PRINEVILLE COIC COMMUNICABLE DISEASE MANAGEMENT PLAN - Updated for COVID-19 March 24, 2021
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PRINEVILLE COIC
COMMUNICABLE DISEASE
MANAGEMENT PLAN
Updated for COVID-19
March 24, 2021
Contents
Chapter Page
A. The Covid-19 Environment and the 2020-2021 COIC Classroom ...................................... 1-5
Key Principles within the COVID-19 Environment ............................................................. 1
Physical Distancing ........................................................................................................ 1
Hand Hygiene ................................................................................................................ 1
Protective Equipment ................................................................................................... 1
Environmental Cleaning and Disinfection ..................................................................... 2
Isolation of Sick People and Quarantine of Exposed People ........................................ 2
Communication ............................................................................................................. 3
Screening ....................................................................................................................... 3
Building.......................................................................................................................... 4
Reporting....................................................................................................................... 4
BinaxNOW Test ............................................................................................................. 4
B. Communicable Disease Control Measures ......................................................................... 5
Reportable or Restrictable ............................................................................................... 5
Reportable Defined ...................................................................................................... 5
Restrictable Defined ...................................................................................................... 5
Guidelines for Exclusion ................................................................................................ 5
Other Excludable Symptoms ......................................................................................... 5-7
Sample Letter to Parents, Guardians, and School Community ........................................ 8
Recommended Actions for Symptoms or Health Care Provider Diagnosis...................... 9-16
Guidelines for Handling Body Fluids................................................................................. 17
Page i
Standard Precautions .................................................................................................... 17
General Recommendations........................................................................................... 17
Education ................................................................................................................... 17
Training ...................................................................................................................... 17
Standard Precautions ................................................................................................. 18
Additional Precautions ............................................................................................... 18
Legal Issues ................................................................................................................ 18
Guidelines for Bloodborne Infections like HIV, Hepatis B and C ...................................... 19
General Background ...................................................................................................... 19
Hepatitis B ..................................................................................................................... 19
The Illness .................................................................................................................. 19
Carriers ...................................................................................................................... 19
Transmission .............................................................................................................. 19
Vaccine ...................................................................................................................... 19
Specific Recommendations for Hepatitis B ................................................................ 20
Screening for HBV Carriers......................................................................................... 20
HBV Carriers ............................................................................................................... 20
Immunizing Staff ........................................................................................................ 20
Immunizing Parents or Residential Caretakers .......................................................... 20
Hepatitis C Virus (HCV) .................................................................................................. 20
HIV/AIDS ...................................................................................................................... 21
General Considerations.............................................................................................. 21
About HIV ................................................................................................................... 21
School Attendance ..................................................................................................... 21
Legal/Privacy ............................................................................................................. 21
Page ii
Infection Control ....................................................................................................... 22
HIV and Athletics........................................................................................................ 22
Employee Education and Training ............................................................................. 22
Human Immunodeficiency Virus (HIV) Infection .......................................................... 23
Carriers. ..................................................................................................................... 23
Transmission ............................................................................................................. 23
Legal Issues. .............................................................................................................. 23
Confidentiality Issues. ............................................................................................... 23
COVID-19 ADDENDA ............................................................................................................... 24
Ready Schools, Safe Learners – Public Health and School Reentry decision Tool............... 24
Six Principles of Crisis and Emergency Risk Communication .............................................. 24
Welcome Back letter ........................................................................................................... 25
Possible COVID-19 Exposure at COIC................................................................................... 26
COIC School Closure Letter ................................................................................................. 27
COVID-19 Exposure at COIC ................................................................................................. 28
Teacher / Staff Response Script for Positive Case ............................................................... 29
Parent Checklist from CDC .................................................................................................. 30
Know The Facts about coronavirus [POSTER] ..................................................................... 31
Conozca la informacion sobre el coronavirus [POSTER] ...................................................... 32
SCHOOL SCENARIOS SUMMARY ............................................................................................. 33
1) HOW TO HANDLE EXPOSURE TO COVI-19 ....................................................................... 34
2) HOW TO HANDLE COVID-A9 ILLNESS .............................................................................. 35
3-A) HOW TO HANDLE A NEGATIVE COVID-19 VIRAL TEST ................................................. 36
3-B) HOW TO HANDLE A POSITIVE COVID-19 VIRAL TEST ................................................... 37
4-A) HOW TO HANDLE WHEN A PERSON DOES NOT GET TESTED SITUATION 1................. 38
Page iii
4-B) HOW TOHANDLE WHEN A PERSON DOES NOT GET TESTED SITUATION 2.................. 39
4-C) HOW TOHANDLE WHEN A PERSON DOES NOT GET TESTED SITUATION 3.................. 40
5) HOW TO HANDLE A POSITIVE COVID-19 VIRAL TEST ...................................................... 41
6) HOW TO HANDLE MULTIPLE POSITIVE COVID-19 VIRAL TESTS-SAME COHORT ............. 42
7) HOW TO HANDLE MULTIPLE POSITIVE COVID-19 VIRAL TESTS-DIFFERENT COHORTS... 43
Page iv
For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
_____________________________________________________________________________________________________________________
A. The COVID-19 Environment and the 2020-2021 Prineville COIC Classroom
Key Principles and Processes
Physical distancing. Minimizing close contact (
For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Face masks will be provided during screening at building entry points for students without
masks.
