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MUST BE REPORTED WITHIN A WEEK

By fax, telephone, or mail

To report a suspect or confirmed disease, condition or outbreak complete the following to have information routed to the correct Public Health program as indicated in table below:

Online CalREDIE* Form in the Provider Portal (PP) or Manual Lab Reporting Module (MLRM),

Electronic Laboratory Reporting (ELR) Feed via CalREDIE,

Electronic Case Reporting (eCR) Feed via CalREDIE,

Confidential Morbidity Report (CMR),

Microsoft Form/Workbook (Outbreaks ONLY), and/or

Fax

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Herpes simplex virus infection is characterized by lesions around the genitals, rectum or mouth caused by either HSV-1 or HSV-2. HSV-1 is the main cause of herpes infections around the mouth, but can also cause genital herpes. HSV-2 causes the majority of genital herpes, but HSV-1 genital herpes is increasing. Both primary and recurrent infections can occur, with the primary infection usually more severe than recurrent infections. Asymptomatic or mild infections are common for both HSV-1 and HSV-2. HSV awareness is important because genital herpes lesions are a risk factor for the contraction of Human Immunodeficiency Virus (HIV.)

CAUSE

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)

SYMPTOMS

Most individuals infected with HSV-1 or HSV-2 are asymptomatic, or have very mild symptoms that go unnoticed or are mistaken for another skin condition. Symptomatic primary infections usually last longer and are more severe than reactivation of a latent infection (recurrent infection).

Oral herpes:

Primary (often occurs before the age of 5)

  Fever and irritability

  Tender submandibular adenopathy (swollen lymph nodes)

  Rash or inflammation of oral mucosa and/or gums

  Lesions around the mouth

  Conjunctivitis and Keratitis possible

  Potential CNS involvement (meningoencephalitis)

  Potential CNS involvement (meningoencephalitis) Genital herpes:
Primary

  Vesicular lesions around the genitals or rectum; painful

  Lymphoadenopathy (swollen lymph nodes)

  Fever, body aches, head ache

  Painful urination as urine makes contact with lesions

  Vaginal discharge

  Potential CNS involvement (meningitis, encephalitis) Recurrent

  Tingling in affected area prior to lesion development

  Vesicular lesions around the genitals or rectum

o Often less painful than lesions of primary infection

  Painful urination as urine makes contact with lesions

  Vaginal discharge

  Potential CNS involvement (meningitis, encephalitis)

HSV-1 is most frequently spread through contact with saliva or herpetic lesions. HSV-2 is most frequently spread through sexual contact with an infected individual. Both HSV 1 and 2 can be transmitted in the presence or absence of symptoms because asymptomatic infection with viral shedding is common. Transmission to a neonate usually occurs via the birth canal of an infected mother.

INCUBATION (time from exposure to onset of symptoms) 2 to 14 days, average is 4 days

CONTAGIOUS PERIOD

HSV can be isolated for 2 to 7 weeks after primary stomatitis (rash or sores in mouth) or primary genital lesions appear. After a recurrent infection, the virus can usually be isolated for 5 days. Asymptomatic viral shedding is possible.

EXCLUSION
Child care and School: Children with primary herpes and uncontrolled drooling.

DIAGNOSIS

HSV diagnosis is often made my examining symptoms and taking a sample from a lesion if necessary. Blood tests are available and useful for asymptomatic infection or if a patient presents themselves after symptoms have resolved. HSV-1 and HSV-2 antibodies can be distinguished.

TREATMENT

HSV will remain in the body for life. Antiviral medication is recommended for primary and recurrent HSV infection. Antiviral medications will vary by symptoms present (oral, genital, CNS involvement). Antiviral medication can be used to reduce the length and severity of lesion outbreaks, and reduce viral shedding (communicability). Treatment can be used as prophylaxis to reduce the incidence of recurrent infection, but not primary infection.

PREVENTION/CONTROL

  In general, avoid contact with HSV lesions (both oral and genital.)

  Wash your hands immediately if you touch HSV lesions on your body or someone

else’s body; autoinoculation is possible.

  Health care personnel should wear gloves when in contact with potentially infectious

lesions.

  Avoid kissing people and sharing personal items with people who have oral sores or

lesions.

  Use latex condoms during sexual practices.

  Treat infections with antiviral medication to reduce communicability.

  If primary genital herpes infection occurs in late pregnancy, a cesarean section is

recommended.

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MUST BE REPORTED WITHIN 24 HOURS
By fax, telephone, or mail
To report a suspect or confirmed disease, condition or outbreak complete the following to have information routed to the correct Health program as indicated in table below:

Online CalREDIE* Form in the Provider Portal (PP) or Manual Lab Reporting Module (MLRM),

Electronic Laboratory Reporting (ELR) Feed via CalREDIE,

Electronic Case Reporting (eCR) Feed via CalREDIE,

Confidential Morbidity Report (CMR),

Microsoft Form/Workbook (Outbreaks ONLY), and/or

Fax

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Chickenpox (also known as varicella) is an acute viral illness. It is a common childhood infection that may be prevented by vaccination. It is highly contagious, but rarely serious for most children.

CAUSE

Varicella-zoster virus (VZV), a member of the Herpesvirus family

SYMPTOMS

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may first show up on the face, chest, and back then spread to the rest of the body, including inside the mouth, eyelids, or genital area. It usually takes about one week for all the blisters to become scabs.

