A GUIDE

TO COMMON INFECTIONS
for Child Care Providers and Schools

August 2022
INFECTION INDEX
Amoebiasis 7 Mononucleosis 14
Bed Bugs 6 Mumps 14
Bite (child to child) 4 Norovirus 15
Campylobacter 7 Pinkeye (Conjunctivitis) 15
Chickenpox (Varicella) 7 Pinworm 16
Common Cold 8 Respiratory syncytial virus (RSV) 16
Cold Sore (Herpes Simplex Type 1) 8 Ringworm 17
Coronavirus Disease (COVID-19) 8 Roseola (Sixth Disease) 17
Diarrhea 4 Rotavirus 18
Escherichia coli (E. coli) 9 Rubella (German Measles) 18
Fifth Disease 9 Salmonella 18
Giardia 9 Scabies 19
Hand/Foot/Mouth Disease (Cocksackie Virus) 10 Scarlet Fever 19
Hepatitis A 10 Shigellosis 19
Hepatitis B 11 Shingles 20
Impetigo 11 Strep Throat 20
Influenza 12 Tick Bite 5
Lice 5 Thrush 20
Measles (Red Measles) 12 Whooping Cough (Pertussis) 21
Meningitis 13 Yersiniosis 21
Molluscum Contagiosum 13
INTRODUCTION
This booklet will help support you in the management of a child attending your facility who has a communicable disease. It provides information about common
communicable diseases, including signs and symptoms, how they are spread, if it is a reportable disease and links to additional resources. If a person is suspected
or confirmed of having a disease from the Diseases of Public Health Significance list, the Windsor-Essex County Health Unit (WECHU) must be informed.

The Health Protection and Promotion Act (R.S.O. 1990, c. H.7, part IV, s. 28)
If the principal of a school or manager of an institution (e.g., daycare) who suspects or knows
that a child in their facility has a reportable disease, they should monitor and report to the
health unit immediately.

Reporting High Absenteeism Rates

In order to remain proactive in preventing the spread of communicable diseases, we ask that you report to the
Health Unit when there are trends/clusters of absenteeism in your facility/classroom/cohort which are above
the normal absenteeism rate, or when you are concerned about the high absenteeism rate overall. For further
information or consultation, please contact your School Nurse or call extension1555.

2 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 WHAT IS A COMMUNICABLE DISEASE?
Any disease that can be spread from one person to another is considered communicable or contagious. When a person is sick,
there are only certain times that they can give the disease to others (known as the contagious period). During this period, it may be
recommended that a child or staff be excluded from school or day care to prevent the spread of infection.

How is an infection spread?

Communicable diseases are illnesses that are caused by germs, which include bacteria, viruses, parasites, or fungi. These germs are
found in body secretions, such as feces (poop), mucus, phlegm or in tiny droplets that are breathed, coughed, or sneezed out.
Germs that cause communicable diseases are spread from person-to-person in different ways. Some germs are spread through the
air, like influenza (flu). Others are spread by touching a person infected with the illness or by touching an object that has the germ,
like chickenpox. Germs can also be spread through water or contaminated food, like salmonella.

PREVENTING INFECTION
In your institution, you can control germs effectively by:
• Encouraging hand hygiene and ensuring that there is ample supply of • Stressing the importance of not sharing any personal items, such as
warm running water, soap, paper towels, and alcohol-based hand rub cups, eating utensils, chapsticks, brushes, etc.
(70-90% alcohol) available. Hand hygiene is the most important way • Routinely cleaning and disinfecting surfaces and objects (e.g., toys,
to prevent the spread of infections. Wash your hands thoroughly and books, desks, doorknobs, counters, etc.) that come in contact with
frequently using warm water, soap, and rubbing your hands together children. Increase the frequency when indicated to control certain
for a minimum of 15 seconds (about the time it takes to sing “Happy diseases.
Birthday”). Allow time for children to wash hands after washroom
• Handling and disposing of contaminated items properly.
breaks and before eating.
• Practicing safe food handling including washing all uncooked fruits and
• Teaching and practicing respiratory etiquette, including coughing and/
vegetables in clean water, and storing and cooking food properly.
or sneezing into your elbow or tissue and then washing your hands.
• Encouraging parents to keep their child at home if they are sick.
• Encouraging parents to keep their child(ren)’s vaccinations up-to-date.
FAQ’S
What do I do if a child has diarrhea? What do I do if a child is bitten by another?
Generally, all the germs that cause diarrhea are found in the feces of an Young children often bite. Most bites are harmless and don’t break the skin.
infected person. These germs can spread directly from person-to-person and If a biter breaks the skin or if blood is drawn into the mouth of the biter,
indirectly from contaminated hands of staff and children, as well as objects, germs can be transmitted. If that happens, it is recommended that the
surfaces, food, or water. children be seen by a health care provider.
Diarrhea may be dangerous in infants and young children because it may
cause dehydration. Some signs of dehydration to look How should you care for a wound from a bite?
for include: Always wear gloves when handling blood and bodily fluids. If the skin is not
• Decreased urination • No tears • Dry skin and mouth broken, clean the wound with soap and water, and apply a cold compress.
• Sunken eyes • Grayish skin If the skin is broken:
Children should be excluded from school until the diarrhea is gone or a 1. Let the wound bleed freely.
doctor determines the child is not infectious. 2. Clean with soap and water.
Parents should be notified at once if any of the following are present: 3. Report the incident/bite to the parents.
• Diarrhea • Fever • Vomiting 4. Encourage medical follow-up.

