• Communicable Diseases
  • Prevent the spread of communicable diseases by following good health habits:  
    • Avoid close contact with people who are sick

    • Stay home when you are sick

    • Cover your mouth and nose with a tissue when you cough or sneeze; then put your used tissue in the waste basket

    • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue

    • Wash your hands often with soap and warm water for at least 20 seconds, especially after coughing or sneezing and before preparing foods or eating

    • Use an alcohol-based hand rub if soap and water are not available

    • Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill

    (Source:  Centers for Disease Control and Prevention:  https://www.cdc.gov/flu/protect/stopgerms.htm)
  • .
    Conjunctivitis (Pink Eye)
    What is Pink Eye?
    Pink eye, also known as conjunctivitis, is one of the most common and treatable eye conditions in children and adults. It is an inflammation of the conjunctiva, the thin, clear tissue that lines the inside of the eyelid and the white part of the eyeball. This inflammation makes blood vessels more visible and gives the eye a pink or reddish color.

    What causes Pink Eye?
    There are four main causes of pink eye:
    • Viruses
    • Bacteria
    • Allergens (like pet dander or dust mites)
    • Irritants (like smog or swimming pool chlorine) that infect or irritate the eye and eyelid lining
    How is Pink Eye treated?
    Most cases of pink eye are mild and get better on their own, even without treatment. However, there are times when it is important to see a healthcare provider for specific treatment and/or close follow-up. You should see a healthcare provider if you have pink eye along with any of the following:
    • Moderate to severe pain in your eye(s)
    • Sensitivity to light or blurred vision
    • Intense redness in the eye(s)
    • A weakened immune system, for example from HIV or cancer treatment
    • Symptoms that get worse or don't improve, including bacterial pink eye that does not improve after 24 hours of antibiotic use
    • Pre-existing eye conditions that may put you at risk for complications or severe infection
    How Do I Stop Pink Eye from Spreading?
    Pink eye caused by a virus or bacteria is very contagious and spreads easily and quickly from person to person.
    Pink eye that is caused by allergens or irritants is not contagious, but it is possible to develop a secondary infection caused by a virus or bacteria that is contagious.
    You can reduce the risk of getting or spreading pink eye by following some simple self-care steps:
    • Wash your hands.
    • Avoid touching or rubbing your eyes.
    • Avoid sharing eye and face makeup, makeup brushes, contact lenses and containers, and eyeglasses.
    (Source: Centers for Disease Control & Prevention: https://www.cdc.gov/features/conjunctivitis/)
  • .

    Hand, Foot, & Mouth Disease (Coxsackievirus)
    What is Hand, Foot, and Mouth Disease (HFMD)?
    Hand,  foot,  and mouth disease is a common viral illness that is most frequently seen in the summer and early fall. This illness generally is mild and is most commonly caused by coxsackievirus A16 and enterovirus 71.
    What are symptoms of HFMD?
    Symptoms of HFMD often include:
    • fever
    • reduced appetite
    • sore throat
    • a feeling of being unwell
    • painful sores in the mouth that usually begin as flat red spots
    • a rash of flat red spots that may blister on the palms of the hands, soles of the feet, and sometimes the knees, elbows, buttocks, and/or genital area
    These symptoms usually appear in stages, not all at once. Not everyone will get all of these symptoms. Some people may show no symptoms at all, but they can still pass the virus to others.

