Campylobacter
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Usually begin 2 to 5 days after swallowing the bacteria and last for 1 to 2 weeks.1
Diarrhea, abdominal pain, feeling unwell, fever, nausea, and vomiting.1
Symptoms can be mild to severe and can mimic appendicitis. Severe complications are rare.1
Some people recover and then have a relapse.1
Transmission:
Through eating or drinking the organism in undercooked meat and poultry, contaminated food or water, raw milk and other dairy products, and raw vegetables or eggs.1
Through contact with infected pets or farm animals.1
Cross-contamination can occur by touching raw or undercooked meat or poultry and then touching other food or surfaces such as knives, cutting boards, plates, or hands.1
Infectious Period:
The shedding of the bacteria is shortened by antibiotic treatment.5
Without treatment, shedding of the bacteria typically continues for 2 to 7 weeks, and relapse of symptoms may occur.1
Exclusion:
Exclude until symptom free for 24 hours, or 48 hours after completion of antibiotic or anti-diarrheal medications.1
If a relapse occurs, exclude again, and seek medical attention as needed.1
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Chickenpox (Varicella)
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Reporting:
Schools should report cases daily, using the Chickenpox - Daily Reporting Form.
Signs and Symptoms:
Typically begins with a fever, aches, and pains.2
After 1 to 2 days, a rash will develop. The rash is usually itchy and will appear on the scalp and face, spreading quickly down the body and onto the arms and legs. The spots start as flat pink spots that turn into small fluid filled blisters.
After 4 to 5 days, the fluid filled blisters will form scabs.2
Most children will lose their appetite and have a headache during the first few days as well.2
Transmission:
The virus enters the body by the nose or mouth. It usually develops 2 to 3 weeks after contact with an infected person.2
Person to person through direct contact with the virus. It can be spread by touching a blister, or the liquid or wet crust from a blister.2
It can survive in the air for several hours and be caught by being in a room with an infected person or in a room where an infected person has been recently.2
A pregnant woman with chickenpox can pass it on to her baby before birth. Mothers can also give it to their newborn babies after birth.2
Once the rash transitions to scabs, it is no longer contagious.1
It cannot live on objects like sheets, counters, or toys.2
Infectious Period:
It can be contagious for as long as 5 days. However, typically an individual will be contagious 1 to 2 days before the onset of the rash and until all lesions are crusted over.1
Contagiousness may be prolonged in individuals with weaker immune systems.1
Exclusion:
For childcare and schools, no exclusion necessary, unless too ill to participate in activities or has a fever with behavioural change.1
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Gastroenteritis
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Reporting:
Report to the Health Unit as soon as an outbreak is suspected: 2 or more individuals affected within a 48 hour period, with an epidemiological link (specific unit or floor, same caregiver).1
Signs and Symptoms:
Nausea, vomiting, diarrhea, abdominal pain or tenderness, headaches, chills, fever, and/or myalgia.1
Transmission:
Germs can be found in the stool or vomit of infected people and spread easily to others, especially when in direct contact with an infected person who has symptoms.3
Through eating food or drinking liquid that is contaminated.3
Through touching your mouth after touching contaminated surfaces or objects.3
Infectious Period:
Varies depending on the cause of illness.1
Exclusion:
Exclude until the individual has been at least 48 hours without symptoms.8
Once a specific causative agent is known, disease-specific exclusions apply.8
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Giardia
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Some people have no symptoms at all, while others may experience diarrhea, abdominal cramps, bloating, fatigue, weight loss, and frequent passing of loose, pale, or greasy stools.1
Severe complications from prolonged infection include arthritis and damage to the lining of the intestine.1
Transmission:
Swallowing Giardia picked up from surfaces containing stool from an infected person or animal.1
Drinking water or using ice made from water sources where Giardia may live.1
Swallowing water while swimming or playing in water where Giardia may live.2
Eating uncooked or improperly prepared foods that contain Giardia.2
Having direct contact with someone who is ill with Giardiasis.6
Infectious Period:
The contagious period varies but can last for months.1
Individuals are most contagious during the diarrhea phase.5
Exclusion:
Consult with the Health Unit.