4 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
What do I do if a child is bitten by a tick? What do I do if a child has head lice?
Children who are bitten by a tick are at risk for Lyme Disease, Outbreaks of head lice are common among children in schools
Rocky Mountain Spotted Fever, Powassan Virus Disease, and and institutions everywhere. It is spread by direct head-to-head contact
Tularemia. Ticks vary in size and colour, but the species that spreads Lyme with infested persons and through objects used by them such as
Disease is the blacklegged deer tick, which is usually small (3 to 5mm) headgear and hairbrushes. As long as there are live eggs on the person
and dark. If a child has been bitten by a tick, it is important to remove the or on objects the person touches, head lice can be passed from
tick as soon as possible, as the likelihood of infection increases if a tick has person-to-person. Lice eggs can live away from the host for up to 3 days.
been attached for 24 hours or more. If a child is bitten by a tick: Hatched head lice can survive for only 1 to 2 days away from a person.
1. Using tweezers, grasp the tick close to the skin. If a child has head lice, the parents should be advised that:
2. Pull the tick gently and do not twist. 1. Clothing, bedding, and other objects used by the infested person
3. Do not squeeze, smother or burn the tick. should be treated by laundering with hot water, drying in a hot dryer,
dry cleaning, or using an effective chemical insecticide.
4. Gently wash the bite with a disinfectant (e.g., alcohol).
2. Household and close personal contacts should be examined and
5. Save the tick in a container and advise the parent to submit a picture
treated if applicable.
of the tick to [Link]. This is a free online service that uses a
photograph of the tick to identify its type. Please note that the Health
Unit no longer accepts ticks for testing or identification. How is head lice treated?
6. Recommend to the parent to follow-up with their health care provider Head lice can be treated by using specific chemical shampoo and
to notify them of their child’s tick bite. removing all lice eggs or by using the wet combing method, which
is non-chemical and is much less effective. It is not recommended for
7. Refer to [Link] for further information.
children with head lice to be excluded from school.

How do I prevent
head lice?
Head lice can be prevented by
encouraging parents to check
their children for lice routinely,
and discouraging children
Source: ©All Rights Reserved. from sharing towels, clothing,
Public Health Agency of combs, and hats.
Canada. Reproduced with
permission from
the Minister of Health, 2015.
What do I do if a child has bedbugs? How is bedbug bites treated?
Bedbugs are small, wingless insects that feed on humans Most bedbug bites go away without treatment. However, the bites can get
and animals. They do not fly or jump, but are moved from infected. It is important to keep the skin clean and not to scratch them. If
place to place as people move. They hide in small spaces, such as seams of the bites are very itchy or get infected, see your health care provider.
clothes, bags, and furniture. They are very difficult to get rid of. It is not recommended for children with bedbugs to be excluded from
If a child has bedbugs, the parents should be advised to: school. Observe for symptoms of infestation in school, and call professional
1. Consult professional pest control services and discuss options that are pest control services as needed.
safest for humans and the environment.
2. Vacuum all the crevices and mattresses in your house. How do I prevent bedbugs?
3. Wash all laundry in the hottest water possible, and put them in a 1. Regularly clean your house, including your mattress.
hot dryer for 20 minutes. 2. Minimize clutter.
4. Cover your pillows and 3. Inspect used furniture or clothes.
mattress with a plastic cover. 4. When traveling, inspect your room and furniture and keep your
5. Minimize clutter. items off the floor.
For more information on bedbugs, visit [Link]

INFECTIOUS DISEASE AND PREGNANCY

If you are pregnant or planning to become pregnant:
1. Review your immunization status and occupation with a family
doctor, preferably before pregnancy.
2. Avoid contact with people who appear ill.
3. Wash your hands often.