    How is HFMD spread?
    The viruses that cause HFMD can be found in an infected person’s nose and throat secretions (such as saliva, sputum, or nasal mucus), blister fluid, and feces (stool). An infected person may spread the viruses that cause HFMD to another person through close personal contact, the air (through coughing or sneezing), contact with feces, contact with contaminated objects and surfaces. For example, you might become infected by kissing someone who has HFMD, or by touching a doorknob that has viruses on it then touching your eyes, mouth or nose.
    Who is at risk for HFMD?
    Infants and children younger than five years old are most likely to get HFMD, because they do not yet have immunity (protection) to the viruses that cause HFMD. However, older children and adults can also get HFMD. In the United States it is more common for people to get HFMD during summer and early fall.
    How is HFMD treated?
    There is no specific treatment for HFMD. Fever and pain can be managed with over-the-counter fever reducers and pain relievers. It is important for people with HFMD to drink enough fluids to prevent dehydration (loss of body fluids).
    How can I protect myself from becoming infected with HFMD?
    There is no vaccine to protect against HFMD. However, you can reduce the risk of getting infected with the viruses that cause HFMD by following good health habits.
    If a child is diagnosed with HFMD, should they be excluded from school/daycare or team sports?
    Exclusion from school or sports is recommended for ill individuals until they are fever free for 24 hours without fever reducing medicine. The decision about whether an individual is healthy enough to return to sports should be made by their health care provider.
    For school exclusion guidance, go to:  http://www.nj.gov/health/cd/outbreaks.shtml
    Should team sports be cancelled or schools closed during outbreaks of HFMD?  
    NJDOH does not recommend cancelling team sports or closing school for outbreaks of HFMD or most infectious diseases.   Schools should work with local health departments (LHD) to ensure that recommended control measures (e.g., exclusions, increased cleaning) are being followed. LHDs should be advised if team sports are cancelled or schools closed for outbreaks of communicable disease.
    Single cases of HFMD are not reportable in New Jersey. However, confirmed or suspect outbreaks of any communicable disease are immediately reportable to the local health department of the jurisdiction in which the school is located. An outbreak is defined as an occurrence of disease greater than would otherwise be expected at a particular time and place.  If you suspect an outbreak may be occurring, call your LHD and refer to the guidance document referenced above. A directory of local health departments can be found at http://localhealth.nj.gov. Notification MUST be made by phone. 
    (Source: NJ Dept. of Health: http://nj.gov/health/cd/documents/faq/hfmd_faq.pdf)
  • .

    Influenza (Flu)
    What is the difference between influenza (the flu) and norovirus (the stomach flu)?
    Influenza (the flu) is a respiratory disease that affects your air passages, such as your nasal passages and lungs. 
    Norovirus (the stomach flu) is an intestinal disease that affects your stomach.  The virus causes your stomach or intestines or both to get inflamed. This leads you to have stomach pain, nausea, and diarrhea and to throw up.  
    While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to influenza — more commonly in children than adults — these problems are rarely the main symptoms of influenza.
    What is the difference between a cold and the flu?
    The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar symptoms, it can be difficult to tell the difference between them based on symptoms alone.
    In general, the flu is worse than the common cold, and symptoms are more common and intense.
    Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose.
    What are the symptoms of the flu versus the symptoms of a cold?
    The symptoms of flu can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness).
    Cold symptoms are usually milder than the symptoms of flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems.
    What should I do if I get sick with the flu?
    Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

    If, however, you have symptoms of flu and are in a high risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).

    Certain people are at high risk of serious flu-related complications (including young children, people 65 and older, pregnant women and people with certain medical conditions). This is true both for seasonal flu and novel flu virus infections. (For a full list of people at high risk of flu-related complications, see People at High Risk of Developing Flu–Related Complications). If you are in a high risk group and develop flu symptoms, it’s best for you to contact your doctor. Remind them about your high risk status for flu.

    Health care providers will determine whether influenza testing and treatment are needed. Your doctor may prescribe antiviral drugs that can treat the flu. These drugs work better for treatment the sooner they are started.
    How long should I stay home if I am sick with the flu?
    CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or other necessities. Your fever should be gone without the use of a fever-reducing medicine, such as Tylenol. You should stay home from work, school, travel, shopping, social events, and public gatherings.
    Please visit:
    - CDC's comprehensive website regarding the flu:  https://www.cdc.gov/flu/index.htm
    - And click here to view the NJ Dept of Health's Feb. 2018 notice regarding flu activity in schools.  
    (Source:  Centers for Disease Control and Prevention: https://www.cdc.gov/flu/about/qa/coldflu.htm; https://www.cdc.gov/flu/takingcare.htm; https://www.cdc.gov/flu/about/qa/disease.htm#seasonal-flu) 
  • .
    Measles (Rubeola)
    What are the symptoms of measles?
    Measles, or rubeola, is a very contagious disease caused by a virus. Measles starts with a fever. Soon after, it causes a cough, runny nose, and red eyes. Then a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body. Measles can be serious for young children. It can lead to pneumonia, encephalitis (swelling of the brain), and death. Measles spreads through the air when an infected person coughs or sneezes. It is so contagious that if one person has it, 90% of the people around him or her will also become infected if they are not protected.

