Common Diseases and Infection Control in School - 1 Adebola E. Orimadegun

What is a communicable disease? “any condition which is transmitted directly or indirectly to a person from an infected person or animal through the agency of an intermediate animal, host, or vector, or through the inanimate environment”.

Other Definitions Infectious: Caused by a germ (bacteria, virus parasite, fungus) Communicable: Can be spread from person to person Reportable: Required to be reported to the local health authority department

Modes of transmission Direct Indirect Food-borne – E. coli, Salmonella (typhoid), Air-borne/Inhalation Contaminated water- Cholera, rotavirus, Hepatitis A Skin to skin Blood-borne or sexual Indirect Vector-borne- malaria Formites/clothing

Importance of Communicable Diseases Significant burden of disease especially in low and middle income countries Social impact Economic impact Potential for rapid spread Human security concerns Intentional use

Measles Symptoms Fever, runny nose, cough, sore / red eyes, photophobia Red-brown blotchy rash that spread from face to trunk to extremities Transmission: Airborne transmission via respiratory droplets (or contact with nasal or throat discharge) Treatment: Supportive therapy Isolation: Exclude for at least 5 days following the onset of rash

Mumps Symptoms: Swelling of parotid glands (unilateral or bilateral), fever, headache Transmission: Contact with nose or throat discharge, saliva, or respiratory droplets Treatment: Supportive therapy Isolation: Excluded for 9 days after the onset of parotid swelling

Mumps

Chickenpox (Varicella) Symptoms: Rash that begins maculopapular and progresses to vesicular; often starts on trunk of body Transmission: Direct contact with drainage from lesions or airborne respiratory droplets Communicability: Contagious 1-2 days prior to rash onset through 6 days after appearance of vesicles Treatment: Symptomatic treatment Isolation: Excluded from school until 6th day after rash onset or until all lesions are dry

Conjunctivitis Symptoms: Redness of eye, discharge Allergic: Thick, ropey strands of discharge; intense itching Viral: Watery discharge Bacterial: “Goopy” discharge Transmission: Contact with discharge from eye or respiratory secretions Treatment: Eye drops Isolation: Exclude until 24 hours of antibiotic treatment (if ordered)

Scabies Caused by mite that burrows under the skin and lays eggs Symptoms: Bumps or linear burrows (especially in between the fingers, inside the wrist, elbows, armpits, belt-line, genital area) with intense itching; patchy red rash may be present Symptoms may not occur until 2-6 weeks after infestation Can transmit infection during this time

Scabies..2 Transmission: Direct skin to skin contact Treatment: Topical scabicide applied from jaw line to soles of feet; reapply again in 7-10 days Individuals who have had skin-to-skin contact with the case should also be treated Isolation: Excluded from school for 24 hours following treatment with appropriate scabicide Mite does not remain viable off the skin of the host for more than 24 hours

Scabies...3

Ringworm Fungal infection of skin on the body, scalp, groin (jock itch) or feet (athlete’s foot) Symptoms Scalp: Scaly patches of temporary baldness; brittle hair Skin: Flat, ring-like rash; may itch or burn Feet: Scaling and cracking of skin, especially between toes; blisters may be present Transmission: Skin to skin contact or contact with contaminated items or pets Treatment: OTC or prescription antifungal cream

Ringworm

Simples steps to control infections in school Sources and spread people, food, contaminated surfaces such as toilets, kitchens, toys and animals such as pets can spread infections. From person to person. Germs are carried in the faeces and spread on unwashed hands to other places (e.g. taps, toilet flushes, other people, food) Via contaminated utensils, work surfaces.

CONTAINMENT MEASURES Isolate sick child Exclude affected pupils and staff members until symptom free for 48 hours Staff should not work in other schools or childcare settings during the outbreak, even if they are not symptomatic. Wear gloves and apron for contact with an affected pupil or environment

Wash hands with soap and water after contact with an affected patient or environment, after removing gloves and apron. Remove exposed food such as fruit, also condiments, sauce bottles. Regular toilet inspections

HAND HYGIENE Hand washing and drying most important procedures for preventing the spread of infection. VITAL to prevent person to person transmission Encouraged – After going to the toilet, before and after eating, supervision of young children

HAND HYGIENE Easy access to liquid soap and paper towels Hot and cold running water “Mr Soapy Soap”: May be supplied free! In addition to hand washing alcohol gels can also be used.

Six stage hand washing technique

Enhanced cleaning Increase frequency Toilet areas, handles, fomites

Thank you