Gloves will be used as needed.
Environmental cleaning and disinfection. Areas of use, especially of high-touch surfaces like
doorknobs, keyboards and student desks and tables, will be wiped and sanitized at the end of morning
and afternoon sessions.
Routine cleaning and disinfecting will follow the CDC cleaning and disinfecting guide and will
occur between the AM and PM classes and at the end of the day.
COIC follows the CDC Cleaning guide https://www.cdc.gov/coronavirus/2019-
ncov/community/disinfecting-building-facility.html
Daily wipe-downs occur between AM and PM sessions and at the end of the school day. COIC
staff are responsible for disinfecting high use areas in their cohort areas. Bathrooms are wiped
down at the same time by a rotating schedule of staff.
In the case of an exposure in a single cohort, room cleaning will follow guidelines established by
Crook County Health Department (CCHD).
In the case of a school wide exposure, school cleaning will follow CCHD protocols.
The following poster will be posted in each classroom, bathroom, and office:
Isolation of sick people and quarantine of exposed people. COIC Prineville’s isolation area is the
outdoor foyer or the storage room closest to the entrance. Primary symptoms of concern: cough, fever
or chills, shortness of breath, or difficulty breathing.
Muscle pain, headache, sore throat, new loss of taste or smell, diarrhea, nausea, vomiting, nasal
congestion, and runny nose are also symptoms often associated with COVID-19.
If any of these occur, students will be placed in isolation and guardians will be called for a
pickup. If no guardian is available, other transportation will be arranged.
Page 2
For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Communication. Staff will have undergone training in distancing, COIC COVID-19 process
implementation and compliance with OHA, ODE, and Crook County Health Department (CCHD)
guidelines.
Parents will have received a letter (see pages 8 & 25) explaining the processes that COIC will
have in place to protect their child.
In the event of a COVID-19 exposure by student, staff, or other, stakeholders will receive a letter
(see pages 26 – 28).
Crook County Health Department (CCHD) will be informed of any student or staff exhibiting
COVID-19 symptoms.
COIC staff will notify CCHD of any COVID-19 diagnosis.
CCHD contact person is Katie Plumb, 541 447 5165.
Screening. Daily screening by cohort will take place at the West Entrance and will consist of
temperature reading for fever, questions for self-reporting of symptoms, and the wearing of a mask –
which will be provided if student is not wearing one.
Students with symptoms will be isolated and sent home or isolated until transportation is
arranged.
The building entry and exit schedule is staggered to so that each student has around 30 seconds
to be screened individually by their cohort teacher.
Building. COIC will restrict student traffic to one direction by means of painter’s tape arrows in the
floor. The entrance will be one-way for entry at the beginning of the day and one-way for exit at the
end. The door near the bathrooms may also be used in one direction for exit.
The designated Physical Distance Enforcer is the lead teacher.
Bathrooms are limited to one student and will be monitored.
Cohorts are assigned to specific rooms based county metrics.
The Prineville classrooms will have at least 40 ft2 per students based on a maximum cohort size
of 15.
Hallway traffic will be limited to one student and staff.
HVAC set to MERV 13 standard.
COIC follows the ASHRAE guidance: https://www.ashrae.org/news/ashraejournal/guidance-
for-building-operations-during-the-covid-19-pandemic
Reporting. Student Cohort logs note the following: Name, Screening, Time In / Out, Staff Contact, Other
Contact, Symptoms.
Cohort logs are integrated into the COIC information system enabling immediate and
permanent records.
Contact logs reviewed daily by COIC staff
Cohorts include one for the Work education group (crew).
Page 3
For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Daily log for other (non-regular school staff) to contain: Name, Contact information, Date of
visit, and Time of Entry and Exit.
These logs will be maintained for at least 4 weeks after the completion of the term.
BinaxNOW Testing. Staff and students who develop COVID symptoms during the day, after the
initial screening, will be isolated and tested for COVID antigen per the OHA training protocols.
COIC Prineville has registered with OHA and has received the BinaxNOW test kits. All
COIC staff have participated in the training and are able to administer the test.
Students under the age of 18 require signed parental permission which is done on
enrollment.
See guidance from the Oregon Health Authority.
https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le3560.pdf
Page 4
For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
B. Communicable Disease Control Measures (Includes all Diseases)
Reportable or Restrictable – Some communicable diseases may be in both categories.
Reportable diseases. These are to be reported to Crook County Health Department (CCHD) by the
diagnosing health care practitioner. A school administrator may receive information from a parent or
other source regarding a student’s possible diagnosis with a “reportable” disease. The school
administrator will then refer that information to the to CCHD, with appropriate consent. The health
department will provide directions regarding the student’s return to school and any action necessary to
prevent the spread of disease to others.
Restrictable. These diseases are communicable diseases for which the school administrator is
required by Oregon law to exclude a child. When the administrator has reasonable cause to believe that
the child has a school-restrictable disease, the child must be excluded until no longer infectious to
others, as determined by the local public health authority, a licensed physician or school nurse,
depending on the child’s illness or condition.
After a student has been diagnosed by a licensed health care provider as having a communicable
disease, the information in pages 11–17 of this document will assist school administrators regarding
student attendance and restrictions.
CCHD will be contacted for reporting concerns or questions.
