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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 2. Recommendations for Care of Children in Special Circumstances
SCHOOL HEALTH
Although clustering of children together in the school setting provides opportunities for spread of infectious diseases, school attendance is important for children and adolescents, and unnecessary barriers and impediments to attending school should be minimized. Determining the likelihood that infection in one or more children will pose a risk for schoolmates depends on an understanding of several factors, including the following: (1) the mechanism by which the organism causing the infection is spread; (2) the ease with which the organism is spread (contagion); and (3) the likelihood that classmates are immune because of immunization or previous infection. Decisions to intervene to prevent spread of infection within a school should be made through collaboration among school officials, local public health officials, and health care professionals, considering the availability and effectiveness of specific methods of prevention and the risk of serious complications from infection.
Infectious agents are spread through one or more of the following routes of transmission: fecal-oral; respiratory; contact with infected skin; and contact with blood, urine, or body secretions. In the school setting, respiratory tract secretions and skin contact provide the most common means of transmission of microorganisms. In the care of preschool children in out-of-home child care (see Children in Out-of-Home Child Care, p 123) and older children with health problems or developmental disabilities, transmission via the fecal-oral route and through contact with urine also is an important consideration. Specific circumstances, such as care of bleeding injuries or intimate contact between classmates, provide an opportunity for spread via blood and other body fluids.
Generic methods for control and prevention of spread of infection in the school setting include the following:
For vaccine-preventable diseases, documentation of the immunization status of enrolled children should be
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