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Communicable Disease and Infection Control


What diseases do I need to report?

The NH Dept of Health and Human Services Communicable Disease Control and Surveillance Sections determine what illnesses require mandatory reporting. The link below gives information about what diseases need to be reported, the mandatory reporting timeframe, and contact information.

Please note: Some illness need to be reported within 24 hours ("Diseases with an asterisk (*) and in red must be reported within 24 hours of diagnosis or suspicion of diagnosis") while the others must be reported within 72 hours.

http://www.dhhs.nh.gov/dphs/cdcs/documents/reportablediseases.pdf Acrobat Reader

How do I make a report?

If you know or suspect the diagnosis of one of the reportable diseases, you must contact NH DHHS Communicalbe Diseas Control and Surveillance. The same link provided above explains specifically what information needs to be relayed to NH DHHS. (Some of the requested information will not apply to school health services.) The contact information for Communicable Disease Control and Surveillance at NH DHHS is included on the lower right of the linked page.

Does this violate FERPA?

No, under the following provisions: if the DHHS has determined that a disease must be reported within 24 hours, this qualifies as a potential public health emergency. Therefore, FERPA allows you to disclose that information. If a disease must be reported within 72 hours, that is an urgent rather than emergent need for information. As a result, you must get parental consent prior to reporting the confidential information relating to those diseases. Once theNH DHHS has the information it is protected by HIPAA.

I have seen several cases of an illness/symptom in the last week but it is not on the reportable disease list. Should I notify someone?

Yes. "Any suspect outbreak, cluster of illness, or unusual occurrence of disease that may pose a threat to the public's health must be reported within 24 hours of recognition." If you are uncertain, feel free to call NH DHHS at (603) 271-4496 for guidance and assistance with disease management.

Do I need to report shingles?

No. You only need to report chicken pox. Shingles is a painful rash that results from reactivation of the virus that is dormant inside anyone who has had chicken pox.

Should children with shingles be excluded from school?

No, as long as the lesions can be covered. The rash is most often on the torso but can appear on the face, head, neck or limbs. Once the rash appears, it is possible for others to contract chicken pox if they do not already have immunity. When the lesions are completely crusted over, they are no longer contagious. If the lesions are actively weeping, they should be covered by a dressing in addition to the child's normal clothing so that the drainage may be contained. If the drainage cannot be contained they cannot be in school.

In the case of disseminated shingles (not a localized rash) or in immune compromised patients, it is possible for the virus to be aerosolized and transmitted by inhalation. In these rare instances, obtain guidance from the child's medical provider. Shingles can be very painful and parents may opt to keep their children home if they are having significant discomfort.

A student has been diagnosed with MRSA; do I need to take any special precautions?

MRSA stands for methicillin-resistant Staphylococcus aureus. In other words, it is a Staph infection that is resistant to a certain class of antibiotics. Staph is a very common bacteria present on the skin of many healthy people. Though it can cause infections internally, school nurses will primarily deal with it as a skin infection. Any break in the skin provides an opportunity for bacteria to enter. Since Staph is frequently present on the skin, it is common for this bacteria to be introduced at an injury site. The proper treatment for any skin injury is thorough washing with soap and water to limit the likelihood of infection.

Evidence of infection can include redness, warmth, tenderness, and swelling at the injury site. Frequently the individual's normal immune response will clear the infection on its own. If it does not appear to be improving, medical intervention is necessary. If a student has sought medical treatment, they may provide you with specific instructions from the doctor who is treating them. In general the following recommendations are appropriate for any skin infection.

1. Keep the infected site covered to limit the spread of the bacteria. If drainage from the infection cannot be contained, the child should not be in school. Staph can live on objects for up to 24 hours.

2. Explain to the student the importance of hand washing after touching the affected area.

General recommendations to all students and school staff.

1. Encourage all students to wash their hands frequently with soap and water or an antimicrobial hand wash with at least 60% alcohol.

2. Discourage sharing of personal items that contact the skin like towels or razors.

3. Establish a protocol for cleaning athletic equipment.

If an individual student has been diagnosed with MRSA, you do not need to alert the school or community. You may need to enlist the help of teachers caring for younger students who may need to be reminded to keep the infection covered, stop picking, wash hands, etc. It might be reasonable to remind PE teachers or coaches about proper equipment cleaning but it is not necessary to point out the infected student. A MRSA diagnosis might be a good motivator for you to re-introduce the importance of infection control to your school staff and student body. The DHHS Web site also has some valuable fact sheets on Staph and MRSA.

What should I know about EEE and West Nile Virus?

The NH DHHS has some great prevention tips and on its EEE and West Nile Virus web site.

What about Lyme Disease?

The NH DHHS Lyme Disease web page should be your starting point. It includes tips on prevention and tick removal along other great resources.

What can we do in my school to help prevent the spread of infectious disease?

Stress the importance of good old-fashioned hand washing as a first step. Vigorously rub hands with warm soapy water for at least 20 seconds after wiping nose/ mouth, after using the rest room, after touching objects from the ground/trash, before eating, etc. If soap and water are not available, an antimicrobial hand wash with at least 60% alcohol is a good substitute.

Teach students to cough or sneeze in their elbows rather than in their hands or into the air.

Establish a procedure for cleaning classrooms, lunchrooms, restrooms, athletic facilities, school buses, etc.

Ensure that students are immunized appropriately.

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New Hampshire Department of Education
101 Pleasant Street | Concord, NH | 03301-3494
Telephone: (603) 271-3494 | TDD Access: Relay NH 711