DISEASE

INCUBATION PERIOD

COMMON SIGNS AND SYMPTOMS

RECOMMENDATIONS

Chickenpox

(Varicella)

From 2 to 3 weeks, usually 13 to 17 days.

Sudden onset with slight fever and itchy eruptions which become vesicular (small blisters) within a few hours. Lesions commonly occur in successive crops, with several stages of maturity present at the same time.

Communicable for as long as 5 days before eruption of vesicles and for not more than 5 days after the appearance of the first crop of vesicles.
CASE: Exclude form school for at least 6 days after eruption first n early pregnancy who have not had chickenpox.
CONTACTS: On appearance of first sigh or symptom, exclude form school for 7 days.

Cryptosporidiosis

From 2 to 14 days.

Watery diarrhea and low-grade fever.

CASE: Exclude until cessation of diarrhea.
CONTACTS: School exclusion not indicated. 

Fifth Disease 

(Erythema Infectiosum)

From 4 to 20 days.

Mild illness without fever. Rush characterized by a vivid reddening of the skin especially of the face which fades and recurs; classically, described as a "slapped check appearance".

CASE: Exclusion from school not required.
CONTACTS: School exclusion not indicated.

German Measles 

(Rubella)

From 14 to 23 days, usually 16 to 18 days.

Mild symptoms, slight fever, rash of variable character lasting about 3 days; enlarged head and neck lymph glands common. Joint pain may occur especially in older children and adults.

Communicable for 7 days before onset of rash and at least 4 days thereafter.
CASE: Exclude form school for 7 days after onset of rash. Avoid exposure to women in early pregnancy. Check immunization records.
CONTACTS: Those who are pregnant and not immunized should be urged to seek medical advice.

Giardiasis

From 1 to 4 weeks.

Frequently asymptomatic, but may have diarrhea.

CASE: Exclude until cessation of diarrhea. Exclusion of asymptomatic carriers of giardia is not recommended.
CONTACTS: School exclusion not indicated.

Hepatitis A

(Infections Hepatitis)

From 15 to 50 days, usually 28 days.

Fever, loss of appetite, nausea, abdominal discomfort and weakness followed by jaundice. Many unrecognized mild cases without jaundice occur, especially in children.

Communicability greatest from 7 days before to several days after onset of jaundice.
CASE: Exclude from school until physician advises return. Convalescence may be prolonged.
CONTACTS: School exclusion not indicated.

HIV

(Human Immunodeficiency Virus Infection)

Variable

A broad range of disease manifestations affecting multiple organ systems. May children remain asymptomatic.

CASE: Follow advice of child's physician and/or the local health department.
CONTACTS: School exclusion not indicated.

Impetigo contagiosa

unknown

Multiple skin lesions usually of exposed areas (e.g., elbows, legs and knees), but may involve any area. Lesions vary in size and shape, and begin as blisters which rapidly mature into brown crusts on a reddened base. Healing from center outward produces circular area which may resemble ringworm.

CASE: Exclude from school until physician advises return (usually 1 day).
CONTACTS: Exclusion from school not indicated. Observe carefully for symptoms.

Measles 

(Rubeola, Red Measles)

From 8 to 13 days, usually 10 days.

Prodrome characterized by fever followed by reddened eyes, runny nose, and cough. Dusky-red blotch rash appears on day 3 or 4 and lasts 4 to 7 days.

Communicable from beginning of prodromal period to 4 days after appearance of the rash.
CASE: Exclude from school until at least 4 days after appearance of the rash.
CONTACTS: Check immunization records. Exclude from school immediately on sighs of prodrome.

Meningitis, Haemophilus

Unknown, probably 2 to 4 days.

Sudden onset of fever, vomiting, lethargy and stiff neck. Progressive stupor or coma are common.

CASE: Exclude from school until physician advises return.
CONTACTS: School exclusion not indicated. Observe carefully for symptoms, especially fever. Parents of day care/nursery school contacts should be advised to check with their children's physicians concerning prophyiactic treatment with rifampin. Discuss problem with local health department.

Meningitis, Meningococcal

From 1 to 10 days, usually 3 to 4 days.