If symptomatic and attending childcare or school, exclude until 24 hours after diarrhea has stopped, regardless of taking antibiotics or not.1
If anti-diarrheal medication is taken, exclude until 48 hours after diarrhea has stopped.1
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Hepatitis A
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Reporting:
Report to the Health Unit via telephone immediately.
Signs and Symptoms:
Fever, jaundice (yellowing of the skin and whites of the eye), abdominal discomfort, fatigue, dark-brown urine, nausea, loss of appetite, and occasionally diarrhea can occur.2,5
Children younger than 6 years of age usually have few or no signs or symptoms.1
Symptoms are more common in older children and adults.5
Transmission:
Through eating or drinking something contaminated with the stool of an infected person (food handler), or by close personal contact.1
Through exposure to food or water contaminated with the Hepatitis A virus.1
Outbreaks have been caused by contaminated water, produce, and raw or undercooked shellfish harvested from contaminated water.1
Infectious Period:
It is most contagious during the 2 weeks before symptoms begin until 1 week after the onset of jaundice.5
Exclusion:
Consult with the Health Unit.
Food handlers, childcare staff and attendees, and healthcare workers should be excluded for 14 days after the start of symptoms, or 7 days after the start of jaundice, whichever comes earlier.1
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Hepatitis B
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Many people who are infected do not have any symptoms.5
Those who do have symptoms will experience jaundice (yellowing of the skin and whites of the eye), tiredness, loss of appetite, joint pain, pain in the stomach area, nausea, and/or vomiting.5
Transmission:
Through contact with infected body fluids, such a blood, saliva (spit), semen, and vaginal fluids.2,3
Through contact with blood or body fluids if these get into a cut, break in the skin, or into the eyes or mouth; during sex; from sharing needles during drug use; from infected and non-sterilized needles in a tattoo or piercing shop; or from sharing toothbrushes or razors.2
Infectious Period:
It can be spread as long as the virus is present in the blood of the infected person. This can be for the lifetime of an infected person who is a chronic carrier.5
Exclusion:
No exclusion required.
Children with Hepatitis B should never be excluded from childcare based solely on their Hepatitis B virus status. Children with behavioural or medical risk factors, resulting in a high-risk for biting, should be assessed on a case by case basis by the child's treating physician.3
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Influenza
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Reporting:
Only laboratory confirmed cases are reportable to the Health Unit.
Signs and Symptoms:
A new or worsening cough, shortness of breath, fever, sore throat, headache, muscle aches, and tiredness.1
Infections in children may also be associated with some gastrointestinal symptoms such as nausea, vomiting, and/or diarrhea.1
Transmission:
Through the air when a person coughs or sneezes. The droplets released by the sick person may land in the eyes, nose, or mouth of a person nearby (within 2 metres).1,2
Directly through kissing, touching, or holding hands with an infected person.2
Indirectly through touching contaminated objects or surfaces (toy, doorknob, used tissue) and then touching one's face or eyes.1,2
Infectious Period:
Potentially 24 hours prior to the onset of symptoms.1
It's ability to shed in nasal secretions (mucus) is usually highest during the first 3 days of illness and stops within 7 days.1
The infectious period can be longer in young children or those who are immunocompromised.1
Exclusion:
Ill individuals should remain home until they do not have a fever, do not develop any new symptoms, and symptoms have been improving for at least 24 hours (48 hours for nausea, vomiting, and/or diarrhea).9
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Measles
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Reporting:
Report to the Health Unit via telephone immediately.
Signs and Symptoms:
Begin 7 to 21 days after exposure to a case of measles and will include fever, cough, drowsiness, irritability, and conjunctivitis.1
Small, white spots can appear on the inside of the mouth and throat but are not always present.1
3 to 7 days after the start of symptoms, a red blotchy rash appears on the face and progresses down the body.1
Complications can include diarrhea, pneumonia, blindness, and encephalitis (swelling of the brain).1
Transmission:
Measles is highly contagious and is spread from person to person through droplets from an infected person's nose or throat (sneezing and coughing).1
Measles can remain in the air of closed spaces for up to 2 hours after an infected individual leaves the room, and it can be caught just by being in a room1 with a person with measles or where someone with measles has been recently.2
Infectious Period:
It is very contagious.2
It is most contagious from 4 days before the rash appears to 4 days after the rash appears.1
Those who are immunocompromised (weakened immune system) may be contagious for the duration of their entire illness.1
Exclusion:
Exclude from work, school, childcare, and other activities for 4 days from the onset of the rash and only return once well enough to participate comfortably in activities.3
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Meningitis
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Reporting:
Report to the Health Unit via telephone immediately.
