Communicable Diseases
| Chicken Pox | Hepatitis A |
| Common Cold | Hepatitis B |
| Conjunctivitis (Pink Eye) | Impetigo |
| Fever Blisters/Cold Sores |
Scabies |
| Fifth Disease | Strep Throat/Scarlet Fever |
| Head Lice | Mononucleosis (Mono) |
Chicken Pox
- IMMUNIZATION: Recommended for children 12 months of age and older.
- INCUBATION PERIOD: Usually 13 to 17 days, but ranges from 10 to 21 days.
- SYMPTOMS: Sudden onset of mild fever, rash on second day as superficial raised pimples which shortly become filled with clear fluid. Later, scabs form. Lesions may continue to appear, more on the trunk, up to the tenth day of the disease.
- PERIOD OF COMMUNICABILITY: As long as 5 days but usually 1 to 2 days before onset of rash, and not more than 5 days after onset of rash OR until all lesions are crusted.
- MODE OF TRANSMISSION: From person to person by direst contact with vesicle fluid OR by droplet or airborne spread from respiratory tract of infected person. Also direct contact with lesion fluid of persons with herpes zoster (shingles).
- SCHOOL ATTENDANCE: May return when all lesions are crusted, generally day 6 after onset of rash.
- CONTACTS/ FOLLOW UP: Susceptible individuals should be considered infectious 10-21 days following exposure. Susceptible individuals having serious medical conditions or if pregnant should be refered to their private physicians for evaluation for preventive therapy (VZIG) within 96 hours to prevent or modify disease.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
- IMMUNIZATION: None available.
- INCUBATION PERIOD: Usually 48 hours, but ranges from 12 to 72 hours.
- SYMPTOMS: Runny nose, sneezing, watery eyes, irritated nose and throat, coughing, elevated temperature, chills, aches and fatigue.
- PERIOD OF COMMUNICABILITY: Unknown, but most contagious during presence of acute symptoms such as coughing and sneezing.
- MODE OF TRANSMISSION: Primarily by contact with discharges from respiratory tract of infected persons by airborne route, probably by droplets as well.
- SCHOOL ATTENDANCE: Exclude if fever is greater than 100 degrees F or if excessive coughing is present. Need not be excluded if symptoms are mild/moderate and child is able to participate in routine activities.
- CONTACTS/FOLLOW-UP: Observe for other respiratory or viral illnesses such as strep throat, influenza, or chicken pox which may began with symptoms similar to the common cold. Child's health status should be monitored.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
Conjunctivitis (Pink Eye)
- IMMUNIZATION: None
- INCUBATION PERIOD: Usually 24 to 72 hours
- SYMPTOMS: Reddening of the white of the eye and inner eyelids, with or without purulent (pus) drainage
- PERIOD OF COMMUNICABILITY: Entire course for active infection
- MODE OF TRANSMISSION: Direct contact with discharges from the eye or upper respiratory tract of an infected person; from contaminated fingers, clothing, other items
- SCHOOL ATTENDANCE: Preferably child should not attend school until examined by a physician and approved for re-admission. Otherwise, child should be excluded from school during acute stage of infection
- CONTACTS/FOLLOW-UP: No recommendations
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
Fever Blisters/Cold Sores (Herpes Simplex Latent Infection)
- IMMUNIZATION: None
- INCUBATION PERIOD: 2 to 12 days
- SYMPTOMS: Superficial clear vesicles (fluid filled blisters) on an erythematous base, usually on the face and lips which crust and heal within a few days.
- PERIOD OF COMMUNICABILITY: Until lesions crusted, generally 4 to 5 days. Virus is present in highest concentration in the first 24 hours after appearance of vesicles.
- MODE OF TRANSMISSION: Contact with saliva of infected person or carrier. Avoid mouthing of toys.
- SCHOOL ATTENDANCE: Only children who cannot control oral secretions should be excluded from daycare or school. If herpes lesions are abundant on face or in the mouth, or the child has difficulty chewing or swallowing, they should be evaluated by a physician. Restrict contact with other children who have eczema or skin conditions.
- CONTACTS/ FOLLOW UP: No Recommendations
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
return to topFifth Disease (Erythema Infectiosum, Parvovirus B19)
- IMMUNIZATION: None available.
- INCUBATION PERIOD: Usually 4 to 14 days; may be as long as 28 days.
- SYMPTOMS: May include low grade fever, nonspecific headache and tiredness; within the next week, a red rash generally appears on the face giving a "slapped cheek" appearance. The rash may then extend to the body and tends to fade and reappear. Sometimes, the rash is lacy in appearance and may be itchy. The rash may persist for over a week, and may recur in response to sunlight or a warm bath. Some persons may have vague signs of illness or no symptoms at all.