6 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 Note: This guide is for information purposes only. Diagnosis of the following infections must be made by a health care provider.

*RECOMMENDED SCHOOL REPORTABLE

INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Amebiasis Commonly seen 2-4 weeks after A person can spread the Person-to-person by fecal-oral Exclude for 24 hours after Yes
Parasite exposure: germ as long as the germ is route (e.g., unwashed hands). diarrhea resolves.
• Severe diarrhea present in the feces. This may Putting anything in the mouth OR
• Stomach cramps or pain continue for months. that has had contact with infected 48 hours after completion
• Bloody feces feces (e.g., toys). of medical treatment.
• Fever
Swallowing contaminated food or
• Chills water.
• Weight loss

Campylobacter Commonly seen 2-5 days after A person is contagious for as Person-to-person by fecal-oral Exclude until symptom free Yes
Bacteria exposure: long as the germ is present route (e.g., unwashed hands). for 24 hours.
• Diarrhea that can be bloody in the feces; usually several Putting anything in the mouth OR
• Feeling unwell days to several weeks. that has had contact with infected 48 hours after completion
• Fever feces (e.g., toys). of medical treatment.
• Nausea / vomiting
Swallowing contaminated food or
• Stomach cramps or pain water, such as raw or undercooked
meats.
Contact with infected animals.

Chickenpox Commonly seen 14-16 days after A person is contagious for Person-to-person via contact with Exclude until child is well Yes
(Varicella) exposure, but can range from as long as 5 days, but usually blisters. enough to participate in Reporting
Virus 10-21 days: 1-2 days, before rash starts By breathing in contaminated air activities. forms are
• Small red bumps all over the and until all blisters are from an infected person who is Parents and staff available on
body, which may develop into crusted over (usually about sneezing, coughing, or speaking. (especially pregnant or the Health
itchy, fluid-filled rash that then 5 days after rash onset).
becomes encrusted Touching your eyes, mouth, or nose immunocompromised Unit website
after touching contaminated hands, persons) should be at
• Mild fever notified of chickenpox in [Link]
surfaces, or objects (e.g., toys).
• Feeling unwell the classroom. Pregnant
May develop after contact with a women should consult
person who has shingles. their health care provider
promptly.
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Common cold Commonly seen 12 hours A person is usually contagious By breathing in contaminated air Exclude if too ill (if fever No
Virus to 5 days after exposure: 24 hours before symptoms from an infected person who is present, excessive coughing
• Runny or stuffy nose appear until 5 days after start sneezing, coughing, or speaking. and sneezing) to participate
• Sneezing of symptoms. Touching your eyes, mouth, or nose in activities.
• Sore throat after touching contaminated hands,
• Cough surfaces, or objects (e.g., toys).
• Decreased appetite
• Fever (with some colds)

Cold Sore Commonly seen 2 days to 2 weeks The virus persists in the body Person-to-person via saliva of Exclude if too ill to No
(Herpes Simplex after exposure: and infections may reoccur. infected person or items wet with participate in activities.
Type 1) • Tingling sensation or itching at A person is most contagious infected saliva, such as kissing or Avoid direct contact with
Virus site of sore when symptoms are present. sharing eating utensils. lesions, cold sores, or drool.
• Fever
It is possible to spread the
• Irritability
virus for many years even
• Painful sores in or around the
when there are no symptoms
mouth
present.

