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Disease information and exposure notices for schools and childcare

The County of Santa Clara Public Health Department provides guidance and exposure notices for schools and childcare providers responding to cases or outbreaks of communicable disease.

Communicable disease case and outbreak toolkit

For guidance on reporting and responding to specific communicable diseases commonly encountered in school and childcare settings, refer to the Communicable Disease Case and Outbreak Toolkit for Schools and Childcare.

This toolkit includes links to requirements and guidance for disease prevention in schools and childcare sites; one example is cleaning instructions. 

 

All outbreak management steps are shown as a checklist. We recommend downloading and printing the toolkit for easy reference and use in outbreak situations.

Consider reviewing this toolkit with staff twice a year.

Thumbnail of communicable disease toolkit cover

 

 

Disease reporting requirements

Under Title 17, California Code of Regulations §2508, schools and childcare providers are required to report:

  • Individual cases of Title 17 diseases, such as measles, pertussis; and
  • Outbreaks that meet the criteria below. To report a disease or outbreak, call (408) 885-4214, select option 3 and ask for a Public Health Nurse. 
DISEASEOUTBREAK REPORTING THRESHOLD
Gastrointestinal (GI) illnesses
  • Three (3) or more cases of vomiting or diarrhea in a student or staff member. Diarrhea is 3 or more instances of loose stools in a 24-hour period.
  • Symptom onset occurring within 72 hours and within the same group, such as a single classroom, sports team, or after-school group.
  • Distribute the vomiting and diarrhea exposure notice to students and staff in English | Spanish | Vietnamese
Respiratory illnesses
  • 10 percent or more of the total population of students and staff, facility-wide, are absent with influenza-like illness1 within a 3-day period
  • 20 percent or more of students and staff in the same group (such as a single classroom, sports team, or after-school group) with influenza-like illness1, with a minimum of five (5) ill, within a three-day period

If 5 percent of the total population of students and staff, facility-wide, test positive for COVID-19, see the County's COVID-19 reporting guidelines.

1 Influenza-like illness is defined as fever (100°F/37.8°C or higher) plus cough and/or sore throat.

Reportable Title 17 diseases

1 or more cases of Title 17 diseases2

For COVID-19, refer to the County's COVID-19 reporting requirements.

 

 

What steps do I need to take if a child or staff is sick?

For cases of specific communicable diseases, see the tables in the next section to answer the following questions:

  1. Is this disease reportable?
  2. Do I need to post an exposure notice? 
  3. Does the individual need to be excluded?
  4. When can the individual return, if excluded?

If a disease or condition is not specified, you may refer to the more general CDPH guidance for responding to symptoms of illness in childcare or school.

 

Disease information, exposure notices, and exclusion/return criteria for children and staff

Refer to the table below for information on common childhood diseases as well as reporting requirements, PDF exposure notices (available in English, Spanish, and Vietnamese), and exclusion and return criteria for children and staff.

Disease/Condition

Linked to additional information.

Reporting

Is this disease reportable to Public Health?

Notification

Exposure notice needed?

Exclusion

Exclude from school/childcare while symptomatic?

Return

When can the individual return?

AmebiasisNo, unless individual is a food handlerNo, unless instructed by Public Health in the case of a food handlerYes

If not a food handler, 48 hours after symptoms resolve

If a food handler, when directed by Public Health

Bed bugsNoNoNoN/A
CampylobacterYesNoYesAfter diarrhea3 resolves
ChickenpoxNo, unless individual is hospitalized, died, or is part of an outbreak

Yes, and consult with Public Health if there are concerns for exposure to pregnant or immunocompromised people

English | Spanish | Vietnamese

Yes, and non-immune siblings of cases should also be excluded from day 8 after sibling's rash appeared through day 21

For cases: after all blisters have scabs

For non-immune siblings of cases: after 21 days have passed since the sibling's rash appeared

Clostridioides difficile (C. diff)NoNoYes48 hours after diarrhea3 resolves
COVID-19Yes, see COVID-19 reporting guidance for childcare and TK-12 schoolsNo, but schools are encouraged to send a general notification to the entire school community during times of elevated community transmission of COVID-19YesFollow CDPH COVID-19 guidelines
CryptosporidiosisYesYes, if recreational water exposure occurred on site - contact Public Health for exposure noticeYes48 hours after symptoms resolve, and stay out of public swimming pools until 2 weeks after diarrhea3 resolves
E. coli O157:H7/Shiga toxin-producing E. coliYes

Yes

English | Spanish | Vietnamese

Yes

If restricted4, when directed by Public Health

If not restricted, 48 hours after symptoms resolve

GiardiaNo

Yes

English | Spanish | Vietnamese

Yes48 hours after symptoms resolve
Hand, foot, and mouth diseaseNo

Yes

English | Spanish | Vietnamese

Yes, if symptoms include fever or uncontrolled drooling with mouth soresAfter fever-free for 24 hours without the use of fever-reducing medication; children should not return with difficulty or pain while eating or drinking
Head liceNo

Yes

English | Spanish | Vietnamese

Yes, but they do not need to be sent home immediately; they can stay until the end of the dayAfter receiving appropriate treatment
Hepatitis AYesYes - contact Public Health for exposure noticeYes7 days after onset of jaundice (or onset of symptoms if no jaundice) AND diarrhea3 resolves
HiB (Haemophilus influenzae type b) - InvasiveYes (if less than 5 years of age, any invasive disease is reportable; if 5 and older, only meningitis cases are reportable)Yes - contact Public Health for exposure noticeYesWhen 24 hours have passed after starting antibiotics and symptoms are improving
ImpetigoNo