Guidelines for Exclusion. Students and school staff who are diagnosed with a school-restrictable
disease must be excluded from work or attendance. Susceptible students and school staff may also be
excluded following exposure to selected diseases, per instructions to the school administrator from
CCHD or per OHA state-wide posted notices. [OAR 333-019-0010; 333-019-0100]
Other Excludable Symptoms
Fever. A measured oral temperature of 100.4°F, with or without the symptoms below.
Stay home until temperature is below 100.4°F for 72 hours WITHOUT the use of fever-reducing
medication such as ibuprofen (Advil), acetaminophen (Tylenol), aspirin.
Skin rash or sores. Any new rash if not previously diagnosed by a health care provider OR if rash is
increasing in size OR if new sores or wounds are developing day-to-day OR if rash, sores or wounds
are draining and cannot be completely covered with a bandage.
Stay home until rash is resolved OR until sores and wounds are dry or can be completed covered
with a bandage OR until diagnosis and clearance are provided by a licensed healthcare provider.
Page 5For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Difficulty breathing or shortness of breath. Not explained by situation such as exercise: feeling
unable to catch their breath, gasping for air, breathing too fast or too shallowly, breathing with extra
effort such as using muscles of the stomach, chest, or neck.
Seek medical attention; return to school when advised by a licensed healthcare provider.
Concerning Cough. A persistent cough that is not yet diagnosed and cleared by a licensed healthcare
provider OR any acute (non-chronic) cough illness OR cough that is frequent or severe enough to
interfere with active participation in usual school activities.
Stay home until 72 hours after cough resolves.
If pertussis (“whooping cough”) is diagnosed by a licensed healthcare provider, student must be
excluded from school until completion of a 5-day course of prescribed antibiotics or until
cleared for return by the local public health authority. If COVID-19 is diagnosed, exclude until
cleared for return by the local public health authority.
Diarrhea. Three or more watery or loose stools in 24 hours OR sudden onset of loose stools OR
student unable to control bowel function when previously able to do so
Stay home until 48 hours after diarrhea resolves.
Vomiting. At least 1 episode that is unexplained
Stay home until 48 hours after last episode
Headache with a stiff neck and fever OR headache with recent head injury. Not yet seen and
cleared by licensed health provider.
Recent head injury: consider ODE concussion guidance.
Jaundice. Yellowing of the eyes or skin (new or uncharacteristic)
Must be seen by a licensed prescriber and cleared before return to school
Concerning eye symptoms. Colored drainage from the eyes or unexplained redness of one or both
eyes or eye irritation accompanied by vision changes or symptoms such as eye irritation, pain,
redness, swelling or excessive tear production that prevent active participation in usual school
activities.
Students with eye symptoms who have been seen and cleared by a licensed prescriber may
remain in school after indicated therapy has been started.
Behavior change. Unexplained uncharacteristic irritability, lethargy, decreased alertness, or increased
confusion OR any unexplained behavior change accompanied by recent head injury not yet assessed
and cleared by a licensed healthcare provider.
In case of head injury, consider ODE concussion guidance.
Page 6For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Major health event. May include an illness lasting more than 2 weeks; a surgical procedure with
potential to affect vital signs or active participation in school activities; or a new or changed health
condition for which school staff is not adequately informed, trained, or licensed to provide care.
Student should not be at school until health and safety are addressed.
School staff should follow appropriate process to address reasonable accommodations and
school health service provision in accordance with applicable federal and state laws.
Student requiring more care than school staff can safely provide
Student should not be at school until health and safety are addressed.
School staff should follow appropriate process to address reasonable accommodations and
school health service provision in accordance with applicable federal and state laws.
Page 7For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SAMPLE LETTER TO SCHOOL COMMUNITY
BEGIN LETTER PAGE 1
Dear Parent/Guardian:
DO NOT SEND AN ILL STUDENT TO SCHOOL.
Please call the school office to notify us if your student is ill. The box on the back of this page gives
examples of when your student should not be in school.
If your student’s symptoms are related to a chronic condition, contact the school and follow school
policies for chronic condition management.
Please contact your health care provider about serious illness, including any fever of 103°F or higher. If
you need help in finding a health care provider, you may contact your local health department.
Notify school staff if your student requires medication during school hours. Follow school protocols for
medication at school. Unless otherwise instructed, if your student’s illness requires antibiotics, the
student must have been on antibiotics for 24 hours before returning to school. Antibiotics are not
effective for viral illnesses.
To help protect all students, please notify the school if your child is diagnosed with any of these
diseases: chickenpox, COVID-19, diphtheria, E. coli diarrhea, hepatitis, measles, mumps, pertussis,
rubella, Salmonella, scabies, shigellosis, tuberculosis, or another disease as requested. The school will
protect your private information as required by law. [OAR 333-019-0010]
With consent, the school nurse may consult with your doctor about your student’s health in order to
keep your student safe, healthy, and ready to learn.
END LETTER PAGE 1
Page 8For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
BEGIN LETTER PAGE 2
When Should I Keep My Student Home?
NOTE: These are school instructions, not medical advice. Please contact your doctor with health
concerns.
Student’s Symptoms or Illness Student May Return to School When*
Fever: temperature by mouth greater than 100.4 No fever for at least 72 hours without the use of
degrees fever-reducing medicine.
Skin rash or open sores Rash is gone; sores are dry or can be completely
covered by a bandage; or with orders from
doctor to school nurse.
