

Pet reptiles should not be 

allowed in child care centers. 

Pet reptiles should not be allowed 

to roam freely throughout the 

home or living area. 

For more information, contact the Illinois Department of Public Health, 

Division of Infectious Diseases, 525 W. Jefferson St., Springfield, IL 62761; 

telephone 217-785-7165 or TTY (hearing impaired use only) 800-547-0466. 

Printed by Authority of the State of Illinois • P.O. # 511561 10M 1/01

Food Safety

Wash hands and surfaces often 

You can’t see, taste, or smell them. They’re sneaky little 

critters, and they can spread throughout the kitchen and 

get onto cutting boards, utensils, sponges, countertops, and 

food. They’re foodborne bacteria — and if eaten, they can cause 

foodborne illness. So on your mark, get set, go . . . clean! 

The Big 3 

Use these tips to keep your hands, surfaces, 

and utensils squeaky clean! 

Splish, Splash 

Wash hands, utensils, and surfaces in hot, 

soapy water before and after food preparation 

and especially after preparing raw meat, 

poultry, eggs, or seafood. Also, remember to 

wash your hands after using the bathroom, 

changing diapers, or handling pets. 

All A-board 

Cutting boards (including plastic, non-porous, 

acrylic, and wooden boards) should be run 

through the dishwasher or washed in hot, 

soapy water after each use. Discard boards that 

are excessively worn. 

Towel Toss 

Consider using paper towels to clean up 

kitchen surfaces. When done, throw away the 

towel. If you use cloth towels, wash them often 

in the hot cycle of your washing machine. 

BAC! Attack 

How long should you 

wash your hands to 

send bacteria down 

the drain 

a. 5 seconds 

b. 10 seconds 

c. 15 seconds 

d. 20 seconds 

Using a 

disinfectant 

cleaner or a mixture 

of bleach and water 

on surfaces can 

provide some added 

protection against 

bacteria.

Fruit & Veggie 

Recipe for Safety 

Here’s a simple formula for keeping fruits and veggies clean. 

Prep the Kitchen — Before preparing fruits and vegetables, wash 

your hands and clean your cutting board and utensils with hot, 

soapy water. 

Add Water — To remove any lingering dirt, thoroughly wash fresh 

produce under running water. 

Scrub Thoroughly — Use a vegetable brush to scrub fruits and 

vegetables that have firm surfaces, such as potatoes, carrots, etc. 

Cut Accordingly — Cut away any damaged or bruised areas on produce. 

Bacteria can thrive in these places. 

’Fridge Messages of the Day 

• Wipe up spills immediately. 

• Clean refrigerator surfaces 

with hot, soapy water. 

• Once a week, throw out 

perishable foods that should no 

longer be eaten. 

Did You Know 

20% of consumers don’t wash hands and kitchen 

surfaces before preparing food. Clean hands and 

surfaces are your first step in safe food handling. 

FDA/USDA Consumer Survey, 1998 

When cooking, 

don’t forget to 

wash your food 

thermometer after 

each use. 

Wash out 

lunchboxes or 

totes every 

night. 

If you have questions or concerns about food safety, contact: 

• The U.S. Department of Agriculture (USDA) Meat and Poultry 

Hotline at (888) 674-6854 or (202) 720-3333 (Washington, DC area). 

The TTY number for the hearing impaired is (800) 256-7072. 

• The U.S. Food and Drug Administration (FDA) Food Information 

Line at (888) SAFE FOOD. 

• The Fight BAC! 

(R) 

Web site at: www.fightbac.org 

Partnership for Food Safety Education • 655 15th St. NW, Suite 700 • Washington, DC 20005

Combat Cross-Contamination 

Get it straight – it’s safe to separate! 

Did you know that improper handling 

of raw meat, poultry, and seafood 

can create an inviting environment 

for cross-contamination As a 

result, bacteria, that yucky germ 

known as BAC!, can spread to 

food and throughout the kitchen. 

Learn more about preventing 

cross-contamination by using 

this helpful chart, and remember 

to spread the word — not the bacteria! 

Separate . . . Don’t Cross-Contaminate 

Keep it Clean! 

Lather Up 

Always wash hands, cutting boards, 

dishes, and utensils with hot, soapy 

water after they come in contact 

with raw meat, poultry, and seafood. 

Take Two 

If possible, use one cutting 

board for fresh produce and 

use a separate one for raw 

meat, poultry, and seafood. 

Watch those Juices! 

