3414P Procedure - Infection Diseases

An infectious disease is caused by the presence of certain microorganisms in the body. Infectious diseases may or may not be communicable or in a contagious state.
Diseases in a contagious state may be controlled by the exclusion from the classroom or by referring the student for medical attention student. Staff members of a school must advise the school nurse and principal or designee when a student exhibits symptoms of an infectious disease based on the criteria outlined in this procedure. The school nurse and principal or designee must be provided with as much health information as is known about the case in a timely manner so that appropriate action can be initiated. (See Infectious Disease Control Guide for School Staff.)
List of Reportable Diseases
In consultation with the school nurse, the district will report suspected disease or disease with known diagnosis to the local health department as indicated on the Notifiable Conditions page of the Washington Department of Health’s website.  
Cluster of Cases
The occurrence of any generalized (covering greater than 75% of the body) rash with or without fever, cough, runny nose, and reddened eyes in a school MUST be reported IMMEDIATELY to the school nurse, who will in turn report as necessary to the local health department. Localized rash cases diagnosed as unrelated to contagious disease, such as diaper rash, poison oak, etc. need not be reported. In addition to rash illnesses, any unusual cluster of infectious disease must be reported to the school nurse.
Identification and Follow-Up
  1. The length of absence from school for a student ill from a contagious disease is determined by the directions given in the Infectious Disease Control Guide, instructions provided by the health care provider, or instructions from the local health officer.
  2. The principal has the final responsibility for enforcing all exclusions.
  3. Follow-up of suspected communicable disease cases should be carried out in order to determine any action necessary to prevent the spread of the disease to additional children.
Reporting at Building Level
  1. A student with a diagnosed reportable condition will be reported by the school principal or designee to the local health officer or state health officer if local health officer is not available) as per the schedule.
  2. When symptoms of communicable disease are detected in a student who is at school, the regular procedure for the disposition of ill or injured students will be followed unless the student is fourteen years or older and the symptoms are of a sexually transmitted disease. In those instances, the student has confidentiality rights that prohibit notification of anyone but the health department. In all other instances, the principal or designee will:
    1. Call the parent, guardian, or emergency phone number to advise him/her of the signs and symptoms;
    2. Determine when the parent or guardian will pick up the student;
    3. Keep the student isolated but observed until the parent or guardian arrives;
    4. Notify the teacher of the arrangements that have been made prior to removing the student from school; and
    5. Notify the school nurse to ensure appropriate health-related interventions are in place.
First Aid Procedures
  1. Students should be asked to wash their own minor wound areas with soap and water under staff guidance when practicable. If performed by staff, wound cleansing should be conducted in the following manner:
    1. Soap and water are recommended for washing wounds. Individual packets with cleansing solutions or saline can also be used;
    2. Gloves must be worn when cleansing wounds which may put the staff member in contact with wound secretions or when contact with any bodily fluid is possible;
    3. Gloves and any cleansing materials will be discarded in a lined trash container that is disposed of daily according to WAC 296-823 - Occupational exposure to bloodborne pathogens and included in the most recent OSPI Infectious Disease Control Guide;
    4. Hands must be washed before and after treating the student and after removing the gloves; and
    5. Treatment must be documented in a health log program.
  2. Thermometers will be handled in the following manner:
    1. Only disposable thermometers, non-mercury thermometers with disposable sheath covers, and/or temporal scan thermometers should be used when taking student's temperatures; and
    2. Disposable sheath covers will be discarded in a lined trash container that is secured and disposed of daily. Temporal scan thermometers will be disinfected after each use.
Handling Of Body Fluids              
  1. Body fluids of all persons should be considered to contain potentially infectious agents (germs). Body fluids include blood, semen, vaginal secretions, drainage from scrapes and cuts, feces, urine, vomit, saliva, and respiratory secretions.
  2. Gloves must be worn when direct hand contact with body fluids is anticipated (e.g., treating nose bleeds, bleeding abrasions), when handling clothes soiled by body fluids (e.g. urine and/or feces), when diapering children, and when sanitizing spaces used for diapering. Hand washing is the most important intervention for in preventing the spread of disease and must take place after gloves are removed and between care of multiple students.
  3. Used gloves must be discarded in a secured lined trash container and disposed of daily according to WAC 296-823 - Occupational exposure to bloodborne pathogens and included in the most recent OSPI Infectious Disease Control Guide. Hands must then be washed thoroughly.
  4. Self-treatment of minor injury, when reasonable, will be encouraged.
  5. Sharps will be disposed in an approved container. Sharps containers must be maintained upright throughout use, be tamper-proof and safely out of students’ reach, be replaced routinely, and not be allowed to overfill.
  6. General cleaning procedures will include use of a 10% bleach solution to kill norovirus and C.difficile spores.
For other universal precautions, the district will comply with WAC 823 - Occupational exposure to bloodborne pathogens and the OSPI Infectious Disease Control Guideline.
Treatment of Students with Chronic Medical Conditions (e.g. HIV; AIDS; Hepatitis)
On the disclosure that a student has been identified as having Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS), or Infectious Hepatitis, the superintendent, principal, parent, local health officer, school nurse, and the student’s licensed healthcare provider will confer as necessary and determine the appropriate placement of the student. The student will be accommodated in a least restrictive manner, free of discrimination, without endangering the other students or staff. The student may only be excluded from school on the written concurrence of the public health officer and the student's licensed healthcare provider that remaining or returning to school would constitute a risk either to the student, employees, or other students.
All discussions and records will be treated as confidential, consistent with RCW 70.24.105.
Release of information regarding the testing, test result, diagnosis, or treatment of a student for a sexually transmitted disease, HIV, drug or alcohol or mental health treatment, or family planning or abortion may only be made pursuant to an effective release and only to the degree permitted by the release. To be effective, a release must be signed and dated, must specify to whom the release may be made, and state the time period for which the release is effective. Students fourteen and older must authorize disclosure regarding HIV, sexually transmitted diseases, or reproductive healthcare issues. Students thirteen and older must authorize disclosure regarding drug or alcohol treatment or mental health treatment. Students of any age must authorize disclosure regarding family planning or abortion. Parents must authorize disclosure pertaining to younger students.
Any disclosure made pursuant to a release regarding reproductive healthcare, including sexually transmitted diseases, HIV/AIDS, or drug or alcohol treatment must be accompanied by the following statement:
"This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is not sufficient for this purpose."
The district will ensure that newly hired school district employees receive the HIV/AIDS training regarding:
  1. History and epidemiology of HIV/AIDS;
  2. Methods of transmission of HIV;
  3. Methods of prevention of HIV including universal precautions for handling of body fluids;
  4. Current treatment for symptoms of AIDS and prognosis of disease progression;
  5. State and federal laws governing discrimination of persons with HIV/AIDS; and
  6. State and federal laws regulating confidentiality of a person’s HIV antibody status.
New employee training will be provided within six months from the first day of employment in the district.
Continuing employees will receive information within one year of district receipt from OSPI on new discoveries or changes in accepted knowledge of transmission, prevention, and treatment for HIV/AIDS.
Date: 4/12/88
Revised: 1/9/91; 10/14/08; 4/9/13; 10/8/13