New Cough illness In general, when symptom-free for 72 hours.
If pertussis (whooping cough) is diagnosed, after
taking 5-day course of prescribed antibiotics, or
when cleared for return by local public health
authority. If COVID-19 is diagnosed, with orders
from CCHD.
Diarrhea: 3 loose or watery stools in one day OR Symptom-free for 48 hours.
newly not able to control bowel movements
Vomiting Symptom-free for 48 hours.
Headache with stiff neck and fever; OR with Symptom-free or with orders from doctor to
recent head injury school nurse.
Jaundice: (new) yellow color in eyes or skin After orders from doctor CCHD to school nurse.
Red eyes or eye discharge: yellow or brown Redness and discharge is gone OR with orders
drainage from eyes from doctor to school nurse.
Acting different without a reason: unusually After return to normal behavior OR with orders
sleepy or grumpy OR acting differently after a from doctor to school nurse.
head injury
Major health event, like surgery OR an illness After orders from doctor to school nurse.
lasting 2 or more weeks
Student’s health condition requires more care After measures are in place for student’s safety.
than school staff can safely provide
To notify the school about your student’s illness, please call COIC staff at 541-447-9292 or 541-280-
6604
END LETTER PAGE 2.
Page 9For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Recommended Actions for Symptoms or Health Care Provider Diagnosis
If you become aware the child has any of the following diseases, then clearance by the CCHD is required
before the child returns to school: Chickenpox, COVID-19, diphtheria, hepatitis A, hepatitis E, measles,
mumps, pertussis (whooping cough), rubella, Salmonella enterica serotype Typhi infection, scabies,
Shiga-toxigenic E. coli (STEC) infection (O157 and others), shigellosis, and infectious tuberculosis. Call
Crook County Health Department (CCHD) with questions.
Children with any of the symptoms listed on pages 3–4 should be excluded from school until the
symptoms are no longer present, or until the student is cleared to return by a licensed physician or by a
school nurse, or licensed health practitioner.
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
Spread by:
AIDS (Acquired Immune • Strict adherence to standard
• Direct contact with
Deficiency Syndrome)
potentially infectious blood to
• AIDS is a later stage of an precautions when handling
Exclude: NO broken skin, mucous
infection caused by the Human body fluids
Restriction: NO – See pages 19- membranes or through
Immunodeficiency Virus (HIV). • Report, to school nurse or
21 puncture wounds
• Swollen lymph nodes, loss of administrator, all accidental
Report: YES – call CD
appetite, chronic diarrhea, body fluid exposures to broken
coordinator at CCHD Communicable:
weight loss, fever or fatigue, skin, mucous membranes or
• Lifetime infection after initial
cancers and other infections puncture wounds (e.g., bites,
infection with virus
needle stick injuries)
Spread by:
• Direct contact with infectious • Restrict walking barefoot,
ATHLETE’SFOOT
areas sharing towels, socks & shoes
• Dry scaling and/or cracking
Exclude: NO • Indirect contact with infected • Encourage use of sandals in
blisters and itching, especially
Restriction: No articles shower
between toes and bottoms of
Report: NO • Routine disinfection of
feet
Communicable: showers and locker room floors
• Until treated with approved agents
Exclude: Exclusion status may Spread by:
vary • Direct contact with drainage
BOILS – (See Also STAPH SKIN
according to the state of the from sores or nasal secretions
INFECTION) • Standard precautions
lesion in question. Refer to from carrier
• Large pimple-like sore, • Wash hands thoroughly and
Exclusion Guidelines on pages • Indirect contact with infected
swollen, red, tender may be often
4-5. articles
crusted or draining • No cafeteria duty while
Restriction: May attend with
• Headache, fever may be lesions present
licensed health care provider Communicable:
present • Good personal hygiene
permission, or lesion is dry and • As long as sores drain if
crusted with no drainage untreated
Report: NO
Spread by:
Exclude: Refer to Exclusion • Airborne droplets from • Immunization required – see
CHICKENPOX(Varicella) Guidelines on pages 4-5. coughing website for current
• Malaise, slight fever, blister- Restriction: Exclude until • Direct contact with drainage information: Immunization
like rash, or red rash, usually chickenpox lesions have from blisters or nasal Requirements for School and
beginning on trunk, blisters, crusted or dried with no secretions Child Care | Getting Immunized
scab over further drainage (minimum of • Indirect contact with infected • Exclude exposed, susceptible
5 days after rash appears) articles persons from school
Report: NO • Wash hands thoroughly and
Communicable: often.
Page 10For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
• 2 days before to 5 days after • Cover mouth and nose if
rash appears coughing or sneezing
• Encourage safe disposal of
used tissues
• Contact school nurse
regarding possible
earlier return to school if
lesions are crusted/dried
before 5th day after rash
appears
• Staff and students with
impaired immune responses
should consult their health care
provider, if exposure to a
confirmed or suspected case
has occurred.
Spread by:
• Direct mucosal contact with • Wash hands thoroughly and
infected tissues, secretions and often.
CMV(Cytomegalovirus)
excretions (urine, saliva, breast • Strict adherence to standard
• Caused by a human herpes
milk, cervical secretion and precautions when handling
virus
semen) body fluids.
