FILE:  JGCC-AP

Cf:  JGCC

 

CALCASIEU PARISH SCHOOLS

ADMINISTRATIVE PROCEDURES                             DATE ISSUED: 8-1-91

                                                                                       REVISED:  11-1-16

 

SUBJECT:  STUDENT HEALTH SERVICES (COMMUNICABLE DISEASE CONTROL)

 

Communicable Disease Control (Further explanation, JGCC part I)

 

LOUISIANA IMMUNIZATION REQUIREMENTS FOR STUDENTS IN ACCORDANCE TO La. Rev. Stat. Ann. §17:170

 

STUDENT IMMUNIZATIONS – SCOPE OF REQUIREMENTS

 

Middle School Requirement:

 

Beginning with the 2009-2010 school year and continuing thereafter, a student shall provide satisfactory evidence of current immunizations against meningococcal disease, and any other age appropriate vaccines, as a condition of entry into the sixth grade.  Further, any student who has attained the age of eleven years or who is entering grade other than grade six shall provide satisfactory evidence of current immunizations against meningococcal disease and any other age appropriate vaccines as a condition of entry into that grade.

 

At the time of registration, students must show proof of immunization of the following vaccines: Tetanus Diphtheria Acellular Pertussis vaccine (TdaP); two (2) doses of Varicella vaccine; two (2) Measles, Mumps, Rubella (MMR) vaccines; three (3) Hepatitis B (HBV) vaccines; and one (1) Meningococcal Vaccine (MCV4).

 

Kindergarten / First Time Enterers:

 

Beginning in school year 2009-2010, two (2) doses of Varicella vaccine shall be required in Louisiana schools for entry into kindergarten or first time enterers into school.  In addition, prior to school entry, these students must have documented proof of immunizations for: two (2) doses of Measles, Mumps, Rubella (MMR) vaccine; three (3) doses of Hepatitis B (HBV) vaccine; and booster doses of Diphtheria Tetanus Acellular Pertussis (DTaP) and Poliovirus (Polio) vaccines administered on or after their 4th birthday and prior to school entry.  If a student is not complete (up-to-date for age), he/she must present a record indicating the student is in progress of receiving vaccines, and follow-up must be provided for compliance with the above requirements.

 

Pre-Kindergarten / Daycare / HeadStart:

 

Beginning school year 2009-2010, two (2) doses of Varicella vaccine will be required in Louisiana schools for entry into Pre-K, Kindergarten, Daycare, and HeadStart programs for children aged 4 years and older.  If a second dose of Varicella vaccine has been received at least 30 days after the first dose, no additional doses are required.  This is in addition to the regular age appropriate vaccines required depending on the child’s age.  Prior to entry, these students must have documented proof of immunizations for: two (2) doses of Measles-Mumps-Rubella vaccine; three (3) doses of Hepatitis B vaccine; and booster doses of DTaP and Polio vaccines administered on or after their 4th birthday and prior to school entry.

 

Communicable Disease Control (Further explanation, JGCC part II)

 

A decision concerning notification of parents in regards to a students' illness requires judgment based on the student's statement of his/her complaints and observation of his/her appearance and behavior.  As guides for dealing with sick students, the following principles are suggested:

 

  1. Give careful consideration to the student's statement of his/her complaints.  It is not always possible to secure objective evidence of sickness.

  2. A child with temperature of 100.5 degrees Fahrenheit or higher shall not be permitted to remain in school.

  3. A child may return to school after a febrile illness under the following condition:

 

    1. following a mild illness (no physician involved) the child's temperature must have remained below 100.5 degrees Fahrenheit (oral or rectal) for at least one full day, or

    2. following a more severe illness (a physician was involved) the child's temperature must have remained below 100.5 degrees Fahrenheit (oral or rectal) for at least one day, and a written note from the physician states (1) that it is safe for the child to return to school and (2) that he or she is not a health threat to others.

 

  1. A child vomiting or with loose stools may be excluded from school.

  2. Students with severe colds, sore throats, or productive coughs should not stay at school.

  3. Presence of abdominal discomfort, not definitely explained as menstrual cramps, may signify appendicitis.  The parent/legal guardian should be notified and urged to secure a medical opinion.  No food or medication shall be given at school.

  4. Purulent nasal discharge, purulent conjunctivitis (pink eye), severe headache, and skin eruptions may be indications of acute communicable disease.  Students with these conditions should be considered contagious unless facts or expressed medical opinion indicates otherwise.

  5. Scabies (itch), ringworm, impetigo (indian fire); children with these skin diseases are considered to be contagious unless facts or expressed medical opinion indicates otherwise.