Signs and Symptoms:
Sudden onset of a high fever, severe headache, vomiting, confusion, seizures, drowsiness, stiff neck, and skin rash.1
Newborns and infants may present with irritability, refusing meals, unusual sleep patterns, and constant crying.1
Newborns and infants may also have bulging of the soft spots on their heads and lower than normal body temperature.1
Transmission:
Depends on the causative agent.1
Through direct contact or droplets from respiratory secretions (mucus and spit) from the nose or throat.1
Through kissing, coughing, or sneezing when others are nearby.2
Through saliva (spit) when sharing food or drinks (same cup, can, water bottle, drinking straw), mouthed toys, or musical instruments with a mouthpiece.2
Infectious Period:
For enterovirus viral meningitis, shedding of the virus in stool can continue for several weeks, but shedding from the respiratory tract usually lasts a week or less.5
For Haemophilus Influenzae Type B (Hib), meningococcus, and S. pneumoniae, it remains contagious until 24 hours of antibiotics have been completed.5
Exclusion:
Exclude until recovered and well enough to participate comfortably in all activities.3
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Mumps
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Fever, swelling or tenderness of the salivary glands, headache, or cold-like symptoms.1
In some cases, meningitis (a serious disease that infects the fluid around the brain and spinal cord) or encephalitis (swelling of the brain).2
Transmission:
Person to person through droplets from the nose or throat of an infected person. These droplets may land in the nose or mouth of someone who is close by, especially when the infected person coughs or sneezes.2
Contact with saliva (spit) of an infected person through kissing, sharing a glass, or sharing a toy that has been in the mouth.1,2
Infectious Period:
Mumps can be contagious from 7 days before to 5 days after the swelling of the glands occur.1
Exclusion:
Exclude from childcare, school, work, or group activities for 5 days after parotid (salivary glands located between the ear and jaw) swelling appears.3
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Rubella (German Measles)
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Reporting:
Report to the Health Unit via telephone immediately.
Signs and Symptoms:
A rash, of pink or light red spots, that starts on the face and then spreads to the rest of the body. The rash lasts for about 3 days.1,2
Runny nose, swollen glands in the neck (especially behind the ears), eye infection or inflammation, fever, and headache.1,2
Rarely, encephalitis (swelling of the brain) can occur.1
The sickness lasts for about 3 days and generally gets better on its own without any complications. In teens and adults, rubella can be a more serious disease. Joint pain is common.2
Transmission:
Person to person through droplets from an infected person's nose or throat (coughing and sneezing).3
Infectious Period:
Transmission can occur 1 week before to 1 week after the rash first appears.3 This is when it is most contagious.2
Infants with congenital rubella syndrome may shed the virus in respiratory secretions (mucus and spit) and urine for up to a year after birth.3
Exclusion:
Individuals with rubella infection should avoid contact with pregnant females and be excluded from work, school, childcare, and other activities for 7 days after the onset of the rash.3
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Salmonella
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
A sudden onset of headache, fever, abdominal pain, diarrhea, nausea, and sometimes vomiting.1
Transmission:
Through eating food contaminated with the bacteria.6
Person to person through unwashed hands. The bacteria are passed in the stool, and if hands are not washed, food or other objects can become contaminated. The bacteria can then be swallowed by another person, who in turn becomes ill.1
Any raw animal food may carry Salmonella. If these foods are not properly cooked, the bacteria can survive to cause illness when these foods are eaten.1
Through contaminated water.6
Through eating raw fruits and vegetables that not properly washed or are contaminated during food preparation.6
Through contact with animals and their stool.6
Infectious Period:
It sheds in the stool for several days to several weeks after symptoms have resolved.
Rarely, the bacteria can be shed in stool for up to 1 year.1
If antibiotics are used, the amount of time that Salmonella sheds can be longer.1
Exclusion:
Contact the Health Unit.