• Most severe form of the
Exclude: Refer to Exclusion • Indirect contact with infected • Take care when handling
disease occurs to infants
Guidelines on pages 4-5. articles diapers or toileting children
infected from mother during
Restriction: No • Women of childbearing age or
pregnancy, premature infants,
Report: NO Communicable: immunocompromised
and the immunocompromised.
• Virus is secreted in urine and individuals should consult with
• A variety of symptoms can
saliva for many months and their medical provider
occur
may persist or be episodic for regarding risks when caring for
several years after initial children identified as carriers of
infection. CMV.
Spread by:
• Direct contact with nose and
throat secretions
COMMON COLD (Upper • Droplets from coughing or • Wash hands thoroughly and
Respiratory Infection) Exclude: Refer to Exclusion sneezing often
• Runny nose and eyes, cough, Guidelines on pages 4-5. • Indirect contact with infected • Cover mouth, nose if
sneezing, possible sore throat, Restriction: No articles coughing or sneezing
fever uncommon Report: NO • Encourage appropriate
Communicable: disposal of used tissues
• 1 day before onset of
symptoms until 5 days after
COVID-19 Exclude: Refer to pages 1-3 See pages 1-3 See pages 1-3
Exclude: Refer to Exclusion Spread by:
DIARRHEALDISEASES Guidelines on pages 4-5. • Direct contact with feces
• Wash hands thoroughly and
• Loose, frequent stools, Restriction: Exclude students • Consumption of water or
often, especially after using
sometimes with pus or blood with acute diarrhea; see to food contaminated with feces
bathroom or diapering/toileting
• Vomiting, headaches, Exclusion Guidelines on pages
children
abdominal cramping or fever 4-5. Communicable:
• No food handling/preparation
may be present Report: Not usually; depends • Varies from hours to several
• No cafeteria duty
on diagnosis; Report cluster days
outbreaks to DCH.
Page 11For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
• Wash hands thoroughly and
often
• Encourage student to cover
mouth/nose when
Spread by:
coughing/sneezing
FIFTHDISEASE • Droplets from coughing or
Exclude: Refer to Exclusion • Encourage safe disposal of
• Bright red cheeks, blotchy, sneezing
Guidelines on pages 4-5. used tissues
lace appearing rash on
Restriction: May attend with • Contact school nurse for
extremities that fades and Communicable:
licensed health care provider recommendations for pregnant
recurs, runny nose, loss of • Greatest before onset of rash
permission or when no rash or
appetite, sore throat, low when illness symptoms occur
signs of illness are present females / immunocompromised
grade fever, headache • No longer contagious after
Report: NO persons exposed by
rash appears
suspected/confirmed case
• Contact CCHD for latest
recommendation for pregnant
females exposed in school
outbreak situations
Spread by:
HAND, FOOT &MOUTH Exclude: Refer to Exclusion • Direct contact with nose and • Wash hands thoroughly and
DISEASE Guidelines on pages 4-5. throat discharges or feces often
• Sudden onset fever, sore Restriction: May attend with • Good personal hygiene
throat and lesions in mouth licensed health care provider Communicable: especially following bathroom
• Blistered lesions on palm, permission or when blisters • During acute stage of illness use
fingers and soles are gone and potentially for several • Reinforce use of standard
Report: NO weeks after in stool precautions
• Refer to CDC guidance on
Spread by:
head lice.
HEAD LICE • Direct contact with infected
• Check siblings/close contacts
• Itching of scaPV person
Exclude: If required by school for symptoms
• Lice or nits (small grayish • Indirect contact with infected
policy • Avoid sharing/touching
brown eggs) in the hair articles (rarely)
Restriction: NO clothing, head gear,
Report: NO combs/brushes
*See additional ODE guidance Communicable:
• Contact school nurse or local
document on Head Lice • Only when live bugs present
medical provider for further
treatment information.
• Wash hands thoroughly and
HEPATITIS A often
• Sudden onset with loss of Spread by: • No food handling or sharing
appetite, fever, nausea, right • Direct contact with feces • School restrictions on home
upper abdominal discomfort Exclude: Refer to Exclusion • Consumption of water or prepared foods for parties
• Later student may have Guidelines on pages 4-5. food contaminated with feces • Immunization required - see
jaundice (yellow color to skin Restricted: May attend only website for current
and eyes), dark urine, or clay- with CCHD permission. Communicable: information:
colored stools Report: YES • Two weeks before symptoms • Immunization Requirements
• May have mild or no until two weeks after onset for School and Child Care |
symptoms Getting Immunized
• Exclude exposed, susceptible
persons from school
HEPATITIS B & C
Exclude: Refer to Exclusion Spread by:
• Fever, headache, fatigue,
Guidelines on pages 4-5. • Infectious body fluids (blood, • Strict adherence to standard
vomiting, aching, loss of
Restriction: NO – See saliva, semen) getting under
appetite, dark urine,
Guidelines for Bloodborne the skin (e.g., through needles) precautions when handling
abdominal pain, clay- colored
Infections like HIV, Hepatitis B or into the eyes; or through body fluids
stools and jaundice
Page 12For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
and C, pages 20-24 for further sexual contact; or mother to • Report all body fluid contact
information. baby transmission. that penetrates the skin such as
Report: YES bites, scratches and needle
Communicable: sticks to the health consultant.
