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 of the infected student from the classroom or by referral for medical attention. Staff members of a school must advise the principal/school nurse when a student possesses symptoms of an infectious disease. The principal/school nurse 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, OSPI).
Notifiable Conditions for Reportable Diseases
Selected diseases must be reported to the local public health authorities at the time a case is suspected or diagnosed. A current list and reporting schedule of notifiable conditions may be found at www.doh.wa.gov or by contacting the local health department.
The local health department will be notified of cases or suspected cases or outbreaks and suspected outbreaks of diseases that may be associated with the school. In order to prevent outbreaks of measles and spread of the disease in school, any rash illness suspected of being measles must be reported immediately. The occurrence of any generalized rash with or without fever, cough, runny nose, reddened eyes in a school must be reported immediately by telephone to the local health department. Localized rash cases such as diaper rash, poison oak, etc. need not be reported.
Identification and Follow-Up
A. The length of absence from school for a student ill from an infectious disease is determined by the directions given in the Infectious Disease Control Guide, instructions provided by the attending physician, or instructions from the local health officer.
B. The principal has the final responsibility for enforcing all exclusions.
C. Screening procedures may be instituted to determine the existence of nuisance type diseases. Cases found shall be evaluated on an individual basis to determine exclusion from school. Information will be sent home to parents/guardians of classmates of a suspected case.
Reporting at Building Level
A. A student who has a reportable disease shall be reported to the local health officer as per Department of Health schedule by the school principal/school nurse.
B. When symptoms of an infectious disease are detected in a student who is at school, the regular procedure for the disposition of ill or injured students shall be followed. In those instances the student has confidentiality rights that proscribe notification of anyone but the Department of Health. These procedures do not apply if the student is 14 years or older and the symptoms are of a sexually transmitted disease. The principal or designee will:
- Call the parent/guardian or emergency phone number to advise him/her of the signs and symptoms.
- Determine when the parent/guardian will pick up the student.
- Keep the student isolated, but observed, until the parent/guardian arrives.
- Notify the teacher of the arrangements that have been made prior to removing the student from school.
First Aid Procedures
A. Wound cleansing should be conducted in the following manner:
- Soap and water are recommended for washing wounds. Individual packets with cleansing solutions can also be used.
- Gloves must be worn when cleansing wounds which may put the staff member in contact with wound secretions.
- Gloves and any cleansing materials will be discarded in a lined trash container that is disposed of daily.
- Hands must be washed before and after treating the student and after removing the gloves.
- Treatment must be documented in a health log.
B. If a thermometer is needed, only reliable disposable thermometers will be used.
Handling of Body Fluids
A. Body fluids of all persons should be considered to contain potentially infectious agents. Body fluids include blood, semen, vaginal secretions, drainage from scrapes and cuts, feces, urine, vomitus, saliva, and respiratory secretions.
B. Gloves must be worn when direct hand contact with body fluids is anticipated (e.g., treating nose bleeds or bleeding abrasions), when handling clothes soiled by urine and/or feces, and when diapering children. If gloves are not available, then hand washing is most important in preventing the spread of disease.
C. Used gloves must be discarded in a secured lined trash container and disposed of daily according to WAC 296-62-08001, Bloodborne Pathogens and included in April 2004 SPI Infectious Disease Control Guide. Hands must then be washed thoroughly.
D. Self-treatment, when reasonable, shall be encouraged.
E. For other universal precautions, the district shall comply with WAC 296-62-08001, Bloodborne Pathogens and the SPI Infectious Disease Control Guideline.
Special Treatment of Students Infected with HIV
A. On the disclosure that a student has been identified as being infected with HIV, the superintendent, principal, parent, local health officer, school nurse and the student’s personal physician shall 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 local health officer and the student’s personal physician, that remaining or returning to school would constitute a risk either to the student, to employees, or to other students.
B. All discussions and records regarding the student’s medical condition will be treated as confidential.
C. 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 a release of information and only to the degree permitted by the release.
- The release must be signed and dated, must specify to whom the release may be made and the time period for which the release is effective.
- Students fourteen (14) and older must authorize disclosure regarding HIV or sexually transmitted diseases.
- Students thirteen (13) 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/guardians must authorize disclosure pertaining to younger students.
D. Any disclosure regarding sexually-transmitted diseases, HIV 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.”
RCW 28A.210.010 Contagious diseases, limiting contact – Rules and regulations
WAC Ch 246-110 School districts and day care centers – Contagious diseases
WAC 243-101-420 Responsibilities of Schools
WAC 296-62-08001 Bloodborne Pathogens
RCW 70.02 Medical records – health care information access and disclosure
RCW 70.24.105 Disclosure of HIV Antibody Test – Exchange of Medical Information