- PERIOD OF COMMUNICABILITY: Infectious for 1-3 days prior to the onset of the rash. Persons with suppressed immune systems who have chronic infection and severe anemia may be communicable for months to years.
- MODE OF TRANSMISSION: Primarily by direct contact with discharges from respiratory tract of infected persons.
- SCHOOL ATTENDANCE: No exclusion is necessary - may exclude for elevated temperature.
- CONTACTS/ FOLLOW UP: No restrictions. For many years, "Fifth Disease" was viewed as an unimportant rash illness of children. Recent studies have shown that the virus may be responsible for serious complications in persons with chronic red blood cell disorders, persons with impaired immune systems, and pregnant women. When outbreaks occur in situations where there is prolonged contact, such as homes, schools and day care centers, these high risk persons should contact their physician for advice.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
Head Lice (Pediculosis Capitis)
- IMMUNIZATION: None available.
- INCUBATION PERIOD: "Nits" (eggs) hatch in a week and reproduce 8 to 10 days after hatching.
- SYMPTOMS: Irritation and itching of the scalp. Presence of insects and eggs or "nits" in the hair, especially at the nape of the neck and about the ears. Lice may appear lighter on persons with fair hair and dark er on persons with dark hair.
- PERIOD OF COMMUNICABILITY: Communicable when live lice are present and moving and/or viable nits are present on the child.
- MODE OF TRANSMISSION: Direct head to head contact, e.g., crowded sleeping conditions; may also be spread by contact with infested headgear, towels, hairbrushes, combs, pillows, bedding, earphones, etc.
- SCHOOL ATTENDANCE: Exclude until live lice and viable nits are eradicated. This requires effective insecticiding of scalp, skin and clothing. Children may return after being treated with a pediculicide and after delousing of personal articles. It is recommended that schools and day care centers have a "no nit" policy and exclude children until all nits have been removed.
- CONTACTS/ FOLLOW UP: When head lice are found in a setting, all close contacts of the infested child should be examined for signs of itching, redness, nits and lice. All household and other intimate contacts should be examined. Concurrent treatment of the child and all of his or her infested contacts as well as disinfection and treatment of clothing and inanimate objects is necessary to eradicate the infestation. Written materials are available on environmental measures to use to clear up infestations.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
- IMMUNIZATION: Two inactivated vaccines available but not part of standard immunization schedule for children.
- INCUBATION PERIOD: Generally 28-30 days, ranges from 15-50 days.
- SYMPTOMS: Many infections are asymptomatic, especially in young children. Mild to severe symptoms may include any or all of the following: sudden onset of fever, weakness, loss of appetite, nausea, dark urine, abdominal discomfort, followed by jaundice (yellowing of eyes and skin).
- PERIOD OF COMMUNICABILITY: Largely contagious two weeks before symptoms appear until one week after jaundice (3 weeks). If jaundice is not present, person should be considered infectious for the two weeks before symptoms started until two weeks after the start of symptoms (total of 4 weeks).
- MODE OF TRANSMISSION: The hepatitis A virus must enter the mouth and be multiplied in the body and passed in the feces. The virus can then be carried on an infected person's hands and can be spread by direct contact, or by eating or drinking food or beverages that were handled by the infected individual. It can also be spread by drinking water contaminated with improperly treated sewage. The ritual sharing between users of both injectable and inhalable drugs provides an ideal method for the transmission of the virus.
- SCHOOL ATTENDANCE: Children and adults with confirmed hepatitis A infection should be excluded while symptomatic and at least 1 week after onset of illness or until Immune Globulin has been given to appropriate staff and children.
- CONTACTS/ FOLLOW UP: (Per Local Health Department) Immune Globulin (IG) is an effective control measure and is recommended for all households, sexual, drug use, and other at risk contacts within 14 days of exposure to hepatitis A.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
- IMMUNIZATION: Part of standard childhood immunization schedule.
- INCUBATION PERIOD: Generally 60-90 days, ranges from 15-180 days and on occasion as long as 9 months.
- SYMPTOMS: Can be asymptomatic for all ages. Infection in children is symptomatic in less than 10% of cases. Typical signs and symptoms include any or all of the following: fatigue, loss of appetite, dark urine, light stools, nausea, vomiting, yellowing of eyes/skin (jaundice) and abdominal pain - all indistinguishable from other types of hepatitis.
- PERIOD OF COMMUNICABILITY: Several weeks before symptoms appear and generally for several months afterward. For persons who become chronic carriers - infectivity is for life. Persons testing "e" antigen (HBeAG) positive are highly infectious.