Food handlers, childcare workers and attendees, and those caring for high-risk individuals should be excluded until symptom free for 24 hours, or symptom free for 48 hours after discontinuing use of anti-diarrheal medications.1
If a relapse occurs, exclude again, and seek medical attention as needed.1
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Shigella
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Watery and loose stools, fever, nausea, abdominal cramps, and vomiting.1
Stools may contain mucus and blood.1
Transmission:
The bacteria are found in the stool of an infected person and can be spread through the oral-fecal route. This means that the stool (usually tiny and invisible amounts) from the infected person gets into the mouth of another person and causes infection.1
It can get into food or water and will cause infection for those who eat or drink it.1
Infectious Period:
The bacteria can still be in the stool of the infected person for up to 4 weeks after illness.5
Some people who are infected may have no symptoms at all but may still pass the bacteria to others.6
Exclusion:
Contact the Health Unit.
Food handlers, healthcare providers, caregivers, or childcare attendees are excluded until they receive one negative stool sample or rectal swab collected at least 24 hours after symptoms stop, or 48 hours after they have been on antibiotics.1
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Verotoxin-Producing Escherichia Coli Infection Indicator Conditions, Including Hemolytic Uremic Syndrome (HUS)
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Diarrhea (which may contain blood), abdominal pain or cramps, vomiting, and dehydration.1
Symptoms can be mild or severe, and usually last less than 5 days.1
Transmission:
Through consuming contaminated food or drink, including undercooked ground beef, lettuce, raw spinach, coleslaw, sprouts, melons, unpasteurized milk and soft cheeses, unpasteurized juice or cider, drinking water or recreational water.1
By not washing hands after touching or handling animals, and by having close contact with someone who has the infection.1
Infectious Period:
It is contagious for as long as the organism is shed, which is usually less than 1 week in adults, but as long as 3 weeks in some children.6
Exclusion:
Contact the Health Unit.
Symptomatic individuals are advised to stay home until two consecutive negative stool specimens or rectal swabs are taken, at least 24 hours apart, and at least 48 hours after the completion of antibiotic and/or anti-diarrheal therapy medications have been used.1
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Whooping Cough (Pertussis)
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Reporting:
Report to the Health Unit via telephone by next working day.
Signs and Symptoms:
Similar to the common cold for the first 2 weeks, including runny nose, red watery eyes, mild fever, and cough.2
The cough can be so aggressive that children vomit or have trouble breathing. It is usually severe for 2 to 3 weeks.2
Transmission:
Through direct contact with droplets from the nose or throat when an infected person coughs or sneezes.3
Infectious Period:
It is most contagious during the first 2 weeks of illness.1 A person is no longer contagious after 5 days of proper antibiotic treatment. If antibiotics are not prescribed, a person can be contagious for 21 days after the cough first started.1
Exclusion:
Contact the Health Unit.
Exclude until an appropriate antibiotic has been taken for 5 full days.3
If no treatment is given, exclude for 3 weeks from the start of the coughing spell.3
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Yersiniosis
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Reporting:
Report to the Health Unit by next working day.
Signs and Symptoms:
Diarrhea, abdominal pain, generally feeling unwell (malaise), fever, nausea, and/or vomiting.1
Diarrhea is more severe in children.1
Transmission:
Fecal-oral spread can occur through contaminated food or water or contact with infected people or animals (puppies and kittens).1
Raw pork and pork products are known to be sources of infection.1
Infectious Period:
Secondary transmission appears to be rare. It can be shed in stool as long as symptoms are present, usually for 2 to 3 weeks. If untreated, people may shed for 2 to 3 months.2
It can be carried by individuals (adults and children) who do not have symptoms.2
Exclusion:
Contact the Health Unit.
