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Indiana State Department of Health

ISDH Home > About the Agency > Schools Communicable Disease Guide > Overview of the School Health Guide Overview of the School Health Guide

Purpose

The health of Indiana's children is the foundation for success in education.  Controlling the spread of communicable disease in the community is the legal responsibility of the Indiana State Department of Health (ISDH) and local health departments (LHD); however, public health officials rely upon the cooperation of schools, health care providers, and parents to prevent the spread of disease.

The purpose of the School Health Manual – 2011, is to provide the best medical information available to prevent the introduction of communicable disease in the school environment and reduce its spread.  The School Health Manual - 2011 was written using the most current information from reliable public health and medical sources.  

This manual is not intended to serve as a policy and procedure manual and should not be used as a substitute for the timely evaluation of suspected infections by a health care provider. Children who may be ill should always be referred for medical evaluation.  This manual is intended to serve as a reference guide to school nurses and school officials regarding communicable disease issues.

Organization and Use of the Manual

The manual is divided into four sections as follows:

Diseases and Conditions
This section contains information on specific disease conditions which the school nurse may encounter.  Each disease condition includes information pertaining to its clinical description, incubation period, mode of transmission, period of communicability, exclusion requirements or recommendations, prevention of infection and care suggestions.  Links to ISDH Quick Facts Sheet and materials from the Centers for Disease Control and Prevention (CDC) pertaining to each condition are available under resources. All diseases that are required by Indiana law to be reported by health care providers and laboratories are denoted by a red stop sign   on the condition page and are identified as being reportable to the local health department in the summary table.  Although schools are not legally required to report cases of reportable communicable diseases, it is recommended that you notify the LHD if you are aware of a reportable case and the LHD has not already been in contact with you. Occasionally a report by a school to the LHD will be the first notification of a reportable illness.

Summary Chart
The summary chart concisely describes in table format the information contained in the individual disease or condition pages in section one.  When the summary chart indicates it is not necessary to inform the LHD about a disease or condition occurring in a student, this does not prohibit you from contacting the LHD for consultation and recommendations. 

Rash Illness Chart
The rash illness chart describes in table format a summary description of common rash illnesses.  In the first column of the table, the rash illness chart contains hyperlinks to pictures of each rash.  

Appendices
The appendices include specific information on Indiana laws pertaining to school health, blood borne pathogens, and other hand washing resources.

Resources

General

The School Health Manual - 2011 is based on the best scientific, public health and medical information available, but cannot address all situations schools may encounter.  Thus, other resources should be available for guidance in school health matters.  A partial list of useful resources includes:


  • The Centers for Disease Control and Prevention (CDC) website at: http://www.cdc.gov/
  • The Indiana Communicable Disease Reporting Rule for Physicians, Hospitals and Laboratories, 410 IAC 1-2.3; December 12, 2008. The communicable disease rule should always be used as the primary guide regarding the control of communicable diseases in Indiana.  This rule provides control measures that should be followed, and where applicable, requires students to be excluded from school if necessary to prevent the spread of diseases.  This rule can be found at http://www.in.gov/isdh/files/comm_dis_rule.pdf%20 (Section 2.3) and is referenced often throughout this manual. Conditions that are not reportable include only recommendations for exclusion from school as there are no specific control measures are found in communicable disease laws or rules.
  • Control of Communicable Diseases Manual, 19th Edition, David Heyman, MD, editor, American Public Health Association. The School Health Manual -2011 is based primarily on recommendations contained in the Control of Communicable Diseases Manual.  The procedures described in the Control of Communicable Diseases Manual should be followed to the extent they are not in conflict with Indiana law or rule, when the condition is not reportable, or when there are no specific legal requirements in Indiana law or rule. 
  • The ISDH web site has a link listing contact information for all local health departments at: http://www.in.gov/isdh/24822.htm

Additional sources of information which can be used by the school nurse include:

  • The Red Book, 28th Edition, 2009 Report of the Committee on Infectious Diseases, American Academy of Pediatrics.

Local Health Department Communications

Local Health Department Staff - LHD and/or ISDH staff investigate each case of reportable illness.  They will assist school staff with implementing exclusion requirements and control measures. It is therefore very important to maintain communication with LHDs concerning individual cases, clusters, and outbreaks of communicable diseases.  By Indiana law, absenteeism rates of 20% or greater must be reported to the LHD.  More information on this law is available at http://www.doe.in.gov/sservices/attendance/legal.html.

In addition, LHD staff can provide assistance on non-reportable communicable diseases.  LHD staff members value the input of school nurses in monitoring disease activity in the community and school environment.

Parent and Community Communications
 

LHDs have the ability to notify health care providers if their medical practice may be affected by a communicable disease in the community (e.g., the need to offer prophylaxis to contacts of a case of pertussis or Neisseria meningitidis or the increased incidence of salmonellosis and the need to test students if symptomatic.)  It is very important that LHDs are aware of communications disseminated to parents/caregivers regarding any current health issues.   The LHD also has the expertise to provide the most current medical advice available regarding communicable diseases.  School nurses and administrators are strongly encouraged to contact their LHD prior to releasing any information to parents/caregivers regarding a reportable communicable disease occurring in their school.  ISDH and LHD staff can provide assistance in drafting communications for parents and the school community.  Some conditions are seasonal (e.g., pertussis and viral meningitis occur usually in the fall, influenza generally occurs in the winter or spring, etc.). The use of ISDH Quick Fact sheets and the CDC materials available in this manual can be used as general information for distribution to parents/caregivers when necessary.