Acute and Chronic Illnesses

 

 

 

 

 

 

 

 

 

 

 

 

Anxiety: 

Please see the below resources related to anxiety in school aged children.

- CDC Mental Health 

- School Avoidance: Tips for Concerned Parents

- 211

 

Asthma: 

Please see the below resources for resources related to asthma in school aged children. 

- CDC Asthma in Children

- American Lung Association: Asthma at School Checklist 

Nebulizers:

• Nebulizers are not permitted for use in school due to infection control and safety concerns, as they generate aerosols that can increase the spread of respiratory illnesses. The CDC recommends the use of metered-dose inhalers with spacers, which are equally effective for delivering asthma medication when used correctly and do not create aerosol exposure. If a student requires around-the-clock nebulizer treatments, they are considered too ill to attend school and should remain at home. Students may attend school and receive asthma medication via inhaler, in accordance with their Asthma Action Plan or sick plan, as ordered by their healthcare provider and deemed appropriate by the school nurse.

 

 

Conjunctivitis/ Pink Eye: 

Signs/Symptoms:

• Eyes have redness, tearing, itching, and scratchy or burning feeling
• Occasionally green or yellow pus forms at the inner eyelids and may form crust on the eyelids or eyelashes. This will be especially noticed when waking from sleep. 
• Your child may rub his/her eyes frequently. Sometimes the eyelids look swollen. It may also occur during a cold.
• Allergic conjunctivitis seen most often with high pollen counts is not contagious and you will see clear watery eyes; pus is rare. 

Incubation:

• Conjunctivitis: 3-5 days. Viral is typically 12 hours to 3 days. Bacterial is typically 1-3 days.

Transmission:

• Person to person by direct contact and surfaces touched with infected eye drainage.
• Viral infections:
  • Are not treated with antibiotics; it will resolve in 3-5 days; a note is required from your physician stating that your child is no longer contagious and the date of return to school.
• Bacterial infections: 
  • Resolve quickly with the antibiotic your physician prescribes; a note is required from your physician stating your child is no longer contagious and the date of return to school.
• Allergic conjunctivitis: 
  • Sometimes treated with non-antibiotic drops; follow your physician's advice; if excluded to home, a note from your physician is required stating that your child is non-contagious and the date of return to school.

Treatment:

• Children with conjunctivitis who appear to be infectious will be sent home immediately. Children with allergic conjunctivitis may be observed at school a day or two; a worsening condition or one that is not improving will be referred home for your physician to assess. Children with visible pus will be excluded and referred to your physician.
• Clean the eye(s) gently with a warm wet compress. To remove crust, leave the wet compress on the eyelid for a few minutes. Gently wipe the eyelid from the nose side to the outer corner. Use a different cloth for each eye. Do this before instilling eye medication if you see pus and/or crusting on eyelids/lashes. Styes are also usually soaked with a warm wet compress; several times a day. When it comes to a head it will drain.
• WASH HANDS FREQUENTLY. Discourage rubbing eyes. Especially wash hands often if your child is rubbing the eyes. Do not share towels, wash clothes etc. If you are having difficulty instilling eye drops, turn your child's head slightly to create a "well" by the eyelid and nose. Tell your child to close the eye. Drop the medicine in the "well" and then tell your child to open the eye. Medicine will then flow into the eye. Hold his/her hands away from the eye so that the medicine is not wiped away. It may take one person to calmly hold your child while another instills the medicine if your child is very young and uncooperative.

General Information:

• Please report episodes of confirmed contagious conjunctivitis to the nurse's office as soon as possible. Please email us even if your child developed conjunctivitis on a non-school day (weekend, holiday).
• Consult your physician if your child's conjunctivitis is not improving

Return to School:

• 24 hours after beginning antibiotic treatment for bacterial conjunctivitis. When symptoms disappear if viral conjunctivitis. 
• We reserve the right to send a student home who displays signs of ill health that may jeopardize the general welfare of the class.

 

 

Coxsackievirus/ Hand Foot and Mouth

Signs/Symptoms:

• Tiny blisters in or around the mouth and on fingers, palms of the hands, buttocks, and soles of the feet lasting longer than a week. One, a few or many blisters in all those areas may be present. 
• You may see common cold signs and symptoms with fever, sore throat, runny nose and cough. Mouth blisters are the most troublesome, making eating and drinking difficult.

Incubation:

• 3-6 days.

Transmission:

• Coughing and sneezing
• Direct contact and fecal-oral route spread the virus. Frequent hand washing, covering your mouth when coughing and sneezing and always washing your hands after using the bathroom will decrease the spread of the virus.