Yes

English | Spanish | Vietnamese

Yes, but they do not need to be sent home immediately; they can stay until the end of the day (keep blisters covered)After starting appropriate treatment; keep blisters covered until they are dry
InfluenzaNo, unless individual is less than 18 years of age and diedNoNo, unless case meets sign/symptom-based exclusion criteriaAfter exclusion criteria are resolved
MeaslesYesYes - contact Public Health for exposure noticeYesPer direction of the Public Health Department
Meningococcal meningitisYesYes - contact Public Health for exposure noticeYesPer direction of the Public Health Department
MRSA (Methicillin-resistant Staphylococcus
aureus)
NoNoNoN/A
MumpsYesYes - contact Public Health for exposure noticeYesPer direction of the Public Health Department
NorovirusNo, unless a food handler or outbreak

Yes - use vomiting/diarrhea exposure notice

English | Spanish | Vietnamese

Yes

If not a food handler and there is not an outbreak, after symptoms resolve

If a food handler or part of an outbreak, 48 hours after symptoms resolve

Parvovirus B19 (Fifth disease)No

Yes

English | Spanish | Vietnamese

No, unless they have a feverAfter fever-free for 24 hours without the use of fever-reducing medication
Pertussis (Whooping cough)YesYes - contact Public Health for exposure noticeYesAfter 5 days of appropriate antibiotic treatment
Pink eye (Conjunctivitis)No

Yes

English | Spanish | Vietnamese

NoN/A
PinwormNo

Yes

English | Spanish | Vietnamese

NoN/A
Respiratory infection (undiagnosed/cause unknown)No, unless an outbreak

Yes, if there is an outbreak

English | Spanish | Vietnamese

No, unless they meet sign/
symptom-based exclusion criteria
After exclusion criteria are resolved
Respiratory syncytial virus (RSV)No, unless individual is less than 5 years of age and died

Yes

English | Spanish | Vietnamese

No, unless they meet sign/
symptom-based exclusion criteria
After exclusion criteria are resolved
RingwormNo

Yes

English | Spanish | Vietnamese

Yes, but they do not need to be sent home immediately; they can stay until the end of the day

General population: After starting treatment

Athletes with tinea corporis: 72 hours after starting treatment unless the affected area can be covered

Roseola (Sixth disease)No

Yes

English | Spanish | Vietnamese

No, unless individual has a feverAfter fever-free for 24 hours without the use of fever-reducing medication
RotavirusNo, unless a food handler or an outbreak

Yes - use vomiting/diarrhea exposure notice

English | Spanish | Vietnamese

Yes

If not a food handler and there is not an outbreak, after symptoms resolve

If a food handler or part of an outbreak, 48 hours after symptoms resolve

RubellaYesYes - contact Public Health for exposure noticeYes, and unvaccinated close contacts of cases should also be excluded

For cases: 7 days after rash appeared

For unvaccinated close contacts: once they receive the MMR vaccine or 23 days after last exposure to a case

SalmonellaYes

Yes

English | Spanish | Vietnamese

Yes

If restricted4, when directed by PHD

If not restricted, 48 hours after symptoms resolve

ScabiesNo

Yes

English | Spanish | Vietnamese

YesAfter receiving appropriate treatment
ShigellaYes

Yes

English | Spanish | Vietnamese

Yes

If restricted4, when directed by PHD

If not restricted, 48 hours after symptoms resolve

ShinglesNo

Yes

English | Spanish | Vietnamese

No, unless rash cannot be coveredWhen rash can be covered or when all lesions have crusted
Strep throat/Scarlet feverNo

Yes

English | Spanish | Vietnamese

YesWhen 24 hours have passed after starting antibiotics and symptoms are improving
Typhoid/Paratyphoid feverYes

Yes

English | Spanish | Vietnamese

Yes

If restricted4, when directed by Public Health

If not restricted, 48 hours after symptoms resolve

Vomiting/diarrhea3
(undiagnosed/cause unknown)
No, unless a food handler or an outbreak

Yes, if there is an outbreak

English | Spanish | Vietnamese

Yes

If not a food handler and there is not an outbreak, after symptoms resolve

If a food handler or part of an outbreak, 48 hours after symptoms resolve

Diarrhea is when 3 or more episodes of loose stools occur in a 24-hour period OR an occurrence of loose stools that is above normal for the person.

Certain staff (food, health care, or childcare staff) and some children (5 years of age and under OR over 5 and need toileting assistance) may be restricted from work/school/group care by the Public Health Department. This means they can go back only when their stool is tested by the Public Health Department Laboratory confirming no bacteria or toxins are found.

FAQ

For cases of specific communicable diseases, use Table 2 above to answer the following questions:

  1. Is this disease reportable?
  2. Do I need to post an exposure notice? 
  3. Does the individual need to be excluded?
  4. When can the individual return, if excluded?

If a disease or condition is not specified, you may refer to the more general CDPH guidance for responding to symptoms of illness in child care or school

No, only use exposure notices from the County of Santa Clara Public Health Department for all diseases listed above.

The school or child care provider can determine where to post the exposure notice so that all parents are notified. You may send the exposure notice home with the child, tape it to the classroom door, email it, and/or post it next to a sign-in/sign-out sheet.

Please call the County of Santa Clara Public Health Department Child Care Health Consultant at (408) 937-2250.