Exclude until symptom free for 24 hours, or 48 hours after completion of antibiotic or anti-diarrheal medications.1
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Cold Sores (Herpes Simplex)
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
During the first (primary) infection, individuals may experience fever, irritability, tender or swollen lymph nodes, painful and fluid-filled blisters in the mouth, gums, or on the lips.5
After the first infection, subsequent infections may occur with clusters of blisters on the lips, commonly called 'cold sores'. During this infection, there are no signs or symptoms.5
Transmission:
Through direct contact with infected lesions or mouth secretions, such as saliva (spit) or drool.6
Infectious Period:
During the first infection, people shed the virus for at least 1 week, and occasionally, for several weeks after signs or symptoms appear.5
After the first infection, the virus may be reactivated from time to time.5
Compared to the first infection, people with recurrent cold sores shed smaller amounts of virus and only for 3 to 4 days after signs and symptoms appear.5
Exclusion:
No exclusion required for simple cold sores.3
Children who attend school or childcare that have extensive mouth lesions and are drooling should be excluded until they can eat comfortably and are well enough to participate in all program activities.3
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Common Cold
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Runny or stuffy nose, sneezing, coughing, headache, sore throat, loss of appetite, tiredness, and mild fever.2
Transmission:
Through the air when a person coughs or sneezes. The droplets released by the sick person may land in the eyes, nose, or mouth of a person nearby (within 2 metres).1,2
Directly through kissing, touching, or hand holding with an infected person.2
Indirectly through touching contaminated objects or surfaces (toys, doorknobs, used tissues) and then touching one's face or eyes.1,2
Infectious Period:
On average, people are considered contagious for about 7 days after their symptoms begin.5
Exclusion:
Ill individuals should remain home until they do not have a fever, do not develop any new symptoms, and symptoms have been improving for at least 24 hours (48 hours for nausea, vomiting, and/or diarrhea).9
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Ear Infections (Otitis Media)
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Unexplained fever, fussiness, difficulty sleeping, tugging or pulling at the ears, and having trouble hearing sounds.5
Transmission:
An ear infection is usually a complication of a cold and does not spread from person to person.3
Infectious Period:
Ear infections are not contagious, but the viral illness that caused the infection can be.2
Most ear infections happen when a person has already had a cold for a few days.2
Exclusion:
No exclusion necessary, unless too ill to participate in activities or has a fever with behavioural change.3
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Fifths Disease
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Fever, muscle pain, headache, sore throat, runny nose, and generally feeling unwell (malaise), up to 21 days before the rash occurs.5
Red "slapped cheek" rash begins on the face and, after 1 to 4 days, is followed by a red, lace-like, itchy rash that appears on the trunk, arms, buttocks, and thighs. It then spreads to the rest of the body.2,3
The rash may last for 1 to 3 weeks. During that time, the rash may come and go. It can be worse with changes in temperature, exposure to sun, and exercise.2
Transmission:
It spreads the same as a cold virus.2
Person to person through direct contact with secretions (mucus and saliva [spit]), after an infected person has coughed or sneezed.2,3
Through touching the hands of an infected person and then putting your hands in your mouth.2
Through touching an object (toy or bottle) that has been touched by someone who has the infection and then putting your hands in your mouth.2
The virus can also be spread from a pregnant woman to her unborn child.2
Infectious Period:
A person is infectious until the rash appears.5
The virus is most contagious a few days before the rash appears. Once the rash appears, it can no longer be spread to anyone else.2
Exclusion:
No exclusion necessary, unless too ill to participate in activities or has a fever with behavioural change.3
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Hand/Foot/Mouth Disease
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Fever, small and painful ulcers in the mouth, or a skin rash that looks like red spots, often with small blisters on top that appear on the palms of the hands, soles of the feet, buttocks, and sometimes will be on other places on the body.2
Headache, sore throat, loss of appetite, lack of energy, vomiting, and/or diarrhea.2
Transmission:
Person to person through direct or indirect contact with the virus present in an infected person's stool or saliva (spit).3 Germs can get on a person's hands or other objects, then spread into someone's mouth, causing infection.2
The virus may remain in the stool for 4 weeks after the onset of illness.3
It is not spread by animals.2
Infectious Period:
It is most contagious during the first week of illness.2
The virus may shed for weeks to months in the stool after the infection starts.5
Respiratory shedding of the virus is usually limited to 1 to 3 weeks.5
Exclusion:
No exclusion necessary, unless too ill to participate in activities or has a fever with behavioural change.3
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Head Lice
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Itching of the skin where lice feed on the scalp or neck.5
Nits attached to hair, most easily seen behind ears and at, or near, the nape.5
Scratching behind the ears and the nape.5
Open sores and crusting from secondary bacterial infection may cause swollen lymph nodes.5
Transmission:
Head lice do not transmit disease, but they do spread through direct or indirect contact, from items such as shared hats, combs, hairbrushes, hair ornaments, and headphones.3
They crawl very quickly.3
People cannot get head lice from animals.2
Infectious Period:
Contagious until live lice are no longer present.5
Nits hatch in 9 to 10 days.2
Lice can live up to 30 days on a person's head, but they die within 2 days away from the scalp.2
Exclusion:
Those with head lice should be treated and can attend school, childcare, or work as usual*.2,3
*Consult with your school, childcare, or work policy.