Treatment:

• No specific treatment. This viral infection does not respond to antibiotics. Treatment is aimed at fever control and drinking enough fluids.
• Your physician may recommend fever-reducing medication. As with other viral infections, DO NOT GIVE CHILDREN ASPIRIN PRODUCTS.
• Blisters heal better if not opened.
• Wash your hands and your child's hands frequently.
• For problems with eating and drinking:
  • Offer only cool bland liquids; soda and strong juices will be too uncomfortable as they "burn" the mouth.
  • Offer soft, bland, non-spicy foods that are not hot (i.e. buttered pasta, soft bread, puddings, etc).
  • For very painful mouth blisters consult your physician.

General Information:

• Please report episodes of confirmed Hand, Foot and Mouth Disease (Coxsackie) to the nurse's office as soon as possible. Please email us even if your child developed Mononucleosis on a non-school day (weekend, holiday).
• There is no vaccine for this virus. Infection with Coxsackie virus generally provides future immunity to the Hand, Foot and Mouth Disease. A second episode is possible from a different subtype (related form) of Coxsackie virus.

Return to School:

• Students must be fever-free for 24 hours without using fever reducing medication.
• Any blisters are scabbed over.
• If students are drooling due to the sores in their mouths, they are unable to return to school until they are able to control their secretions.

 

 

Diabetes 

Continuous Glucose Monitors (CGM)

Students who use a Continuous Glucose Monitor (CGM) may have their device data monitored by the school nurse during the school day if requested by a parent or guardian. If monitoring is requested, the parent or guardian must provide permission for the nurse to access the student’s CGM data and ensure that the nurse is properly connected to the monitoring application. Monitoring will occur using a school-issued device (such as an iPad or laptop) and is intended to support student safety during the school day.

Diabetes Supplies at School 

All students with diabetes—whether they independently manage their care or require assistance—must have appropriate backup diabetes supplies stored in the school health office. These supplies include, but are not limited to: a glucometer, test strips, lancets, insulin and necessary administration supplies, ketone testing strips, emergency glucagon if prescribed, and glucose tablets or other fast-acting glucose if prescribed. These backup supplies are necessary to ensure the student’s safety in the event of CGM malfunction, device disconnection, or other medical need.

If the required backup supplies are not provided and available in the health office, the parent or guardian will be contacted and the student may need to be picked up from school until the necessary supplies are provided. This policy helps ensure that appropriate and timely care can be delivered in the event of a diabetes-related health concern during the school day.

 

 

Lice

Pediculosis (head lice) is a common community issue. While it is a nuisance, it is not infectious and is not disease carrying. Evidence-based prevention measures include assisting parents with the identification of lice and nits, as well as teaching students, parents, and staff effective prevention measures.

School notification letters are no longer being sent home. Communications highlighting cases of head lice have been shown to increase community anxiety and social stigma, while having little effect on the prevention of lice infestations.

CREC does not provide mass screenings for head lice. Checks have not been shown to have a significant effect on the incidence of lice in schools. Our guidelines meet current standards in public health, scientific research and the recommendations of the American Academy of Pediatrics (AAP), the National Association of School Nurses (NASN), and the Centers for Disease Control (CDC).

Here are a few facts regarding pediculosis:

• Live lice move very quickly and may even move to the top of the head when you examine the lower areas, such as the nape of neck, behind ears, etc.
• Lice are grayish, do not have wings, and are about 1/16th inch long. They are not like fleas. They do not jump or fly, but crawl very fast.
• Nits (lice egg cases) are stuck tightly to the hair shaft and are not easily removed.
• Nits and lice are not carried on your pets.

Students should be treated at home PRIOR to returning to school. Families may consult with their medical providers when determining best course of treatment.

 

 

Parovirus/ Fifths Disease

What are the signs or symptoms?

• Fever
• Headache
• Tired, muscle aches
• Uncommon symptoms are itchiness, cough, diarrhea or vomiting, runny nose and joint aches Red "slapped-cheek" rash appears 4 to 14 days (up to 21 days) after these signs or symptoms. This characteristic rash is followed shortly by a lacelike-appearing rash proceeding from trunk to arms, buttocks and thighs.
• Rash may disappear and then reappear after exposure to heat for weeks: once rash appears, the child is no longer contagious and usually does not feel ill. Individuals can be infected and infectious without ever having signs or symptoms. Disease can be severe in people with sickle cell disease or certain blood disorders, as well as those with compromised immune systems.

What are the incubation and contagious periods?

• Incubation Period: 4 - 14 days but can be as long as 21 days.
• Contagious Period: until the rash appears.

How is it spread?

• Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs or sneezes.

What is the treatment?

• Your physician will advise you about managing uncomfortable symptoms.
• As with other viral infections, do not give children Asprin products

When can my child return to school?

• Your child may return to school when his/her symptoms have gone away, and your child is able to partake in the activities of the school day. YOUR CHILD MAY NOT RETURN UNTIL HE/SHE IS FEVER FREE FOR 24 HOURS WITHOUT TAKING TYLENOL OR MOTRIN. We reserve the right to send a student home who displays signs of ill health that may jeopardize the general welfare of the class.