Coronavirus Commonly seen 1-14 days after A person is usually contagious By breathing in air from an Exclude at the direction of Yes
Disease exposure: 48 hours before the onset of infected person who is sneezing, Provincial Public Health/the
(COVID-19) • Fever and/or chills symptoms until at least 10 days coughing, or speaking. Health Unit.
Virus • Shortness of breath after the start of symptoms. Touching your eyes, mouth, or
• Decrease or loss of smell or taste Individuals who are nose after touching contaminated
• Feeling unwell/ extreme tiredness immunocompromised hands, surfaces, or objects.
• Muscle aches/joint pain may be contagious for up
• Nausea, vomiting and/or diarrhea to 20 days after the start of
• Sore throat symptoms.
• Runny nose
• Headache

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
8 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Escherichia coli Commonly seen 10 hours to A person is contagious for Person-to-person by fecal-oral Exclude at the direction of Yes
(E. coli) 6 days after exposure: as long as the germ is in the route (e.g., unwashed hands). the Health Unit.
Bacteria • Diarrhea (may be bloody) feces, which is usually 1 week Putting anything in the mouth
• Mild fever in adults and up to 3 weeks that has had contact with infected
• Stomach cramps or pain in some children. feces (e.g., toys).
Swallow contaminated food or water.
Contact with infected animals.

Fifth Disease Commonly seen 4-21 days A person is contagious a few By breathing in contaminated air Do not exclude if well No
(Parovirus) after exposure: days before the start of the from an infected person who is enough to participate Should advise
Virus • Low-grade fever and cold-like rash until the rash appears. sneezing, coughing, or speaking. in activities. pregnant
symptoms (such as feeling Once the rash appears, they staff and
Touching your eyes, mouth, or
unwell, muscle aches, and are no longer contagious. parents who
nose after touching contaminated
headache) may have
hands, surfaces, or objects
7-10 days before rash appears had exposure
(e.g., drinking cups and utensils).
• Intensely red facial rash (like a to inform
Can spread through transfusion of their health
slapped cheek), spreading to the
blood or blood products. care provider.
trunk, arms, hands, legs, and feet
Mother to fetus transmission (rare). See page
• Rash may reappear, 1-3 weeks
6 for more
later, if exposed to sunlight or heat
information.

Giardia Commonly seen 3-25 days after A person is contagious for as Person-to-person by fecal-oral Exclude until symptom free Yes
Parasite exposure: long as the germ is present route (e.g., unwashed hands). for 24 hours
• Diarrhea in the feces, which can range Putting anything in the mouth OR
• Gas / bloating from weeks to months. that has had contact with infected Symptom free for 48 hours
• Foul-smelling feces feces (e.g., toys). after discontinuing use of
• Frequent loose, pale greasy feces anti-diarrheal medication.
Swallowing contaminated food or
• Fatigue water. Child should not use
• Loss of appetite recreational water venues
• Weight loss Anal sexual activity. (e.g., swimming pools, and
splash pads) for 1 week after
Sometimes no symptoms present.
symptoms have resolved.
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Hand, Foot, and Commonly seen 3-6 days after A person is most contagious By breathing in contaminated air Exclude until child is well No
Mouth Disease exposure: during the first week of illness. from an infected person who is enough to participate in
(Coxsackie Virus) • Mild fever The virus may still be present sneezing, coughing, or speaking. activities.
Virus • Sore throat in the feces for several weeks Touching your eyes, mouth, or nose
• May have painful mouth ulcers or months after start of after touching contaminated hands,
• Rash that may look like red spots, infection. surfaces, or objects (e.g., drinking
often with small blisters, that
The virus is not present for as cups and utensils).
appear on the palms of the hands,
long in respiratory secretions Person-to-person by fecal-oral
soles of the feet, and sometimes
(1 to 3 weeks or less). route (e.g., unwashed hands).
other places of the body

Hepatitis A Commonly seen 15-50 days A person is most contagious Person-to-person by fecal-oral Exclude at the direction of Yes
Virus after exposure: 2 weeks before symptoms route (e.g., unwashed hands). the Health Unit.
• Younger children usually do not appear and until 7 days Putting anything in the mouth
have symptoms; if they do, they after the start of jaundice. that has had contact with infected
are usually mild and brief However, some infants and feces (e.g., toys).
• Feeling unwell children may be contagious
for longer. Swallowing contaminated food or
• Fever
water.
• Loss of appetite
• Nausea Oral-anal sexual activity.
• Abdominal pain
• Yellowing of whites of eyes and
skin (jaundice), and darkening
of urine