Note: The North Bay Parry Sound District Health Unit (Health Unit) does not provide clearance to return to school, childcare, or work. The Health Unit does not perform head checks for lice.
Key Messages about Head Lice Fact Sheet
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Impetigo
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Small, red pimples or fluid-filled blisters with crusted yellow scabs usually on the face (around the mouth, nose, or other skin that is not covered by clothes2) but may be anywhere on the body.5
The sores are generally painless, although there may be burning or itching present.3
Fever, pain, swelling, and weakness can occur if it is more serious.3
Transmission:
Through direct contact when someone touches an impetigo rash.2
Through indirect contact as the germs can get on bed sheets, towels, or clothing that have been in contact with someone's skin. Another person can pick up the germs from touching these objects.2
It can be spread from one part of the body to another by scratching with contaminated fingers.3
Infectious Period:
It remains contagious until at least 24 hours of antibiotic treatment has been completed.5
If untreated, it is contagious until the sores are crusted and healed.5
Exclusion:
Those infected should be excluded from childcare, school, or work until 24 hours after treatment with antibiotics has been started.3
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Mononucleosis
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Usually mild or none, especially in young children.5
Fever, sore throat, fatigue, swollen lymph nodes, and enlarged liver and spleen.5
Rash may occur in those treated with ampicillin or other penicillin.5
Transmission:
Person to person through contact with saliva (spit) or nose and throat secretions of an infected person. This includes coughing or kissing.6
Through sharing objects contaminated by an infected person. This includes toys that children may chew on, or prechewed food given to an infant.6
Infectious Period:
The virus is excreted for many months after infection, and virus shedding can occur intermittently throughout life.5
Exclusion:
No exclusion necessary, unless too ill to participate in activities or has a fever with behavioural change.3
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Norovirus
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Reporting:
Report to the Health Unit as soon as an outbreak is suspected: two or more individuals affected within a 48 hour period, with an epidemiological link (specific unit or floor, same caregiver).1
Signs and Symptoms:
Sudden onset of vomiting, watery diarrhea, nausea, abdominal cramps, and generally feeling unwell (malaise). Fever, headache, or body aches may occur.6
Symptoms can last for 24 to 72 hours.6
Transmission:
Germs can be found in the stool or vomit of infected people and spreads easily, especially when in direct contact with an infected person who has symptoms.6
Through touching contaminated surfaces or objects and then touching your eyes, nose or mouth; it may survive on surfaces for days or weeks.6
Through eating contaminated food or drinks.6
Infectious Period:
Infected individuals are most contagious while sick. However, the virus can be found in stool, even before feeling sick. It can live in stool for 2 or more weeks after recovery, so it is important to wash hands frequently during this time.6
Exclusion:
Exclude until the individual has been at least 48 hours without symptoms.8
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Pinkeye (Conjunctivitis)
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
A scratchy feeling or pain in the eyes, often with lots of tearing.3
The whites of the eyes are pink or red.3 They eyelids may also be swollen.2
Pus or a discharge from the eyes makes eyelids sticky during sleep.3
Transmission:
Spreads easily through direct and indirect contact3 or through droplets.2
Direct contact occurs when tears or discharge from an infected person's eyes are touched and transferred by the fingers to the eyes of another person.5
Indirect contact occurs when an object contaminated with eye fluid is touched or touches another person's eyes.3
Droplet spread occurs when pinkeye is caused by a common cold, as droplets from a sneeze or cough can spread it.2
Infectious Period:
Bacterial conjunctivitis: the contagious period ends when the course of medication is started or when the symptoms are no longer present.5
Viral conjunctivitis: the contagious period continues while the signs and symptoms are present.5
Allergic/Chemical/Immune mediated conjunctivitis: no contagious period.5
Exclusion:
If the pinkeye is caused by bacteria, exclude until the individual has taken antibiotics for 24 hours.2
If the pinkeye is caused by a virus, no exclusion required if no other symptoms are present.3
No recommended exclusion if there is no eye discharge.3
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Pinworms
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