Additional Information:

• There is no vaccine for Fifth Disease. An infection with this virus usually gives future immunity to further episodes of Fifth Disease.
• Please report episodes of confirmed Fifth Disease to the nurse's office as soon as possible. Please email us even if your child was diagnosed on a non-school day (weekend, holiday, vacation).
• Women who may be pregnant should consult with their medical provider if there is a known or suspected exposure to Parvovirus (Fifths Disease)

 

 

Respiratory Illness

• Flu (Influenza) virus usually presents with the following symptoms:  a sudden fever, chills, headache, fatigue, sore throat, dry cough and/or a nasal congestion. While symptoms are similar to a common cold, children with the flu usually have a higher fever and more severe symptoms. If your child experiences flu symptoms, please consult their health care provider. 
• RSV is a common respiratory virus that usually causes mild, cold-like symptoms such as fever, congestion, cough and sneezing.  Symptoms may be more severe in young children and the elderly. With RSV, children can become sick very quickly. If you notice a rapid increase in the severity of symptoms and/or changes in breathing, call your child’s health care provider immediately or go directly to the emergency room. 
• Covid-19 symptoms include sudden loss of taste or smell, cough, headache, shortness of breath, loss of appetite, and sore throat. Symptoms can be similar to those of the common cold or in more severe cases, influenza.  Persons experiencing symptoms are recommended to consult their medical providers.  GPS is no longer tracking Covid-19 cases or contact tracing potential exposures.

In order to promote the health and safety of our school community, we continue to recommend consulting your health care providers regarding the Flu vaccine and COVID-19 boosters, and following our guidelines for when to keep kids home when they are sick. 

 

 

Strep Throat

What are the signs or symptoms?

• Sore throat
• Fever
• Stomach ache
• Headache
• Swollen lymph nodes in neck
• Decreased appetite
• Strep is much less likely if there is…
  • Runny nose
  • Cough
  • Congestion
  • Children younger than 3 years with group A streptococcal infection rarely have a sore throat. Most commonly, these children have persistent nasal discharge (which may be associated with a foul odor from the mouth), fever, irritability and loss of appetite.

What is Scarlet Fever?

• A fine red rash that makes the skin feel like sandpaper. Scarlet Fever is caused by toxins produced by a strep infection of the throat or another area of the body. The rash is usually quite prominent in the armpit and groin area, often making the creases in the bed of the elbow and back of the knee pinker than usual. Sometimes, the area around the mouth has a pale appearance.
• Children who have Scarlet Fever are generally not any sicker than children with Strep Throat who do not have the rash.

What are the incubation and contagious periods?

• Incubation Period: 2 to 5 days
• Contagious Period: The risk of spread is reduced when a person who is ill with Strep Throat is treated with antibiotics. Up to 25% of asymptomatic schoolchildren and a small number of adults carry the bacteria that cause Strep Throat in their nose and throat and are not ill. In outbreaks, a higher proportion of children with no symptoms of illness may be carriers. The risk of transmission from someone who is not sick but is carrying the bacteria is low.
• NOTE: The bacteria that cause Strep Throat also can cause Impetigo.

How is it spread?

• Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs or sneezes. These droplets can land on or be rubbed into the eyes, nose, or mouth. The droplets do not stay in the air, they usually travel no more than 3 feet and fall onto the ground.
• Contact with the respiratory secretions from or objects contaminated by children who carry Strep bacteria. Close contact helps the spread of the infection.

What is the treatment?

• Your physician will confirm Strep Throat by a throat culture. There are two types of cultures: A Rapid Strep Test (with results in 5-20 minutes) or the more sensitive test is a culture that is read 24 hours later.
• An antibiotic is prescribed for at least 7-10 days. It is very important that your child takes the entire course of medication. Do not stop the medication because your child appears well and/or is fever free continue the medication as directed.
• Your physician will advise you about pain/fever reducing medication. Give plenty of liquids. A child with Strep Throat needs plenty of rest; encourage quiet activities.
• You and your child should wash your hands frequently, especially after coughing, sneezing, or using tissues.
• Do not share drinking glasses, eating utensils, etc. The use of disposable paper cups may be helpful the first 24 hours to remind children not to share cups.

Additional Information

• Please report an episode of confirmed Strep Throat to the nurse's office as soon as possible. Please email us even if your child developed Strep Throat on a non-school day (weekend, holiday, vacation).
• Consult your physician if your child's condition is not improving.
• Some children who have Strep Throat/Scarlet Fever may experience very dry peeling palms afterwards. This is normal.

When can my child return to school?

• A negative culture or 24 hours of antibiotics, and your child has not had a fever without the use of fever reducing medication are required before returning.
• YOUR CHILD MAY NOT RETURN UNTIL HE/SHE IS FEVER FREE FOR AT LEAST 24 HOURS WITHOUT TAKING TYLENOL OR MOTRIN. For example, if your child begins antibiotics at 2 pm today, (s)he may not return to school tomorrow, wait until the following school day.