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
10 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Hepatitis B Commonly seen 45-180 days after A person is contagious Person-to-person via contaminated Do not exclude if well Yes
Virus exposure: from weeks before onset blood and bodily fluids that enter enough to participate in
• Younger children usually do not of symptoms to months or a break in skin, wound, or mucus activities.
have symptoms; if they do, they years after recovery from membrane (e.g., sexual contacts,
are usually mild and brief illness. sharing contaminated needles).
• Loss of appetite May be infectious for life. Mother to neonate transmission.
• Tiredness
It is not spread by water, food, or
• Nausea and vomiting
by casual contact.
• Abdominal pain
• Yellowing of whites of eyes and
skin (jaundice), and darkening of
urine
• Rash
• Joint pain

Impetigo Commonly seen 7-10 days after A person is contagious Person-to-person through direct Exclude until 24 hours after No
Bacteria exposure:: from the start of symptoms skin contact with wounds or treatment has been started.
• Cluster of red bumps or blisters until 24 hours after start of discharges from the infected area. Cover lesions on exposed
usually around the mouth, nose, treatment with antibiotics. Can also be spread by touching skin with waterproof
or exposed parts of the body contaminated hands, surfaces, or dressing when possible.
(arms and/or legs) objects where the germs get into
• Blisters may ooze and then your body through a break in skin.
become covered with a honey-
coloured crust
• Can be itchy
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Influenza Commonly seen 1-4 days A person is usually By breathing in contaminated air Exclude until well enough Yes
Virus after exposure: contagious 24 hours before from an infected person who is to participate in activities.
• Sudden onset of fever start of symptoms and sneezing, coughing, or speaking.
and chills up to 7 days after start of Touching your eyes, mouth, or
• Cough symptoms. nose after touching contaminated
• Runny or stuffy nose hands, surfaces, or objects
• Sore throat (e.g., drinking cups and utensils).
• Generalized aches and pains
• Headache
• Feeling unwell and tiredness
• Children may also have nausea,
vomiting, and diarrhea

Measles Commonly seen 7-21 days after A person is usually By breathing in contaminated air Exclude at the direction of Yes
(Red Measles) exposure: contagious from 4 days from an infected person who is the Health Unit.
Virus • Fever before rash to 4 days after sneezing, coughing, or speaking.
• Cough, runny nose appearance of rash. Can also be spread by touching
• Red, watery eyes contaminated hands, surfaces, or
• Small white spots on the inside objects.
of the mouth and throat may be
Very contagious.
present
• Red, blotchy rash on face which
then spreads over body

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
12 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Meningitis Can vary depending on the type Dependent on type of germ By breathing in contaminated air Remain at home until Yes
Bacterial of germ but starts very suddenly: (bacterial, viral, or other) from an infected person who is allowed to return by a
• Severe headache, stiff neck sneezing, coughing, or speaking. health care provider.
Viral
• High Fever Can also be spread by touching
Other causes • Vomiting contaminated hands, surfaces,
• Drowsiness, confusion, or objects.
lack of energy
• Seizures
• Skin rash, especially on hands
and feet
• Irritability, refusing meals,
constant crying, unusual sleep
patterns (newborns and infants)
• Bulging of soft spots on the head
and a lower than normal body
temperature (newborns and
infants)

Molluscum Commonly seen 2-7 weeks after Unknown, but probably Direct skin-to-skin contact with Do not exclude if well No
Contagiosum exposure, but may be seen as persists as long as lesions are the lesions. enough to participate.
Virus long as 6 months after exposure: present. Can also be spread by touching Cover lesions not covered
• 2-5 mm flesh-coloured to contaminated hands, surfaces, by clothing with watertight
translucent raised lesions of objects. bandage if participating in
(bumps), commonly on trunk, contact sports/activities or
face, arms, and legs swimming.
• Most children get 1-20 bumps
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Mononucleosis Commonly seen in A person can be contagious Person-to-person via the saliva of Exclude until child is well No
(Mono Epstein-Barr) 30-50 days after exposure: for a year or more after an infected person or items with enough to participate in
Virus • In young children, usually mild infection. infected saliva, such as kissing or activities.
or no symptoms sharing contaminated objects
• Fever (e.g., toys, toothbrush,
• Sore throat cups, bottles).
• Swollen lymph nodes
• Fatigue
• Possible enlarged liver
and/or spleen