Sudden onset of fever and intense headache. Delirium and coma often appear early; a characteristic (measles like) rush usually follows. Can be fatal despite prompt diagnosis and treatment.

CASE: Exclude from school during acute illness (Non-communicable after f24 hours of appropriate drug therapy).
CONTACTS: School exclusion not indicated. Parents of day care contacts should be urged to seek their physician's advice concerning prophylactic treatment with rifampin. Discuss problem with local health department.

Mumps 

(Infectious Parotitis)

From 2 to 3 weeks, usually 18 days.

Fever with swelling and tenderness of one or both parotid glands located below and in front of the ears. Unrecognized mild cases without swelling may occur.

Communicable from 6 days before swelling until 9 days after.
CASE: Exclude from school for 9 days after the onset of parotid gland swelling.
CONTACTS: School exclusion not indicated.

Pediculosis 

(Head & Hair Lice)

Under optimum conditions, eggs hatch in 7 days and reach maturity in about 10 days.

Severe itching and scratching, often with secondary infection. Scalp and hairy protions of body may be affected. Eggs of head lice (nits) attach to hairs as small, round, gray lumps.

CASE: Exclude from school until treated by a physician.
CONTACTS: Direct inspection of head, body, and clothing recommended. School exclusion not indicated in absence of infestation.

Rotavirus Infections

Usually 1 to 3 days

Diarrhea, usually preceded by vomiting and low-grade fever. May also be accompanied by cough.

CASE: Exclude from school until cessation of diarrhea.
CONTACTS: School exclusion not indicated.

Salmonellosis

From 6 to 72 hours, usually 12 to 36 hours.

Sudden onset of fever, abdominal pain, diarrhea, nausea, and frequent vomiting. Dangerous dehydration may occur in young children.

Stools usually positive for Salmonella for several days to several weeks; a few patients test positive for several months.
CASE: Exclude from school until physician advises return.
CONTACTS: School exclusion and stool cultures not indicated in absence of symptoms.

Scabies

From 2 to 6 weeks.

Begins as itchy raised areas or burrows around finger webs, wrists, elbows, armpits, belt-line, and/or genitalia. Extensive scratching often results in secondary infection.

CASE: Exclude from school until physician advises return.
CONTACTS: Direct inspection of body. School exclusion not indicated in absence of infestation.

Scarlet Fever

Usually 1 to 3 days, rarely longer.

Fever, sore throat, exudative tonsillitis or pharyngitis. Rash appears most often on neck, chest, and skin folds of arms, elbows, groin and inner aspect of thighs.

CASE: Exclude from school during acute illness (Non-communicable after f24 hours of appropriate drug therapy).
CONTACTS: Exclude from school on appearance of sighs or symptoms. Culturing of school contacts and treatment of carriers not usually indicated.

Shigellosis 

(Bacillary Dysentery)

From 1 to 7 days, usually 3 days.

Diarrhea, fever and often vomiting and cramps. In severe cases the stools may contain blood.

CASE: Exclude from school until cessation of diarrhea.
CONTACTS: School exclusion not indicated. Stool cultures indicated only in suspected school outbreaks.

Tinea Corporis 

(Ringworm of the body)

From 4 to 10 days.

Circular well-demarcated lesion that can involve face, trunk or limbs. Pruritus is common.

CONTACTS: Exclude from school not indicated as long as lesions are covered or child is being treated by a physician.
CONTACTS: School exclusion not indicated.

Whooping Cough 

(Pertussis)

Usually 7 days, almost uniformly within 10 days, and rarely exceeding 14 days.

Catarrhal stage begins with upper respiratory symptoms and increasing irritating cough. The paroxysmal stage usually follows within 1 to 2 weeks, and lasts 1 to 2 months. Paroxysmal stage is characterized by repeated episodes of violent cough broken by a high-pitched inspiratory whoop. Older children may not have whoop. Convalescence may require many weeks.

CASE: Exclude from school until physician advises return. (usually 5 days after initiation of erythromycin therapy).
CONTACTS: Check immunization records. Exclude on first sign or symptom.