    What happens if there is a case of measles confirmed in my child's school?
    Please be aware of the following exclusion criteria set forth by the NJ Department of Health (NJDOH) should a case of the measles be confirmed in your child’s school:
    Measles is a reportable communicable disease and, therefore, the Board of Health will be notified immediately of any suspected cases and actively involved in case management. If a student is not vaccinated for Measles, Mumps and Rubella (MMR) and a case of measles occurs in his/her school, they may be excluded until 21 days after rash onset in the last case of measles.  Excluded students may be readmitted if they provide proof of vaccination within 72 hours of first exposure or provide proof of immunity via bloodwork (titer) to the school nurse.
    Adequate measles vaccination for school attendance as per state guidelines is as follows:
    • One or more doses of a measles-containing vaccine administered on or after the first birthday for preschool-age children.
    • Two doses of measles-containing vaccine for school-age children (K-12).
    • There must be written documentation of adequate vaccination on file in your child’s school health office.

    For further information related to your child’s immunity, please contact your child’s physician.

    For further information related to measles, visit www.cdc.gov and/or NJDOH Measles Exposure Guidance (January 2015).

    For further information related to the state’s exclusion criteria, religious exemption, or medical exemption, refer to Chapter 14 New Jersey Stated Sanitary Code Immunization of Pupils in Schools (July 19, 2004).
    (Source: Centers for Disease Control & Prevention: https://www.cdc.gov/measles/; NJDOH: https://www.nj.gov/health/cd/measles/documents/measles_exposures_guidance_01_2015.pdf)
  • .
    Norovirus (Stomach Flu)
    What is the difference between influenza (the flu) and norovirus (the stomach flu)?
    Influenza (the flu) is a respiratory disease that affects your air passages, such as your nasal passages and lungs. 
    Norovirus (the stomach flu) is an intestinal disease that affects your stomach. The virus causes your stomach or intestines or both to get inflamed. This leads you to have stomach pain, nausea, and diarrhea and to throw up.
    While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to influenza — more commonly in children than adults — these problems are rarely the main symptoms of influenza.
    What are the symptoms of norovirus?
     The most common symptoms of norovirus are:
    • diarrhea
    • throwing up
    • nausea
    • stomach pain
    Other symptoms:
    • fever
    • headache
    • body aches
    A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Most people with norovirus illness get better within 1 to 3 days.
    If you have norovirus illness, you can feel extremely ill and throw up or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses.

    How can you prevent yourself from getting the norovirus illness?
    There is no vaccine to prevent norovirus infection, but research is being done in this area.  You can reduce the risk of getting infected with norovirus by following good health habits.
    (Source:  Centers for Disease Control & Prevention: https://www.cdc.gov/norovirus/index.html)
  • .

    What is ringworm?
    Ringworm is a common skin infection that is caused by a fungus. It’s called “ringworm” because it can cause a circular rash (shaped like a ring) that is usually red and itchy. Anyone can get ringworm. The fungi that cause this infection can live on skin, surfaces, and on household items such as clothing, towels, and bedding.

    Ringworm goes by many names. The medical terms are “tinea” or “dermatophytosis.” Other names for ringworm are based on its location on the body – for example, ringworm on the feet is also called “athlete’s foot.”.
    For a comprehensive guide on symptoms, treatment, and prevent, visit:  https://www.cdc.gov/fungal/diseases/ringworm/
    (Source: Centers for Disease Control and Prevention:  https://www.cdc.gov/fungal/diseases/ringworm/definition.html)
  • .
    What is scabies?
    Scabies is an infestation of the skin by the human itch mite. The microscopic scabies mite burrows into the upper layer of the skin where it lives and lays its eggs. The most common symptoms of scabies are intense itching and a pimple-like skin rash. The scabies mite usually is spread by direct, prolonged, skin-to-skin contact with a person who has scabies.