Mumps Commonly seen 16-18 days after A person can be contagious By breathing in contaminated air Exclude at the direction of Yes
Virus exposure, but can range from 7 days before and up to from an infected person who is the Health Unit.
12-25 days: 5 days after swelling of sneezing, coughing, or speaking.
• Some may have no symptoms salivary gland begins. By touching contaminated hands,
• Fever Some may not have typical surfaces, or objects.
• Pain and swelling of salivary symptoms, but can still Contact with saliva through
glands (below and in front of ear) spread the virus. kissing and by sharing food, and
• Muscle aches
drinks.
• Feeling unwell
• Loss of appetite
• Headache
• Swelling of testicle(s)

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
14 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Norovirus Commonly seen 12 to 48 hours A person may be contagious Person-to-person by fecal-oral Exclude until symptom free No
(viral gastroenteritis) after exposure: before the start of symptoms route (e.g., unwashed hands). for 24 to 72 hours.
Virus • Sudden onset of nausea and up to 3 weeks after Swallowing contaminated food or
and vomiting symptoms resolve. A person water.
• Watery diarrhea is most contagious while
symptomatic. Touching your eyes, nose, mouth
• Abdominal cramps
after touching contaminated
• Headache
hands, surfaces, or objects
• Low grade fever (e.g., cups and utensils).
• Feeling unwell
• Muscle aches. Person-to-person by breathing in
vomit droplets).

Pinkeye Commonly seen 1-3 days after A person should be Person-to-person via direct Generally exclude No
(Conjunctivitis) exposure: presumed contagious until contact with discharges from the while untreated and
Virus • Red or pink eyes symptoms have resolved. eye of an infected person. symptomatic.
• Swollen eyes Touching your eyes with If no fever or behavioural
Bacteria
• Itching, irritated, and contaminated hands or objects change, child should be
painful eyes (e.g., mascara wands) allowed to remain in school
• Lots of tearing once medical therapy has
• Discharge or pus from the been received for at least
eyes (usually when caused by 24 hours. If close contact
bacteria) that can make the with other students cannot
eyelids sticky during sleep, and be avoided and careful
can collect in the corners of the hand hygiene cannot be
eyes when awake maintained, then child
should not attend school.
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Pinworm Commonly seen 1-2 months or A person may be contagious Person-to-person via fecal-oral Do not exclude. No
Parasite longer after exposure: for as long as the parasite route (e.g., unwashed hands). Child should see
• Many infections occur without deposits its eggs on the skin Touching your mouth after health care provider for
symptoms around the anus. touching contaminated hands, assessment.
• Itching around the anus surfaces, or objects.
(rectum), especially at night
Eggs survive on surfaces for 2 to
3 weeks (e.g., bed linens, towels,
toys, clothing, toilet seats, or baths).

Respiratory Commonly seen 2-8 days after A person is usually By breathing in air from an Exclude until child is well No
syncytial virus exposure: contagious for 3-8 days after infected person who is sneezing, enough to participate in
(RSV) • Runny nose symptom onset. coughing, or speaking. activities.
Virus • Cough, which may progress to Young children and Touching your eyes, mouth, or
wheezing immunosuppressed nose after touching contaminated
• Decrease in appetite and energy individuals may be hands, surfaces, or objects (e.g.,
• Irritability contagious for as long as 4 toys, door handles, etc.).
• Apnea (pauses while breathing) weeks.

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
16 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Ringworm For ringworm of the scalp, A person can be contagious Direct skin-to-skin contact with Exclude until seen by a No
Fungus commonly seen 10 to 14 days for as long as rash is infected person or animal. health care provider and
after exposure, and 4 to 10 days untreated and/or uncovered. Can also be spread by touching treatment started.
for ringworm of the groin and contaminated hands, surfaces, or Child should not
skin. Unknown for the feet: objects (e.g., combs, unwashed participate in physical
• Skin: flat, spreading, ring-shaped clothes, towels, clothes, or education/sports activities
sore with a raised edge (edge of bedding). that require close contact
sore is usually reddish and may (e.g., wrestling), until
be dry and scaly or moist and 72 hours after treatment.
crusted). When in the groin area, Swimming pools should
also known as “jock itch” also be avoided.
• Feet (especially between toes):
red, swollen, peeling, itching
skin; can also affect the sole and
heel (also known as Athlete’s
Foot)
• Scalp: small, red, and scaly patch,
which spreads, leaving scaly,
temporary bald patches