- MODE OF TRANSMISSION: Spread by direct contact with infected body fluids (blood, semen, vaginal secretions, saliva), and most commonly by needle sharing, needle stick injury, sexual contact or mother-to-infant perinatal transmission. Because HBV is stable on environmental surfaces for equal to or greater than 7 days, transmission can occur via contact with contaminated objects/items.
- SCHOOL ATTENDANCE: Because hepatitis B is not spread by casual contact, child exclusion from school is not generally warranted or justified. Children who are HBV carriers and who have no behavioral or medical risk factors, such as unusually aggressive behavior (biting), generalized dermatitis, or a bleeding problem, should be admitted without restrictions.
- CONTACTS/ FOLLOW UP: (Per Local Health Department) Household and intimate contacts going back six months from onset of symptoms need to be identified. Immune status needs to be clarified. If contact is unimmunized, hepatitis B immunoglobulin (HBIG) and/or vaccine are recommended dependent on type of exposure. If case is pregnant, careful follow-up must be done to assure appropriate treatment of the newborn.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
Impetigo
- IMMUNIZATION: None
- INCUBATION PERIOD: Variable, usually 1 to 10 days, depending upon causative organism.
- SYMPTOMS: Skin lesions with several stages including raised pimples filled with fluid or pus and crusted areas. The infecting organism may be streptococci or staphylocci or both.
- PERIOD OF COMMUNICABILITY: As long as purulent lesions continue to drain.
- MODE OF TRANSMISSION: Direct contact with drainage from lesions, possibly through contact with contaminated objects.
- SCHOOL ATTENDANCE: Exclude until skin lesions are healed, or until 24 hours after medical treatment has been initiated. Current recommendations may include systemic antibiotic medication in addition to topical antibiotics.
- CONTACTS/ FOLLOW UP: Search for draining lesions
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
return to topScabies
- IMMUNIZATION: None
- INCUBATION PERIOD: 2 to 6 weeks before onset of itching in primary infections; may recur in 1 to 4 days.
- SYMPTOMS: Intense itching. An infectious eruption found most frequently on front of wrists, webs of the fingers, elbows and folds of the skin. Rash is non-specific and easily misdiagnosed.
- PERIOD OF COMMUNICABILITY: From day 1 until day following adequate treatment
- MODE OF TRANSMISSION: Skin-to-skin contact, occasionally via transfer from undergarments or bedclothes, bedding of infected person.
- SCHOOL ATTENDANCE: Exclude until the day after adequate treatment is completed.
- CONTACTS/ FOLLOW UP: Single infections in a family are uncommon. Treat bed mats, family contacts, other close contacts having repeated skin-to-skin contact. Launder bedclothes, sheets, clothes worn in past 3 days by infested person. Launder bedclothes and sheets following treatment of contacts.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
Strep Throat/Scarlet Fever Streptococcal Sore Throat
- IMMUNIZATION: None
- INCUBATION PERIOD: Short, usually ranging 1 to 3 days.
- SYMPTOMS: Streptococcal sore throat is scarlet fever infection without a rash. All symptoms are the same except the rash and peeling do not occur. Sudden onset, with sore throat, fever, tonsillitis or pharynigitis, and tender lymph glands in the neck. Rash, if appears, usually does so within 24 hours upon neck, chest and in the folds of the axilla, elbows and groin. It appears as a fine, pinpoint rash which can be felt (like sandpaper). The face is flushed, with paleness around the mouth. The red papillae of the tongue may show through white coating ("strawberry tongue").
- PERIOD OF COMMUNICABILITY: In untreated, uncomplicated cases, 10-21 days; in untreated persons with purulent discharges, weeks or months; with adequate antibiotic therapy, generally no more than 24 hours from start of therapy.
- MODE OF TRANSMISSION: Mainly contact with respiratory droplets of infected person or carrier. Rarely per casual contact.
- SCHOOL ATTENDANCE: Children should not return to school until at least 24 hours after beginning antibiotic treatment, and until they are fever free. Stress importance of need to complete prescribed treatment.
- CONTACTS/ FOLLOW UP: Symptomatic contacts should be cultured to assure adequate antibiotics treatment if culture is positive for strep.
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.
- IMMUNIZATION: None available.
- INCUBATION PERIOD: From 4 to 6 weeks.
- SYMPTOMS: Sore throat, swollen lymph glands and fever. Disease generally mild in young children.
- PERIOD OF COMMUNICABILITY: Prolonged, may be up to a year or more.
- MODE OF TRANSMISSION: Person-to-person by contact with saliva (i.e: kissing, mouthing of toys of infected person.
- SCHOOL ATTENDANCE: Infected children may attend school.
- CONTACTS/ FOLLOW UP: Not required
Source: Missouri Department of Health, Prevention and Control of Communicable Disease.