• One month prior to • Immunization required for
symptoms to 4 to 6 months or Hepatitis B - see website for
longer after jaundice current information:
• Some individuals have no
symptoms but can transmit the Immunization Requirements for
disease. School and Child Care | Getting
Immunized
Spread by:
HIV Disease (Human
• Blood getting under the skin
Immunodeficiency Virus
Exclude: Refer to Exclusion (e.g., through needles); or • Strict adherence to standard
Disease)
Guidelines on pages 4-5. through sexual contact
• May have acute flu-like
Restriction: NO – See • Some individuals have no precautions when handling
illness
Guidelines for Bloodborne symptoms but can spread the body fluids
• Most often, no symptoms
Infections like HIV, Hepatitis B disease. • Report all body fluid contact
present in early stages of
and C, pages 20-24 for further that penetrates the skin such as
infection
information. Communicable: bites, scratches and needle
• AIDS is a later stage of HIV
Report: YES • Lifetime infectivity after sticks to the school nurse.
infection (See AIDS).
initial infection with virus
• Wash hands thoroughly and
often
Exclude: Refer to Exclusion Spread by: • No cafeteria duty while sores
IMPETIGO (See also Staph Skin Guidelines on pages 4-5. • Direct contact with drainage present
Infections) Restriction: May attend with from sores • Avoid scratching or touching
• Blister-like sores (often licensed health care provider sores
around the mouth and nose), permission, or when lesions Communicable: • Cover sores if draining
crusted, draining and “itching” are dry and crusted with no • As long as sore drains if • No sharing personal items
drainage. untreated when lesions are present
Report: NO • No contact sports (wrestling)
if drainage cannot be
contained.
• Vaccination: recommended
annually for all persons ≥6
Spread by:
months of age
• Droplets from coughing or
• Wash hands thoroughly and
sneezing
often
INFLUENZA(flu) Exclude: Refer to Exclusion
• Cover mouth/nose when
• Abrupt onset, fever chills, Guidelines on pages 4-5. Communicable:
coughing or sneezing
headache, muscle aches, cough Restriction: No • 1-2 days before onset of
• Encourage appropriate
Report: NO symptoms, up to 5 days or
disposal of used tissues
more following the onset of
• See website for up-to-date
illness
information:
http://flu.oregon.gov/Pages/Le
arn. aspx
Spread by:
MEASLES • Airborne droplets from
Exclude: Refer to Exclusion • Contact school nurse or
• Fever, eye redness, runny coughing
Guidelines on pages 4-5. health department immediately
nose, a very harsh cough
Restriction: May attend with for direction
• 3–7 days later dusky red rash Communicable:
CCHD permission • School nurse or health
(starts at hairline and spreads • 4 days before rash until 4
Report: YES - Highly department will identify
down); white spots in mouth days after rash begins
Communicable population at risk and assist
• Most contagious 4 days
with parent notification
before rash appears
Page 13For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
• Immunization required – see
website for current
information: Immunization
Requirements for School and
Child Care | Getting Immunized
• Exclude exposed, susceptible
persons from school
• Wash hands thoroughly and
Spread by:
often
• Direct contact with nose and
• Cover mouth/nose when
throat secretions
coughing or sneezing and
• Droplets from coughing or
MENINGOCOCCALDISEASE practice safe disposal of used
Exclude: Refer to Exclusion sneezing
• Sudden onset of high fever, tissues
Guidelines on pages 4-5.
nausea, vomiting, headache, • No sharing food, drink or
Restriction: None necessary. Communicable:
stiff neck, lethargy eating utensils
Patients are not contagious • Until bacteria are no longer
• May have blotchy, purplish, • Meningococcal vaccine
after treatment. present in discharges from
non-blanching rash recommended for students 11–
Report: YES nose and mouth
18 years of age
• Cases and contacts usually no
• See County Health
longer infectious after 24 hours
Department CD
on antibiotics
Specialist for further
information
Exclude: Refer to Exclusion
Guidelines on pages 4-5.
Spread by:
Restrictions: NO – Bed rest for • Wash and disinfect shared
MONONUCLEOSIS • Direct contact with saliva
a time and withdrawal from items/toys which may be
• Fever, sore throat, swollen
PE/Athletic activities are mouthed or in settings with
lymph nodes, fatigue and Communicable:
encouraged until student has children who drool
abdominal pain • May be infectious for several
recovered fully or with • No sharing food, drink or
months
licensed health care provider eating utensils
permission.
Report: NO
• Wash hands thoroughly and
Spread by:
often
• Direct contact with nose and
• Report to school nurse
throat secretions
MUMPS Exclude: Refer to Exclusion • No sharing of personal items
• Droplets from coughing or
• Painful swelling of neck and Guidelines on pages 4-5. • Immunization required - see
sneezing
facial glands, fever and Restriction: May attend with website for current
possible abdominal pain CCHD permission. information: Immunization
Communicable:
Report: YES Requirements for School and
• 2 days before onset until 5
Child Care | Getting Immunized
days after onset of symptoms.
