5141(R) Health, Regulation

Regulation

HEALTH

Rules and Regulations

A. Diphtheria

1. Report to the county health office;

2. Period of isolation:

• • 1. Patient – until doctor certifies pupil may return;
    2. Adult household contacts (food handlers, janitors, and professional staff) – until doctor certifies adult may return;
    3. Minor household contacts -until doctor certifies children may return.

3. Further action:

• • 1. Previously immunized household and classroom contacts should receive toxoid boosters;
    2. Non-immune household contacts should receive anti-toxin and start on a program of active immunization with toxoid.

B. Hepatitis, infectious (Type A)

1. Report to county health office;

2. Period of isolation:

• • 1. Patient – until end of febrile period and doctor certifies child may return to school;
    2. Adult contacts – no restriction;
    3. Minor contacts – no restriction.

3. Further action – recommended that all household contacts receive, within fourteen (14) days of the onset of illness in the index case, a dose of gamma globulin.

C. Hepatitis, serum (Type B)

1. Report to county health office;

2. Period of isolation:

• • 1. Patient – Until end of febrile period and doctor certifies child may return to school;
    2. Adult contacts – no restriction;
    3. Minor contacts – no restriction.

3. Further action – same as for infectious type A since there is no way of distinguishing between the two types during the incubation period.

D. Meningitis, Meningococcal

1. Report to the county health office;

2. Period of isolation:

• • 1. Patient – until end of febrile period or until 24-hours after the administration of sulfadiazino or penicillin treatment. A doctor must certify that it is safe for the child to return to school;
    2. Adult and minor contacts – no restriction.

File Code: 5141

3. Further action – family members and other close personal contacts of the index case should receive prophylaxis with sulfadiazino.

E. Poliomyelitis

1. Report to the county health office;

2. Period of isolation:

• • 1. Patient – no restrictions. Doctor must certify that child may return to school;
    2. Adult and minor contacts – no restrictions.

3. Further action – adequate prevention of further cases of poliomyelitis depends presently on immunization.

F. Salmonellosis

1. Report to the county health office;

2. Period of isolation:

• • 1. Patient – until clinical recovery and doctor certifies child may return to school;
    2. Adult contacts – no restriction except for food handlers, who will be treated the same as are patients;
    3. Minor contacts – no restrictions.

3. Further action – search for source of illness among contaminated foods, and asymptomatic human carriers may be useful if undertaken early.

G. Smallpox

1. Report to county health office;

2. Period of isolation:

• • 1. Patient – two weeks from onset of disease and until all crusts and scabs have fallen off. Doctor must certify that it is safe for patient to return to school;
    2. Adult contacts – for 16 days from last exposure, unless immunized by previous successful vaccination, in which case the contact may be released from quarantine but maintained under surveillance following successful re-vaccination;
    3. Minor contacts – same as for adults.

3. Further action – individuals with a high risk of exposure should maintain a regular program of revaccination every three years.

H. Typhoid Fever

1. Report to county health office;

2. Period of isolation:

• • 1. Patient – until clinical recovery and doctor certifies child may return to school;
    2. Adult contacts – no restriction except for food handlers, who shall be governed as are cases;
    3. Child contacts – no restrictions.

3. Further action – recommended test should be taken by the patient to determine whether or not he/she is a carrier.

I. Measles (Robeola)

File Code: 5141

1. Report not required by the state, but county health office desires a report;

2. Period of isolation:

• • 1. Patient – should be excluded from school until 5 days from appearance of rash;
    2. Adult or minor contacts – no restrictions.

3. Further action – it is recommended that parents/guardians of school children be notified upon the appearance of the first case of measles in the school, with the recommendation that non-immunized persons immediately consult their physicians regarding the receipt of measles vaccine.

J. Mumps

1. Report not required;

2. Period of isolation:

• • 1. Patient – should be excluded from school for the period of acute illness, but no longer than six days;
    2. Adult and Minor Contacts – no restrictions.

3. Further action – adults may be given hyper-immune globulin, but children should, except in unusual circumstances, be permitted to obtain active immunity to the infection and should not receive prophylactic mumps-immune globulin.

K. Pertussis (Whooping Cough)

1. Report not required;

2. Period of isolation:

• • 1. Patient – should be excluded from school until clinical recovery and for three weeks after onset of typical paroxysms. Doctor must certify that child may return to school. Contact with unvaccinated infants should be avoided.
    2. Adult and minor contacts – no restrictions

3. Further action:

• • 1. Non-immune childhood contacts should receive hyper-immune antipertussis globulin as soon after exposure as possible;
    2. Contacts should be seen daily by the school nurse or physician for a period of 14 days from last known exposure, but may attend school if no symptoms of respiratory infection are detected;
    3. Previously immunized childhood contacts should receive a booster dose of unabsorbed pertussis vaccine.

L. Rubella (3-day German Measles)

1. Report not required;

2. Period of isolation:

• • 1. Patient – should be excluded from school until three days from appearance of rash;
    2. Adult and child contacts – no restrictions.

3. Further action – exposure of pregnant females is to be avoided. Non-immune pregnant females should receive medication.

M. Streptococcal infections (include scarlet fever, sore throat, and erysipelas)

File Code: 5141

1. Report not required;

2. Period of isolation:

• • 1. Patient – should be excluded from school until clinical recovery and the disappearance of purulent discharge. Must have note from doctor certifying that child may return to school;
    2. Adult and child contacts – no restrictions.

3. Further action – it is recommended that all children who are close personal contacts in cases of streptococcal disease receive throat culture, with treatment of positives with specific medication.

N. Chicken pox

1. Report not required;

2. Period of isolation:

• • 1. Patient – should be excluded from school until six days after onset of rash;
    2. Adult and child contacts – no restrictions.

3. Further action – no treatment recommended for contacts except for those with altered immunologic responsiveness, as directed by personal physician.

O. AIDS/ARC or HTLV-III Antibody

1. Children entering grades K through 8 with AIDS/ARC or HTLV-III antibody shall not be excluded from attending school unless the following exceptional conditions are evident:

1. The student is not toilet trained or is incontinent, or otherwise is unable to control drooling;
2. The student is unusually physically aggressive, with a documented history of biting or harming others.
3. The New Jersey State Department of Health will establish an expert medical advisory panel. School districts, based upon advice of the school medical inspector, must seek an evaluation by the panel to individually evaluate those AIDS/ARC or HTLV-III antibody positive children whom a local school nurse deems has any of the exceptional conditions above described, through application to the county chief school administrator of schools, unless the child’s personal physician concurs. School districts seeking review by the panel will bear the burden of proof of demonstrating that the child exhibits the behavior or manifests the symptoms which would justify exclusion. Between the time of referral and the rendering of the evaluation by the panel, the child shall be excluded from school but shall be provided with an alternate educational program. The panel shall render its appraisal as rapidly as possible after referral by the executive county superintendent. Results of the appraisal shall be made to the executive county superintendent, with copies to the commissioner of education and the commissioner of health. If the panel concludes that the child should attend school, the child shall immediately be admitted to school;
4. A school-age child with AIDS/ARC or HTLV-III antibody who is a home bound child shall be provided with special education programs and all other rights and privileges provided by law.

Adopted: No date

Also see regulation for policy 5141.2, Control of Communicable Disease