People may feel very itchy around the anus and vagina, especially at nighttime.2
If the infection is bad, people may lose sleep.2
Some people will have no symptoms.2
Transmission:
Directly when an infected person who scratches the itchy area gets pinworm eggs on the fingers or under the fingernails. If that person touches another person's mouth, they will spread pinworms.2
Indirectly, as eggs can get onto objects such as toys, toilet seats, bathtubs, clothes, or bedding. By sharing these objects, other people can pick up the eggs on their hands and then put them into their mouth.2
Infectious Period:
Pinworms are contagious if the female worms are laying eggs on the skin, around the anus.5
Eggs can live for up to two weeks outside the body, on clothing, bedding, or other objects.2
Exclusion:
Exclusion is not recommended.3
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Respiratory Syncytial Virus (RSV)
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Cough, runny nose, fever, decreased appetite, decreased energy, and irritability.2
Transmission:
RSV is very contagious and spreads the same way as a common cold.2
Through touching droplets containing the virus after someone coughs or sneezes.2
Being close (within 2 metres) to an infected person who is coughing or sneezing.2
Through touching something that has been contaminated by an infected person (toys, door handles, countertops).2
Infectious Period:
It can shed for up to 3 to 4 weeks in young infants, usually beginning a day or so before signs or symptoms appear.5
Exclusion:
Ill individuals should remain home until they do not have a fever, do not develop any new symptoms, and symptoms have been improving for at least 24 hours (48 hours for nausea, vomiting, and/or diarrhea).9
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Ringworms
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
A rash, caused by fungus, that may be ring-shaped, with a raised edge, and scaly patches that blister and ooze. It is usually quite itchy and flakey, and may occur on a person's scalp, body, groin, or feet.2,3
Transmission:
Person to person through direct skin to skin contact or by touching contaminated items (combs or unwashed clothing), locker rooms, or shower and pool surfaces.3
Individuals can also catch ringworm from pets that carry the fungus. Cats and dogs are common carriers.2,3
Infectious Period:
Ringworm of the skin is infectious if the fungus remains present when the lesion starts to shrink.5
It is contagious until treatment has started.5
Exclusion:
Exclude until treatment has started.3
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Roseola (Sixth Disease)
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
High fever lasting 3 to 7 days. Fever may cause seizure activity.5
Children may be cranky or irritable.2
Pinkish red, raised rash lasting from hours to several days that becomes apparent on the day the fever breaks. The spots will turn white when touched and may have a lighter ring around them. The rash usually spreads to the neck, face, arms, and legs. It is usually not itchy.2,5
Many children will not present with any symptoms at all.5
Transmission:
It is contagious even if there is no rash.3
Person to person through close contact with saliva (spit), as the virus can be found in the saliva of many people, even when no symptoms are present.3 It can get onto people's hands and then they rub their eyes or nose and become infected.2
Indirectly, when germs in the nose and throat of an infected person spread through the air as droplets from a cough or sneeze.2
Infectious Period:
After infection, the virus is present in the saliva, on and off, for the rest of a person's life.5
Exclusion:
No exclusion necessary, unless too ill to participate in activities or has a fever with behavioural change.3
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Rotavirus
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Reporting:
Report to the Health Unit as soon as an outbreak is suspected: two or more individuals affected within a 48 hour period, with an epidemiological link (specific unit or floor, same caregiver).1
Signs and Symptoms:
The first signs are usually fever and vomiting.2 Within 12 to 24 hours, people start to pass large amounts of watery diarrhea.2
Severe diarrhea and dehydration are the most common. Dehydration can happen as soon as 6 hours after the illness starts.2
The illness typically lasts 5 to 7 days.2
Transmission:
Germs can be found in the stool or vomit of infected people and spread easily, especially when in direct contact with an infected person with symptoms.6
Through eating contaminated food or drink.6
Through touching your mouth after touching contaminated surfaces or objects, or when in direct contact with an infected person with symptoms.6
Infectious Period:
Rotavirus is not usually detectable after approximately the 8th day of infection.6
Exclusion:
Exclude until the individual has been at least 48 hours without symptoms.8
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Scabies