  6. Lice -- the following shall be adhered to:

    Lice/Nits Protocol for Schools

 

 

      1. Name of student

      2. Date of exclusion

      3. Documentation of parental notification

      4. A copy of letter(s) sent home to parent(s)/guardian(s) regarding lice and/or nits

      5. Readmission date along with name of treatment

 

 

  1. If above protocol has been followed and student is still missing excessive days due to lice/nits, please contact TASK at the Office of Juvenile Justice (337-721-3981) and ask Hope to assist.

 

  1. No child is to be sent or left at home alone when dismissed for medical reasons.

 

JGCC part III - Guidelines for handling body fluids in school

 

Hepatitis B Vaccine

 

The hepatitis B vaccine is available to those employees who are reasonably anticipated, as the result of performing their job duties, to face contact with blood and other potentially infectious materials.

 

The following positions have been identified as those where it is reasonably anticipated that occupational exposure to blood or other body fluids may occur:  School nurses, those special education employees who come in contact daily with body fluids through such means as needles, catheters, diapers, etc.; those athletic department employees who regularly administer first aid; any other employee who regularly administers first aid.

 

Those above identified employees who choose to receive the vaccine should be advised to contact the C.P.S.B. Risk Management Department at 217-4260 to make arrangements to do so.

 

Employees who do not regularly come into contact with body fluids, but who may administer first aid as a collateral duty to their routine work, not as primary job function, will not be offered the immunization until after they have performed first aid involving blood or other potentially infectious materials.  Post incident immunizations should take place within 24 hours after the exposure.  Employees should be advised accordingly and should contact C.P.S.B. Risk Management at 217-4260 to make arrangements for the immunization.

 

What Should Be Done To Avoid Contact With Body Fluids?

 

When possible, direct skin contact with body fluids should be avoided.  Disposable gloves should be available in at least the office of the custodian, nurse, or principal.  Gloves are recommended when direct contact with body fluids is anticipated (e.g., treating bloody noses, handling clothes soiled by incontinence, cleaning small spills by hand).  If contact is made with body fluids, hands should be washed afterwards.  If employees incur exposure to their skin or mucous membranes then those areas shall be washed or flushed with water as appropriate as soon as feasible, following contact.  Disposable gloves are not to be washed or decontaminated for re-use and are to be replaced as soon as practical when they become contaminated or as soon as feasible if they are torn, punctured, or then their ability to function as a barrier is compromised.  Upon contamination, disposable gloves should be deposited in the hazardous material receptacle designated specifically for such use.  Utility gloves may be decontaminated for re-use provided that the integrity of the glove is not compromised.  Utility gloves will be discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised.  Decontamination of utility gloves will be accomplished by utilizing the proper disinfectant.  See the "disinfectant" section of this procedure.

 

What Should Be Done If Direct Skin Contact Occurs?

 

In many instances, unanticipated skin contact with body fluids may occur in situations where gloves may be immediately unavailable (e.g. when wiping a runny nose, applying pressure to a bleeding injury outside the classroom, helping a child in the bathroom).  In these instances, hands and other affected skin areas of all exposed persons should be routinely washed with soap and water.  Items (e.g., towels used to wipe up body fluid) that are soaked through with body fluids should be rinsed and placed in plastic after direct contact has ceased.  Clothing and other non-disposable bags:  If presoaking is required to remove stains, (e.g., blood, feces), use gloves to rinse or soak the item in cold water prior to bagging.  Clothing should be sent home for washing with appropriate directions to parents/teachers.  It is recommended that should an item be visibly contaminated with blood or other body fluids that the object be individually cleaned with a fresh bleach solution made for immediate use as follows:  See the "Laundry Instructions" section of this procedure.  Contaminated disposable items (e.g., tissues, paper towels, diapers), should be handled as with the disposable gloves.

 

How Should Spilled Body Fluids Be Removed From the Environment?

 

Most schools have standard procedures already in place for removing body fluids (e.g., vomitus).  These procedures should be reviewed to determine whether appropriate cleaning and disinfection steps have been included.  Disposable gloves should be worn when removing body fluids and deposited in the hazardous materials receptacle immediately following use.  Many schools stock sanitary absorbent agents specifically intended for cleaning body fluid spills (e.g., ZGIIO*, Parson Mfg. Co. Philadelphia, PA).  Disposable gloves should be worn when using these agents.  The dry material is applied to the area, left for a few minutes to absorb the fluid, and then vacuumed or swept up.  The vacuum bag or sweeping should be dispensed of in the hazardous material receptacle.  Any specimens which could puncture a primary container (For example: broken glass containing blood) should be placed in a "sharps" container if available or within a secondary container which has been lined with a red "hazmat" liner and is puncture resistant and then placed in the primary hazardous materials receptacle.  Broom and dustpan should be rinsed in a disinfectant.  No special handling is required for vacuuming equipment.