Safely Separate 

Separate raw meat, poultry, and 

seafood from other foods in 

your grocery shopping cart 

and in your refrigerator. 

Seal It 

To prevent juices from raw meat, 

poultry, or seafood from dripping 

onto other foods in the refrigerator, 

place these raw foods in sealed 

containers or plastic bags. 

Clean Your Plate 

Never place cooked food back on 

the same plate or cutting board 

that previously held raw food. 

Marinating Mandate 

Sauce that is used to marinate 

raw meat, poultry, or seafood 

should not be used on cooked 

foods, unless it is boiled before 

applying. 







(R) 

• The Fight BAC! Web site at: www.fightbac.org 


Cook to Proper Temperatures 

Cooking food safely is a matter of degrees! Before delving into 

these hot” food safety topics, check out the quiz below and see 

how your safe cooking know-how measures up. 

Cook It Right . . . 

Foods are properly cooked when they 

are heated for a long enough time — and 

at a high enough temperature — to kill 

harmful bacteria that can cause 

foodborne illness. And these 

temperatures vary, depending on 

the food. 

. . . And Keep It Hot 

When serving up hot food buffet-style, 

remember . . . 

• On a buffet table, hot foods should be 

kept at 140° F or higher. Keep food 

hot with chafing dishes, crock pots, 

and warming trays. 

When bringing hot soup, chili, or crab 

dip to an outdoor party . . . 

• Keep it all piping hot before serving. 

Before the party, place these foods in 

insulated thermal containers. Keep 

containers closed until party time. 

Safe Cooking Quiz 

1. Fill in the blanks: Bacteria in food can be 

destroyed by thorough — — — — — — — . 

2. What’s the best way to make sure meat and 

poultry are cooked thoroughly 

a. Feel it with your fingers. 

b. Judge it by its color. 

c. Use a food thermometer. 

d. Taste it. 

3. After you’re done checking the 

temperature of a food, what should 

you do with the food thermometer 

before using it again 

a. Wipe it off with a paper towel. 

b. Place it in another food item and check its 

temperature. 

c. Shout “hooray!” 

d. Wash the food thermometer in hot, soapy 

water. 

4. Who Am I I’m an All-American favorite, 

especially among kids. Before eating me, make 

sure I’m steamy hot. (Hint: I’m also called a 

weiner.) 

 

“Eating Out” Tip of the Day 

Choose menu items that are thoroughly cooked. If it 

appears that any food, such as beef, pork, chicken, 

fish, or eggs, has not been thoroughly cooked, return 

the food for additional cooking.

Thermy TM says, 

“It’s safe to 

bite when the 

temperature is 

right!” 

To keep food safe, cook it thoroughly. 

Always use a clean food thermometer 

to check the internal temperature of 

the foods below. 

Clip & Post 

Safe-Cooking 

Temperature Chart 

Beef/Pork 

• Cook beef roasts and steaks to 145° F for 

medium rare or to 160° F for medium. 

• Cook ground beef to at least 160° F. 

• Cook raw sausages to 160° F. 

• Reheat ready-to-eat sausages to 165° F. 

• Cook pork roasts, chops, or ground patties 

to 160° F for medium, or 170° F for well done. 

Poultry 

• Cook whole poultry to 180° F. 

• Cook chicken breasts to 170° F. 

• Cook stuffing to 165° F. 

Eggs 

• Cook eggs until the yolks and whites are firm. 

• Don’t use recipes in which eggs remain raw or 

only partially cooked. 

Fish 

• Cook fish until it’s opaque and flakes easily 

with a fork. 

• For food safety reasons, avoid eating 

uncooked oysters or shellfish. People with 

liver disorders or weakened immune systems 

are especially at risk for getting sick. 

Leftovers 

• When reheating leftovers, heat them 

thoroughly to at least 165° F. 

3 Sizzling Cooking Tips 

1. Thumbs Up for “Thermy TM ”— 

Use a clean food thermometer, 

which measures the internal 

temperature of cooked foods, to 

make sure meat, poultry, egg 

dishes, casseroles, and other foods 

are cooked all the way through. 

2. Microwave Musts — When 

cooking in a microwave oven, make 

sure there are no cold spots in food 

where bacteria can survive. For best 

results, cover food, stir, and rotate 

for even cooking. If there is no 

turntable, rotate the dish by hand 

once or twice during cooking. 

3. Shake, Rattle, and Roll — 

Bring sauces, soups, and gravies to 

a rolling boil when reheating. 

