Control of Infections in Schools
Julia A. McMillan MD1
1 Associate Professor of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
School staff members, public health officials, and parents often look to pediatricians to provide recommendations for dealing with exposure in school to a variety of infectious diseases (Table 1). It is extremely important to provide accurate, consistent, and sufficient information to allow parents to make individual decisions regarding their children without unnecessary fear. Schools should take appropriate precautions to assure that students are not put at unnecessary risk of serious infection, but they also have a responsibility to protect the privacy of any children whose infection poses little or no risk to their classmates.
In considering appropriate recommendations for exposures to specific infections in schools, it is important to review the available information about the mechanism(s) by which the infection is spread from person to person as well as the likelihood of spread. It also is important to recognize the extent to which contacts would be expected to be immune, either by virtue of previous infection or through immunization. The availability of methods for prevention of infection in susceptible contacts (passive or active immunization, antimicrobial therapy) should be reviewed, and recommendations for implementation made based on the risk of infection and the severity of the disease.
Varicella Exposure
Varicella generally is a mild illness of childhood; 90% of cases occur in children 14 years of age or younger, and most cases in the United States occur in children between the ages of 5 and 10 years (Table 2).