 

Needles

 

Contaminated needles and other contaminated sharps will not be bent, recapped, removed, sheared or purposely broken.  Contaminated sharps are to be placed immediately, or as soon as possible, after use into appropriate sharps containers.

 

Handwashing Procedures

 

After removal of personal protective gloves, employees shall wash hands and any other potentially contaminated skin area immediately or as soon as feasible with soap and water.  Proper handwashing requires the use of soap and water and vigorous washing under a stream of running water for approximately 10 seconds.  Soap suspends easily removable soil and microorganisms allowing them to be washed off.  Running water is necessary to carry away dirt and debris.  Rinse under running water.  Use paper towels to thoroughly dry hands.  If employees incur exposure to their skin or mucous membranes then those areas shall be washed or flushed with water as soon as feasible following contact.

 

Disinfectants

 

An intermediate level disinfectant should be used to clean surfaces contaminated with body fluids.  Such disinfectants will kill vegetative bacteria, fungi, tubercle bacillus and viruses.  The disinfectant should be registered by the U.S. Environmental Protection Agency (EPA) for use as a disinfectant in medical facilities and hospitals.  Various classes of disinfectants are listed below.  Hypochlorite solution (bleach is preferred for objects that may be put in the mouth.)

 

  1. Ethyl or isopropyl alcohol (70)

  2. Phenolic germicidal detergent in a 1 percent aqueous solution (e.g., Lysol*)

  3. Sodium Hypochlorite with at least 100 ppm available chlorine (1/2 cup household bleach in 1 gallon water, needs to be freshly prepared each time it is used).

  4. Quaternary ammonium germicidal detergent in 2 percent aqueous solution (e.g., Tri‑quat*, Mytar* or Sage*.)

  5. Iodophor germicidal detergent with 500 ppm available iodine (e.g., Wescodyne*.)

 

Disinfection of Hard Surfaces and Care of Equipment

 

After removing the soil, a disinfectant is applied.  Mops should be soaked in the disinfectant after use and rinsed thoroughly or washed in a hot water cycle before rinse.  Disposable cleaning equipment and water should be placed in a toilet or plastic bag as appropriate.  Non-disposable cleaning equipment (dustpans, buckets) should be thoroughly rinsed in the disinfectant.  The disinfectant solution should be promptly disposed down a drain pipe.  Remove gloves, discard in appropriate hazardous material waste receptacles and wash hands as indicated above.

 

Disinfection of Rugs

 

Apply sanitary absorbent agent, let dry and vacuum.  If necessary, mechanically remove with dustpan and broom, then apply rug shampoo (a germicidal detergent) with a brush and re-vacuum.  Rinse dust pan and broom in disinfectant.  If necessary, wash brush with soap and water.  Dispose of nonreusable cleaning equipment as noted above.

 

Laundry Instructions for Clothing Soiled With Body Fluids

 

The most important factor in laundering clothing contaminated in the school setting is elimination of potentially infectious agents by use of a fresh bleach solution made for immediate use as follows: 1/2 cup household bleach per gallon of water.  Clothing soaked with body fluids should be washed separately from other items.  Presoaking may be required for heavily soiled clothing.  Otherwise, wash and dry as usual.  If the material is bleachable, use household bleach.  If material is not colorfast, add non­chlorine bleach (e.g., Chorox II*, Borateem*) to the wash cycle.

 

Work Area Restrictions

 

In work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious materials, employees are not to eat, drink, apply cosmetics or lip balm, or handle contact lenses.  Food and beverages are not to be kept in refrigerators, freezers, shelves, cabinets, or on counter tops or bench tops where blood or other potentially infectious materials are present.

 

Post-Exposure

When an employee who for whatever reason, has not received the hepatitis B vaccine incurs an exposure, it should be reported to the appropriate supervisor who at that time should offer the hepatitis B vaccine and instruct the employee to contact the C.P.S.B. Risk Management Department to make arrangements.  Employees who opt not to receive the hepatitis B vaccine should sign the "declination" form.  These forms are on file in the administrator's office; a copy should be forwarded to C.P.S.B. Risk Management.

 

*         Brand names used only for examples of each type of germicidal solution and should not be considered an endorsement of a specific product.

 

Revised:  11-1-93

Revised:  5-7-02

Revised:  11-1-16

 

Ref:    Information and Guideline: Prevention of Disease Transmission in Schools. Acquired Immune Deficiency Syndrome AIDS) State of Connecticut, Department of Education and Department of Health Services, March, 1985

Sample Plan, OSHA Bloodborne Pathogen Standard

29 CFR 1910.1030

Board minutes, 4-16-02, 5-7-02, 11-1-16

 

Calcasieu Parish School Board