Disease reporting 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.
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;
- Unusual disease occurrences; 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.
Table 1. Reporting Requirements for County of Santa Clara Public Health Department
| DISEASE | OUTBREAK REPORTING THRESHOLD |
| Gastrointestinal (GI) illnesses |
|
| Respiratory illnesses |
OR,
1 Acute respiratory illness is defined as new onset of two or more of the following symptoms: fever or chills, cough, sore throat, runny or stuffy nose, difficulty breathing, and body aches |
| Reportable Title 17 diseases | 1 or more cases of Title 17 diseases |
*Schools and childcare should consult their administration or regional licensing office in the event of an outbreak.
What steps do I need to take if a child or staff is sick?
For cases of specific communicable diseases, see Table 2 in the next section to answer the following questions:
- Is this disease reportable?
- Do I need to post an exposure notice?
- Does the individual need to be excluded?
- 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.
Table 2. Disease reporting, exposure notice, and exclusion/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? |
|---|---|---|---|---|
| Amebiasis | No, unless individual is a food handler | No, unless instructed by Public Health in the case of a food handler | Yes | If not a food handler, 48 hours after symptoms resolve If a food handler, when directed by Public Health |
| Bed bugs | No | No | No | N/A |
| Campylobacter | Yes | No | Yes | After diarrhea2 resolves |
| Chickenpox | No, 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) | No | No | Yes | 48 hours after diarrhea2 resolves |
| COVID-19 | No, unless there is a respiratory outbreak as defined in Table 1 | Yes, if there is a respiratory outbreak English | Spanish | Vietnamese | No, unless they meet sign/ symptom-based exclusion criteria | After exclusion criteria are resolved When returning to normal activities, take added precautions like masking over the next 5 days, per CDC guidance |
| Cryptosporidiosis | Yes | Yes, if recreational water exposure occurred on site - contact Public Health for exposure notice | Yes | 48 hours after symptoms resolve, and stay out of public swimming pools until 2 weeks after diarrhea2 resolves |
| E. coli O157:H7/Shiga toxin-producing E. coli | Yes | Yes English | Spanish | Vietnamese | Yes | If restricted3, when directed by Public Health If not restricted, 48 hours after symptoms resolve |
| Giardia | No | Yes English | Spanish | Vietnamese | Yes | 48 hours after symptoms resolve |
| Hand, foot, and mouth disease | No | Yes English | Spanish | Vietnamese | Yes, if symptoms include fever or uncontrolled drooling with mouth sores | After 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 lice | No | Yes English | Spanish | Vietnamese | Yes, but they do not need to be sent home immediately; they can stay until the end of the day | After receiving appropriate treatment |
| Hepatitis A | Yes | Yes - contact Public Health for exposure notice | Yes | 7 days after onset of jaundice (or onset of symptoms if no jaundice) AND diarrhea2 resolves |
| HiB (Haemophilus influenzae type b) - Invasive | Yes (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 notice | Yes | When 24 hours have passed after starting antibiotics and symptoms are improving |
| Impetigo | No | 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 |
| Influenza | No, unless there is a respiratory outbreak as defined in Table 1, or individual was less than 18 years of age and died | Yes, if there is a respiratory outbreak English | Spanish | Vietnamese | No, unless they meet sign/symptom-based exclusion criteria | After exclusion criteria are resolved When returning to normal activities, take added precautions like masking over the next 5 days, per CDC guidance |
| Measles | Yes | Yes - contact Public Health for exposure notice | Yes | Per direction of the Public Health Department |
| Meningococcal meningitis | Yes | Yes - contact Public Health for exposure notice | Yes | Per direction of the Public Health Department |
| MRSA (Methicillin-resistant Staphylococcus aureus) | No | No | No | N/A |
| Mumps | Yes | Yes - contact Public Health for exposure notice | Yes | Per direction of the Public Health Department |
| Norovirus | No, unless a food handler or gastrointestinal outbreak as defined in Table 1 | 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 fever | After fever-free for 24 hours without the use of fever-reducing medication |
| Pertussis (Whooping cough) | Yes | Yes - contact Public Health for exposure notice | Yes | After 5 days of appropriate antibiotic treatment |
| Pink eye (Conjunctivitis) | No | Yes English | Spanish | Vietnamese | No | N/A |
| Pinworm | No | Yes English | Spanish | Vietnamese | No | N/A |
| Respiratory infection (cause unknown) | No, unless there is a respiratory outbreak as defined in Table 1 | Yes, if there is an outbreak English | Spanish | Vietnamese | No, unless they meet sign/ symptom-based exclusion criteria | After exclusion criteria are resolved When returning to normal activities, take added precautions like masking over the next 5 days, per CDC guidance |
| Respiratory syncytial virus (RSV) | No, unless there is a respiratory outbreak as defined in Table 1, or individual was 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 When returning to normal activities, take added precautions like masking over the next 5 days, per CDC guidance |
| Ringworm | No | 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 fever | After fever-free for 24 hours without the use of fever-reducing medication |
| Rotavirus | No, unless a food handler | 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 |
| Rubella | Yes | Yes - contact Public Health for exposure notice | Yes, 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 |
| Salmonella | Yes | Yes English | Spanish | Vietnamese | Yes | If restricted3, when directed by PHD If not restricted, 48 hours after symptoms resolve |
| Scabies | No | Yes English | Spanish | Vietnamese | Yes | After receiving appropriate treatment |
| Shigella | Yes | Yes English | Spanish | Vietnamese | Yes | If restricted3, when directed by PHD If not restricted, 48 hours after symptoms resolve |
| Shingles | No | Yes English | Spanish | Vietnamese | No, unless rash cannot be covered | When rash can be covered or when all lesions have crusted |
| Strep throat/Scarlet fever | No | Yes English | Spanish | Vietnamese | Yes | When 24 hours have passed after starting antibiotics and symptoms are improving |
| Typhoid/Paratyphoid fever | Yes | Yes English | Spanish | Vietnamese | Yes | If restricted3, when directed by Public Health If not restricted, 48 hours after symptoms resolve |
| Vomiting/diarrhea3 (cause unknown) | No, unless a food handler or gastrointestinal outbreak as defined in Table 1 | 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 |
2 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.
3 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.
Assistance and Resources
- Safe Schools for All Hub (California Department of Public Health)
- Considerations when a Child has Symptoms of Illness in Child Care or School (California Department of Public Health)
- Guidance for TK–12 Schools and Child Care Settings to Support Safe In-Person Services and Mitigate the Spread of Communicable Diseases, 2024-2025 School Year (California Department of Public Health)
FAQ
For cases of specific communicable diseases, use Table 2 above to answer the following questions:
- Is this disease reportable?
- Do I need to post an exposure notice?
- Does the individual need to be excluded?
- 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.