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Rash with small, red, raised spots. It is very itchy, usually worse at night. It is found in skin folds between fingers and toes, in the groin area, or around the wrists or elbows, but can be anywhere on the body.2
In infants and young children, the rash can look like marks that appear on the scalp, face, neck, chest, abdomen, and back.2
Transmission:
Through prolonged, close contact, such as when people share a bed. It often spreads within a household.2,3
Short contact, like shaking hands or a hug, usually will not spread scabies.2
Mites cannot live away from human skin for more than 3 days.3
Occasionally, it can be spread from someone's clothes or personal items like bedding.2
Mites on clothing die immediately when the clothing is washed in hot water and dried in a hot dryer.3
Infectious Period:
It is contagious until mites and eggs are destroyed by treatment.5
Exclusion:
Exclude from childcare, school, or work until 24 hours after first treatment has been applied.3
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Scarlet Fever
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Usually begins with a very red sore throat, and fever. There may also be swollen neck glands, chills, body aches, nausea, vomiting, abdominal pain, headache, and loss of appetite.5
1 to 2 days later, a fine red rash starts that feels like sandpaper when touched. Bright red skin often appears on underarms, groin, elbow creases, neck, chest, and inner surface of the thighs.5
The rash generally fades in about 7 days. As the rash fades, the skin may peel at the fingertips, toes and groin areas. The peeling can last for several weeks.7
There may be a whitish coating on the tongue or back of throat, and a strawberry tongue.7
Transmission:
Through direct contact with an infected person or from the large droplets that form when an infected person talks, coughs, or sneezes. If the droplets touch the mouth, nose, or eyes, they can cause infection.6
Those who are sick with an upper respiratory tract infection are more likely to transmit the infection.6
It typically takes 2 to 5 days for someone exposed to Group A Streptococcus (a bacteria) to become sick with scarlet fever.7
Infectious Period:
Generally, no longer contagious after 24 hours of treatment with antibiotics.6
If untreated, usually less contagious after 2 to 3 weeks but can be contagious for weeks or months.6
Exclusion:
Exclude if too ill to take part in routine activities and until 24 hours of antibiotic treatment is taken.3
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Strep Throat
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Generally, strep throat is a mild infection, but it can be very painful.7
A sore throat that can start very quickly, pain when swallowing, fever, red and swollen tonsils; sometimes with white patches or streaks of pus, tiny red spots on the roof of the mouth, or swollen lymph nodes.7
Some children complain of headache, nausea, or a sore stomach.2
Children with strep throat do not usually have cold symptoms (cough and runny nose).2
Transmission:
Through direct contact when someone comes into contact with an infected person's saliva (spit), nose, or sore on the skin.2
Through indirect contact when germs in the nose and throat of an infected person spread through the air (as droplets) from a cough or sneeze.2
Those who are sick with an upper respiratory tract infection are more likely to transmit the infection.6
Infectious Period:
Generally, no longer contagious after 24 hours of treatment with antibiotics.6
If untreated, usually less contagious after 2 to 3 weeks but can be contagious for weeks or months.6
Exclusion:
Exclude if too ill to take part in routine activities and until 24 hours of antibiotic treatment is taken.3
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Thrush
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Reporting:
Individual cases not reportable to the Health Unit.
Signs and Symptoms:
Whitish grey patches on the inside of the cheeks, the roof of the mouth, on gums, and the tongue. Although the patches look like milk, they cannot be rubbed off.2,5
Usually not painful.2
Usually causes no other signs or symptoms.5
Transmission:
Candida, the yeast (a type of fungus) that can cause thrush, is spread through direct contact.3
It can pass from mother to infant at birth, or while breastfeeding.3
Bottle nipples or soothers that have been contaminated with the fungus can also spread it.3
Boiling bottle nipples and soothers can help prevent thrush.3
Infectious Period:
Candida is widespread in the environment, normally lives on the skin, and is found in the mouth and stool.5
Mild infection of the lining of the mouth is common in healthy infants.5
Thrush can occur during or after antibiotic use.5
Repetitive or severe thrush could signal immune problems.5
Exclusion:
Children with thrush or Candida diaper rash can continue to attend childcare, provided they feel well enough to participate comfortably in all program activities.3
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