Other typical symptoms that may begin to appear 1-2 days before rash include: high fever

tiredness
loss of appetite
headache
High Fever

Chickenpox can be severe in newborns and those with weakened immune systems. It rarely occurs in adults, however, when it occurs it may be more severe. Complications that commonly lead to hospitalization and can lead to death include severe skin and soft tissue infections, pneumonia, and encephalitis.

Mild, atypical chickenpox, known as breakthrough varicella, is characterized by no fever, less than 50 lesions, and atypical lesions that don’t progress to vesicles. Breakthrough varicella occurs in vaccinated individuals at least 42 days after vaccination, and is usually shorter than classic chickenpox.

SPREAD

Person-to-person by direct contact with blister fluid or airborne spread of aerosolized blister secretions and respiratory secretions. Indirect spread is possible through articles recently soiled by infected respiratory secretions or blister fluid.

INCUBATION (time from exposure to onset of symptoms) 10 to 21 days, usually 14 to 16 days

CONTAGIOUS PERIOD

As long as 5 days before the rash begins, but usually 1 to 2, until all lesions are crusty/scabbed (usually 5 days after their appearance). Immunocompromised individuals may have a longer period of communicability.

DIAGNOSIS

Usually based on observing symptoms including the characteristic rash.

TREATMENT

Recommend parents/guardians call their healthcare provider.
DO NOT GIVE ASPIRIN or OTHER SALICYLATE-CONTAINING MEDICATIONS TO ANY CHILD OR ADOLESCENT UNDER 18 YEARS OF AGE.

August 2014

Communicable Disease Guide for Schools and Child Care Settings SCHOOL/CHILDCARE GUIDANCE
EXCLUSION
Child care and School: Until all the blisters have scabbed (usually 5 days after their appearance), regardless of vaccination status. Breakthrough varicella in vaccinated children is contagious. The incubation period for chickenpox is 10 to 21 days; it is possible that a child could be incubating (infected with varicella virus, but not yet showing symptoms) when they receive the varicella vaccine. Exclude a child with chickenpox symptoms until the blisters have scabbed regardless of whether or not they have received varicella vaccine.
PREVENTION/CONTROL
• All children should be vaccinated with two doses of varicella vaccine; the first dose is at age 12-15 months and the second dose is typically at 4-6 years of age.
• If you think a child has chickenpox, have the parent/guardian call their healthcare provider before taking the child in.
• Cover nose and mouth with a tissue when coughing or sneezing or cough/sneeze into your elbow. Dispose of used tissues.
• Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth or blister fluid.
• Clean and sanitize mouthed toys, objects, and surfaces and clean and disinfect objects and surfaces contaminated with secretions from the nose or mouth and/or blister fluid at least daily, and when soiled.
• Susceptible persons (did not receive varicella vaccine) who have been exposed to someone with chickenpox should call their healthcare provide immediately. This is especially important for pregnant women and persons with a weakened immune system.

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MUST BE REPORTED IMMEDIATELY :
By phone: 925-313-6740 OR

If it is after work hours, call the Sherriff’s dispatch at 925-646-2441 and ask for the “Health Officer on call.”

Communicable Disease Programs-Acute Communicable Disease

What are the symptoms of flu?

• Fever
• Cough
• Sore throat
• Runny or stuffy nose • Muscle or body aches • Headaches
• Fatigue (tiredness)

Some people can also have vomiting and diarrhea. Symptoms start 1 to 3 days after being exposed to the virus and may last up to one week or longer. Complications caused by the flu can include: pneumonia, ear infections, sinus infections, and dehydration. The flu can also make a person’s chronic medical conditions (e.g. asthma, heart or lung disease, etc.) worse.

How common is flu?

Every year in the U.S., the seasonal flu causes thousands of people to need care in a hospital and some die. Flu that occurs every winter season is called the “seasonal flu”. In California, flu season usually begins in December and can continue through March.

Who can get flu?

Anyone can get the flu. Some people are at higher risk of serious health problems when they get sick with the flu. These people include:
• Pregnant women
• Infants

• The elderly
• People with chronic health conditions (e.g. asthma, diabetes, heart disease, weak immune system, etc.)

What is the treatment for flu?

Specific treatment for influenza will be determined by your health care provider. Some things you can do to help with flu symptoms:
• Get plenty of rest
• Drink lots of liquids

• Eat healthy foods
Over the counter pain relievers can help people with the flu feel more comfortable. Children and teens (anyone under 20 years old) sick with the flu should never take aspirin or aspirin- containing medications without consulting a doctor. There are some flu medications available for people at higher risk of serious health problems but they need a doctor’s prescription and cannot be bought over the counter.

How is flu spread?

Flu is spread from person to person by direct contact with an infected person or through the air from coughing and sneezing. The incubation period (time between exposure to flu virus and start of illness) is estimated to range from 1 to 4 days with an average of 2 days. Once infected, a person sheds virus during the contagious period, which can start as early as 1 day before symptoms appear and continue for another 5 to 7 days after symptoms start.

How is flu prevented?
The best way to prevent flu illness is by getting vaccinated. Influenza vaccination is recommended yearly for everyone 6 months and older. It is safe and effective to receive both flu and COVID vaccine at the same visit.

• Get flu vaccine yearly.
• Wash hands often with soap and warm water.
• Use tissue or upper arm when you cough and sneeze. Dispose of the tissue in a

covered trash bin.
• Clean shared items (e.g. phones, keyboards, office equipment, toys, etc.) more

often.
• Avoid crowds.
• Avoid people who are sick with respiratory illness.
• Exclude children with respiratory illness from daycare and school.
• Stay home for at least 24 hours after becoming fever free or finishing medication if

you are ill with flu or any respiratory illness.