Did You Know 

Only 2% of consumers 

regularly use a food 

thermometer when 

cooking ground meat. 

Food Marketing Institute, 1999 

Compliments of The Partnership for Food Safety Education 

Clip & Post 







(R) 




Refrigerate Promptly 

Bacteria grow most rapidly in the Danger Zone — the 

unsafe temperatures between 40° F and 140° F — so it’s key 

to keep foods out of this temperature range. And since cold 

temperatures keep most harmful bacteria from growing and 

multiplying . . . be sure to refrigerate foods quickly! 

The Top 4 Cool Rules 

1. The Chill Factor — Refrigerate or freeze 

perishables, prepared foods, and leftovers 

within 2 hours or less. Marinate foods in the 

refrigerator. 

2. The Thaw Law — Never defrost food at room 

temperature. Thaw food in the refrigerator, 

in cold water, or in the microwave if you’ll be 

cooking it immediately. 

3. Divide and Conquer — Separate large amounts 

of leftovers into small, shallow containers for 

quicker cooling in the refrigerator. 

4. Avoid the Pack Attack — Don’t over-stuff the 

refrigerator. Cold air must circulate to keep 

food safe. 

’Fridge Quiz! 

Put your knowledge of proper 

refrigeration to the test. 

1. Should hot food be placed 

directly in the refrigerator 

YES o r NO 

2. Refrigeration prevents bacterial 

g rowth. TRUE or FA L S E 

3. At what temperature should you 

set your refrigerator —— ° F 

 

 

 

 

Serve & 

Preserve 

When serving cold food at a buffet, picnic, or barbecue, keep these 

“chilling” tips in mind. 

• Cold foods should be kept at 40° F or colder. 

• Keep all perishable foods chilled right up until serving time. 

• Place containers of cold food on ice for serving to make sure they stay cold. 

• It’s particularly important to keep custards, cream pies, and cakes with 

whipped-cream or cream-cheese frostings refrigerated. Don’t serve them if 

refrigeration is not possible.

Hit the Road! 

The Big 

Foods must remain at a safe temperature while 

thawing. Now is the perfect time to learn about 

the DOs and DON’Ts of defrosting. 

Defrosting 

• Defrost food in the refrigerator. This is the 

safest method for all foods. 

• Short on time Thaw meat and poultry in 

airtight packaging in cold water. Change the 

water every 30 minutes, so the food continues 

to thaw. 

• Defrost food in the microwave only if it will be 

cooked immediately. 

• You can thaw food as part of the cooking 

process, but make sure food reaches its safe 

internal temperature. 

Defrosting 

• Avoid keeping foods in the Danger Zone — 

the unsafe temperatures between 40° F and 

140° F. 

• Don’t defrost food in hot water. 

• Don’t thaw food on the counter. Food that’s 

left out at room temperature longer than 2 

hours is not within a safe temperature range 

and may not be safe to eat. 

When traveling with food, be aware 

that time, temperature, and a cold 

source are key. Here are some tips 

to help keep your travels cool! 

• Keep frozen foods in the refrigerator or 

freezer until you’re ready to go. 

• Always use ice or cold packs and fill 

your cooler with food. A full cooler will 

maintain its cold temperatures longer 

than one that is partially filled. 

• When traveling, keep the cooler in the 

air-conditioned passenger compartment 

of your car, rather than in a hot trunk. 

• If you’ve asked for a doggie bag to take 

home from a restaurant, it 

should be refrigerated 

within 2 hours of serving. 

Did You Know 

23% of consumers’ refrigerators 

are not cold enough! 

Audits International, 1998 








(R) 



Childhood Lead

The Lead Poisoning Pamphlet is available through 

Channing L. Bete. 

Please call 800.628.7733 to order item # 180280-8-96.

Adams 

62301 

62320 

62324 

62339 

62346 

62348 

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Alexander 

62914 

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Bond 

62273 

Boone 

61038 

Brown 

62353 

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Bureau 

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Carroll 

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Pediatric Lead Poisoning High-Risk ZIP Code Areas 

Christian 

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Morgan 

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Winnebago 

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Woodford 

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January 2005 

Printed by Authority of the State of Illinois 

P.O. # 375645 2M 1/05

Keeping Healthy 

Pamphlet

Keeping Healthy Pamphlet is available through 

NAYEC 

(National Association for the Education of Young Children) 

Please call 800.424.2460 to order.

Communicable Disease Manual for Child Care Providers

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