Kane County Health Department

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Kane County Health Department (KCHD) General Guidelines for Control of Outbreaks in Schools and Daycare Settings


I. Reporting

Reporting communicable disease outbreaks in schools and daycares serves multiple important purposes. The immediate objective is to control and prevent further spread of the disease. Additionally, data gathered from outbreak investigations assist schools and public health agencies in identifying and eliminating sources of infection, such as contaminated products. This information also helps in recognizing emerging health issues, identifying carriers to reduce their role in transmission, and developing new prevention strategies tailored for schools and daycares.

In the school setting, it is often challenging to determine whether an outbreak is occurring. Please see the list of outbreaks that schools and daycares are required to report to the KCHD. If your situation does not meet any of these criteria but you suspect an outbreak may be happening, please contact KCHD for further guidance.

An outbreak may be occurring if:

  1. Several children who exhibit similar symptoms are in the same classroom, the same wing of a facility or they attended a common event
  2. There is an increase in school absences with many parents reporting similar symptoms as the reason why their child is not attending school
  3. Two or more students are diagnosed with the same reportable disease

Note: Do not wait for confirmation of an outbreak before reporting in these instances, as the potential for an outbreak exists and early action is critical.

Reporting involves not only the initial notification of an outbreak but also the ongoing provision of routine updates on its status. The school and KCHD should maintain frequent communication regarding case numbers, control measures implemented, and any other pertinent information.

II. Steps in an Outbreak

A) Schools and daycares

Upon suspecting of an outbreak:

1. Gather information to confirm an outbreak. Provide as much of the following as possible:​

  • Provide total number of students and staff in school/daycare.
  • Start a line list (also known as an illness log) that includes all ill children and staff. 
  • Compile a list of extracurricular activities and special events that suspect cases may have attended. Some examples of extracurricular activities or events include sports, social events, clubs, etc.
2. The school/daycare shall notify the KCHD Communicable Disease Program. Notification MUST be made as soon as possible however, no later than 24 hours of being suspected. To report use either of the following methods:

3. Perform active surveillance as directed by KCHD:

  • Be vigilant for new‐onset illness among exposed persons, and review student and staff absenteeism records and histories to identify previous onsets of illness that may not have been accurately recognized as being part of the outbreak. When a student is absent, ask parents to provide the reason for the student's absence in order to determine if the student is part of the outbreak and/or is in need of further follow up by the KCHD.

4. Document and count cases:

  • The school shall maintain a daily log (line list) of the number of students and staff absent due to any illness (see Appendix B).
  • The school shall complete the daily absenteeism log (see Appendix C).
  • The line list and the absenteeism log will be shared with KCHD epidemiologist or the investigator for that outbreak regularly to assess the status of the outbreak, and to provide further recommendations regarding infection prevention and control measures.

 
B) KCHD Communicable Disease Program

Upon notification:

  1. The KCHD staff will determine if an outbreak does exist.
  2. The KCHD staff will assess the report and shall lead the investigation by providing the school with guidance, support and assistance.
  3. Based on the assessment of the KCHD, confirmation of the diagnosis with a laboratory test may be necessary. Lab testing may be done through a private physician and laboratory, or the state laboratory. The KCHD staff shall facilitate lab testing and/or specimen transport if it deems eligible to be tested at the state laboratory.
  4. The KCHD staff should collaborate with the school and daycares to determine the outbreak source.
  5. The KCHD staff, in consultation with IDPH epidemiologist, shall provide recommendations and guidance to the school regarding control measures.

 
 C) School and Daycare Closures

  1. IDPH does not recommend school or daycare closure for outbreaks of infectious disease. The decision to close a school is an administrative decision and one that should be made only after consultation with public health officials and the district medical provider.
  2. Schools should work with KCHD to ensure that recommended control measures (e.g., exclusions, increased cleaning) are being followed. In addition, KCHD in conjunction with IDPH may recommend enhanced surveillance be conducted in a school in order to monitor the progression and ultimate decline of an outbreak.
  3. If the school or daycare decides to close the school based on their administrative decision, then the KCHD should be notified.

 
D) Infection Control During an Outbreak

Ensure compliance of general infection prevention practices, such as:

  1. Hand hygiene – washing hands with soap and water before and after meals, after restroom breaks, or when hands are visibly dirty, and using alcohol-based hand sanitizers during respiratory illness.
  2. Gloves and gowns should be worn during contact with blood, feces or body fluids.
  3. Remove and dispose of gloves after completing tasks, before touching anything else.
  4. Reinforce respiratory etiquette to students and staff (coughing and sneezing into a tissue or elbow, properly disposing of tissues).
  5. Use appropriate barriers including materials such disposable diaper table paper, disposable towels and surfaces that can be sanitized in group care settings.
  6. Restrict use of equipment and toys to use within a specific area and do not allow children to share without cleaning and disinfecting.
  7. Staff assigned to affected classrooms should not rotate to unaffected classrooms.

Additional measures may be necessary, such as:

  1. Cleaning and disinfecting; Increase frequency during an outbreak using EPA registered products for specific organisms.  
  2. Immediately after spills of body fluids, discard fluid contaminated material in a plastic bag that has been securely sealed.
  3. Mops should be cleaned, rinsed with a disinfecting solution, wrung as dry as possible and hung to dry completely. Change mop heads when a new bucket of cleaning solution is prepared, or after cleaning large spills of emesis or fecal material.
  4. Do not use the same cloth for cleaning/disinfecting; use disposable towels and dispose of them immediately after use.

 
E) Infection or Condition and Common Symptoms Exclusion for School/Daycare Children

  • Recommendations for Exclusion due to Health-Related Issues
  • Exclusion Criteria of Communicable Diseases
  • Recommended School Action for Non-Reportable Diseases

F) Sample Letter to Families about Exposure to Communicable Disease (see SAMPLE LETTERS)



​​Outbreak Definitions

Outbreak Line List