• Exclude exposed, susceptible
persons from school
Spread by:
Exclude: Refer to Exclusion
• Direct contact with infectious
PINKEYE (Conjunctivitis) Guidelines on pages 4-5.
saliva or eye secretions
• Eyes tearing, irritated and Restriction: May attend with • Wash hands thoroughly
• Indirect contact with infected
red, sensitive to light licensed health care • No sharing of personal items
articles
• Eye lids puffy, may have provider/school nurse • Consult with school nurse or
yellow discharge permission or symptoms are licensed medical provider
Communicable:
gone
• As long as drainage is present
Report: NO
Spread by:
PINWORMS Exclude: NO
• Direct contact with infectious
• Nervousness, irritability, Restriction: Restriction may be • Wash hands thoroughly
eggs by hand from anus to
itching of anus, abdominal pain necessary in situations where • Good personal hygiene
mouth of infected person
Page 14For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
• Sometimes no symptoms are students are unable to control • Indirect contact with infected • Consult with school nurse or
present bowel function, otherwise No. articles licensed medical provider
Report: NO
Communicable:
• As long as female worms are
discharging eggs in the anal
area
• Eggs remain infective in an
outdoor area for about 2
weeks
Spread by:
Exclude: Refer to Exclusion • Direct contact with infectious
RINGWORM– SCAPV • Wash hands thoroughly
Guidelines on pages 4-5. areas
• Patchy areas of scaling with • No sharing of personal items,
Restriction: May attend with • Indirect contact with
mild to extensive hair loss especially combs, brushes, hats,
licensed health care provider infectious areas
• May have round areas of etc.
or school nurse permission or
“stubs” of broken hair • It is not necessary to shave
when symptoms are gone. Communicable:
the student’s head.
Report: NO • Until treated
Spread by: • Wash hands thoroughly
Exclude: Refer to Exclusion • Direct contact with infectious • No sharing of personal items
RINGWORM– SKIN Guidelines on pages 4-5. areas • Special attention to cleaning
• Ring-shaped red sores with Restriction: May attend with • Indirect contact with and disinfecting, with approved
blistered or scaly border licensed health care provider infectious areas anti-
• “Itching” common or School Nurse permission or
when symptoms are gone. Communicable: fungal agent, gym/locker areas
Report: NO • Until treated • No sport activity until lesions
disappear
Spread by:
SCABIES Exclude: Refer to Exclusion
• Direct skin contact
• Intense itching, raised small Guidelines on pages 4-5.
• Indirect contact with infected • Wash hands thoroughly
red or pus-filled sores Restriction: May attend with
articles • Screen close contacts/siblings
• Common between fingers, licensed health care
for symptoms
behind knees, around waist, provider/school nurse
Communicable: • No sharing of personal items
inside of wrists, on arms permission
• Until treated
Report: NO
SHINGLES (Herpes Zoster) • Keep lesions covered with
• Painful skin lesions which are dressings. If lesions are on area
a result of the same virus that of body where dressing cannot
Exclude: Refer to Exclusion
causes chicken pox Spread by: be secured (e.g., face, hand),
Guidelines on pages 4-5.
• Lesions may appear in crops • Direct contact with draining consult
Restriction: May attend with
• May occur in immune- skin areas
licensed health care provider
compromised children with school nurse if available or
permission and if lesions can
• Usually on trunk, may be Communicable: DCH.
be covered with dressing or
accompanied by pain, itching • As long as lesions are • Contact school nurse or CCHD
when lesions are
draining for recommendations for
scabbed/dried
or burning of affected area pregnant
Report: NO
• Head ache may precede females/Immunocompromised
eruption person if exposure occurs at
school.
STAPH SKIN INFECTIONS Exclude: Refer to Exclusion Spread by:
• Draining sores, slight fever, Guidelines on pages 4-5. • Direct contact with drainage • Wash hands thoroughly
aches and headache Restriction: May attend with from sores • Good personal hygiene
• Affected area may be red, licensed health care provider • Indirect contact with infected • No sharing towels, clothing or
warm and/or tender permission or when lesions are articles personal items
dry/crusted or gone • No food handling
Page 15For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
SCHOOL EXCLUSION/ SCHOOL
TRANSMISSION/ RECOMMENDED SCHOOL
DISEASE/SYMPTOMS RESTRICTION and REPORTING
COMMUNICABILITY CONTROL MEASURES
TO CCHD
Report: NO Communicable: • No contact sports until lesions
• As long as sores are draining are gone
Spread by:
STREP THROAT – SCARLET
• Direct contact with nose and
FEVER(streptococcal
throat secretions
infections)
• Strep throat: Sore throat, Exclude: Refer to Exclusion
Communicable:
fever, swollen, red tonsils, Guidelines on pages 4-5. • Wash hands thoroughly
• Greatest during symptoms of
tender neck glands, headache, Restriction: May attend with • Encourage covering mouth &
illness. Some individuals are
bad breath, abdominal pain or licensed health care nose when coughing & sneezing
carriers without symptoms and
nausea provider/school nurse • Encourage appropriate
may be infectious for weeks or
• Scarlet Fever: Same as strep permission. disposal of used tissues
months.
throat with a red blotchy, Report: NO
• Treated cases are no longer
sandpapery rash on trunk and
infectious after 24 hours on
a “strawberry” tongue
antibiotics unless fever persists
Spread by:
• Primarily by airborne
droplets from infected person
TUBERCULOSIS
through coughing, sneezing or
(infectious/active) • Observe TB rule compliance:
Exclude: Refer to Exclusion singing
• Fatigue, weight loss, fever,
Guidelines on pages 4-5.