    How soon after infestation do symptoms of scabies begin?
    If a person has never had scabies before, symptoms may take as long as 4-6 weeks to begin. It is important to remember that an infested person can spread scabies during this time, even if he/she does not have symptoms yet.

    In a person who has had scabies before, symptoms usually appear much sooner (1-4 days) after exposure.
    What are the signs and symptoms of scabies infestation?
    The most common signs and symptoms of scabies are intense itching (pruritus), especially at night, and a pimple-like (papular) itchy rash. The itching and rash each may affect much of the body or be limited to common sites such as the wrist, elbow, armpit, webbing between the fingers, nipple, penis, waist, belt-line, and buttocks. The rash also can include tiny blisters (vesicles) and scales. Scratching the rash can cause skin sores; sometimes these sores become infected by bacteria.

    Tiny burrows sometimes are seen on the skin; these are caused by the female scabies mite tunneling just beneath the surface of the skin. These burrows appear as tiny raised and crooked (serpiginous) grayish-white or skin-colored lines on the skin surface. Because mites are often few in number (only 10-15 mites per person), these burrows may be difficult to find. They are found most often in the webbing between the fingers, in the skin folds on the wrist, elbow, or knee, and on the penis, breast, or shoulder blades.

    The head, face, neck, palms, and soles often are involved in infants and very young children, but usually not adults and older children.

    Can scabies be treated?
    Yes. Products used to treat scabies are called scabicides because they kill scabies mites; some also kill eggs. Scabicides to treat human scabies are available only with a doctor’s prescription; no "over-the-counter" (non-prescription) products have been tested and approved for humans.
    (Source: Centers for Disease Control & Prevention: https://www.cdc.gov/parasites/scabies/gen_info/faqs.html)
  • .
    Strep Throat
    What is the difference between a sore throat and strep throat?
    Many things can cause that unpleasant, scratchy, and sometimes painful condition known as a sore throat. Viruses, bacteria, allergens, environmental irritants (such as cigarette smoke), and chronic postnasal drip can all cause a sore throat. While many sore throats will get better without treatment, some throat infections—including strep throat—may need antibiotic treatment.
    Strep throat is an infection in the throat and tonsils caused by group A Streptococcus bacteria (called "group A strep"), which spread through contact with droplets from an infected person's cough or sneeze. Unlike sore throats caused by viruses, strep throat is treated with antibiotics prescribed by a physician.
    What are the symptoms of strep throat?
    In general, strep throat is a mild infection, but it can be very painful. Symptoms of strep throat usually include:
    •     Sore throat that can start very quickly
    •     Pain when swallowing
    •     Fever
    •     Red and swollen tonsils, sometimes with white patches or streaks of pus
    •     Tiny, red spots (petechiae) on the roof of the mouth (the soft or hard palate)
    •     Swollen lymph nodes in the front of the neck
    Other symptoms may include a headache, stomach pain, nausea, or vomiting — especially in children.  Someone with strep throat may also have a rash known as scarlet fever (also called scarlatina).  It usually takes two to five days for someone exposed to group A strep to become ill.
    Cough, runny nose, hoarseness (changes in your voice that makes it sound breathy, raspy, or strained), and conjunctivitis (also called pink eye) are not symptoms of strep throat and suggest that a virus is the cause of the illness.
    How do I know for sure if I have strep throat?
    Your clinician can swab your throat to quickly see if group A strep bacteria are causing your sore throat; looking at your throat is not enough to make a diagnosis. If the test is positive, antibiotics will be prescribed to help you get well quickly, prevent complications, and keep you from spreading the infection.
    What do should I do if I am diagnosed with strep throat?
    People with strep throat should stay home from work, school, or daycare until they have taken antibiotics for at least 24 hours.  Antibiotics taken for strep throat reduce the length of time you’re sick and help prevent the spread of infection to friends and family members.
    (Source:  Centers for Disease Control and Prevention:  https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html; https://www.cdc.gov/dotw/strepthroat/index.html)