night sweats, cough, chest CDC - Tuberculosis (TB)
Restriction: May attend only Communicable:
pain, hoarseness & coughing • Report to school nurse or
with CCHD permission • As long as living bacteria are
up blood in later stages of consult with county health
Report: YES discharged through coughing.
disease department
Specific drug therapy usually
diminishes communicability
within weeks
Spread by:
• Direct contact nose and
• Immunization required - see
throat secretions
WHOOPINGCOUGH(Pertussis) website for current
• Droplets from coughing or
• Begins with mild “cold” information:
sneezing
symptoms and progresses to
Exclude: Refer to Exclusion
violent fits of coughing spells Immunization Requirements for
Guidelines on pages 4-5. Communicable:
that may end in a whooping School and Child Care | Getting
Restriction: May attend only • Greatest just before and
sound (infants & toddlers) or Immunized
with CCHD permission during “cold” symptoms to
vomiting (older children & • Exclusion of exposed,
Report: YES about 3 weeks without
adults) susceptible persons from
treatment.
• Slight or no fever school may be required; consult
• If treated with antibiotics,
with local public health
infected person is
authority
communicable 5 days
Page 16For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Guidelines for Handling Body Fluids
Standard Precautions
“Standard Precautions” refer to a system of infectious disease control, which assumes the body
fluids of all persons are infectious. Standard Precautions are designed to reduce the risk of
transmission of all communicable diseases, whether a person exhibits symptoms of illness or not.
Standard Precautions refer to the use of barriers or protective measures when dealing with the
following:
• Blood;
• All body fluids, secretions and excretions, except sweat, regardless of whether they contain
visible blood;
• Non-intact skin; and
• Mucous membranes
Strict adherence to Standard Precautions and the appropriate use of personal protective equipment
will decrease the risk of infection from bloodborne microorganisms as well as the transmission of all
communicable diseases.
Only employees who have been trained as described in the Oregon OSHA Bloodborne Pathogens rule
should render first aid, offer assistance for ill or injured students, or be assigned other tasks that involve
the potential risk of body fluid contact (e.g., feeding, diapering or delegated nursing tasks such as
gastrostomy tube feedings or blood glucose monitoring). Other employees should be given information
about avoidance measures. Peer tutors and volunteers in the school must also receive general
information about avoidance measures and cannot be assigned any task or offer assistance with tasks
where there is expected contact with body fluids.
General Recommendations
Education. School personnel and the general public should receive intensive education about
bloodborne infections on a regular basis. This education should emphasize information about how the
infections are spread and how they are not spread. It should be done before problems arise in individual
schools. The Oregon Public Health Division, CCHC, Oregon Department of Education, education service
districts and local school districts should cooperate to deliver this education.
Training. All school staff members, including teachers, instructional assistants, support staff,
administrators, custodians, bus drivers and secretaries should be fully informed of these
recommendations and basic prevention measures including personal hygiene and immunizations as part
of annual in-service training. Adopted procedures should be carried out in all school situations. All COIC
Youth staff undergo Safe Schools training in Blood Borne Pathogens.
Page 17For further COVID-19 information call Katie Plumb, Crook County Health Department 541 447 5165
To report cases, call Crook County Health Department 541 447 5165
________________________________________________________________________________________________________
Standard Precautions. Because of the risk of bloodborne transmission from infected persons, and
because most infected students will not be identifiable, standard precautions should be observed by
persons in all situations involving exposure to blood, body fluids or excrement. Routine care involving
exposure to all children’s body fluids and excrement, such as feeding and diaper changing, should be
performed by persons who are aware of the modes of possible disease transmission.
In any setting, good hand washing after exposure to blood and body fluids and before caring for another
child should be observed and gloves should be worn.
Any open lesions on the caregiver’s hands should be covered. These precautions must be used for all
children, not just those known or suspected to be infected:
Wear disposable gloves when providing first aid for bleeding injuries.
Wash your hands immediately after completing the first aid with soap and running water for at
least 20 seconds (http://www.cdc.gov/Features/HandWashing/).
Avoid skin, mouth or eye contact with the blood from an injured child. If such an exposure
occurs, wash skin with soap and water and rinse eyes or mouth thoroughly with water.
Clean up any spilled blood with absorbent material and clean with soap and water, followed by
disinfectant for 10 minutes. Use germicidal products with an EPA number or a freshly made
solution of 1 part bleach to 9 parts water.
Blood-contaminated items such as gloves, bandages and paper towels should be disposed of
properly. Please consult your district policy for proper disposal of these items.
Report the first aid situation to your supervisor.
Additional Precautions. The following additional precautions should be applied in all school settings.
These procedures will help prevent transmission of many infections in addition to bloodborne
infections. These include:
A sink with soap, hot and cold running water and disposable towels should be available close to
the classroom.
Sharing of personal toilet articles, such as toothbrushes and razors should not be permitted.
Skin lesions that may ooze blood or serum should be kept covered with a dressing.
Exchange of saliva by kissing on the mouth, by sharing items that have been mouthed and by
putting fingers in others’ mouths should be discouraged.
Environmental surfaces and toys that may be regularly contaminated by student’s saliva or
other body fluids should be washed with soap and water and disinfected daily, or anytime they
are soiled. Changing tables should be cleaned and disinfected.
Legal Issues. Oregon law requires health care providers to report any person diagnosed with
hepatitis B, hepatitis C or HIV infection to the CCHD (Oregon County Department Directory).
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