Roseola Commonly seen 9-10 days after A child is most contagious By breathing in contaminated air Exclude until child is well No
(Sixth Disease) exposure: when a high fever is present, from an infected person who is enough to participate
Virus • Sudden high fever (above 39.5°C) and possibly contagious in sneezing, coughing, or speaking. in activities.
that lasts 3-7 days. Some children those with no symptoms. Touching your eyes, nose, mouth
with high fever may have with hands after touching hands,
seizures (or convulsions) surfaces, or objects (e.g., cups and
• Red, raised rash (lasts hours to utensils) contaminated with an
days) that appears when fever infected person’s saliva.
breaks (usually 4th day)
• Some may not get a rash
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Rotavirus Commonly seen 1-3 days after A person may be contagious Person-to-person by fecal-oral Exclude until diarrhea and No
(viral gastroenteritis) exposure: 2 days before start of route (e.g., unwashed hands). vomiting have stopped and
Virus • Vomiting symptoms and up to 10 Swallowing contaminated food or well enough to participate
• Fever days after symptoms start. water. in activities.
• Watery diarrhea An infected person can still
spread the virus, even if they Touching your mouth with hands
do not have any symptoms. that have touched contaminated
hands, surfaces, or objects.

Rubella Commonly seen 14-21 days after A person can be contagious By breathing in contaminated air Exclude at the direction of Yes
(German Measles) exposure: 1 week before and at least from an infected person who is the Health Unit.
Virus • Widespread rash (red or pink) 4 days after the rash appears. sneezing, coughing, or speaking.
that usually starts on the face Can also be spread by touching
• Swollen glands behind the ears contaminated hands, surfaces, or
• Mild fever objects.
• Headache
• Feeling unwell
• Mild coughing, runny nose, and
reddened eyes

Salmonella Commonly seen 12-36 hours after A person is contagious to Person-to-person by fecal-oral Exclude until symptom free Yes
Bacteria exposure, sudden onset of: others for as long as the route (e.g., unwashed hands). for 24 hours.
• Nausea and vomiting germ is present in the feces; Swallowing contaminated food or OR
• Headache typically several weeks. water, such as raw or undercooked Symptom free for 48 hours
• Fever meats. after stopping the use of
• Diarrhea
Touching your mouth with hands anti-diarrheal medication.
• Abdominal pain/cramps after touching contaminated
• May have mucous and blood in hands, surfaces, or objects.
feces
Contact with infected animals.

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
18 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Scabies Commonly seen 2-6 weeks after A person is contagious until By direct and prolonged Exclude until seen by No
Parasite exposure. If previously infected, mites and eggs are destroyed skin-to-skin contact with an a health care provider
symptoms may develop by treatments. infected person. and until 24 hours after
1-4 days after re-exposure: By sharing contaminated clothing, appropriate treatment
• Pimple-like, very itchy red rash towels, and bedding. completion.
(most itchy at night) usually in
between fingers, around the Sexual transmission.
wrists and elbows, in the armpits,
and on the abdomen and thighs
• Caused by mites under
the skin

Scarlet Fever Commonly seen 2-5 days after Untreated individuals are By breathing in contaminated air Exclude until at least No
(Streptococcus) exposure: most contagious for from an infected person who is 12 hours after start of
Bacteria • Fever 2-3 weeks after the start of sneezing, coughing, or speaking. appropriate treatment and
• Sore throat and maybe a red (or the infection. Person-to-person via direct child is well enough to
strawberry) tongue contact with a person’s saliva, participate in activities.
• Swollen glands nasal, or wound discharges.
• Red, sandpaper-like rash
appearing most often on neck,
chest, folds of armpit, groin,
elbow, and inner thigh

Shigellosis Commonly seen 1-3 days after A person is contagious while Person-to-person by fecal-oral Exclude at the direction of Yes
Bacteria exposure: they have symptoms and route (e.g., unwashed hands). the Health Unit.
• Diarrhea until the germ is no longer Swallowing contaminated food or
• Blood and/or mucus in feces present in the feces, usually water, such as raw or undercooked
• Nausea within 4 weeks after illness. meats.
• Fever
Can also be spread by touching
• Abdominal cramps contaminated hands or objects or
• Vomiting through sexual contact.
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Shingles • Pain A person is contagious when Shingles cannot be passed from Keep rash covered. No
(Herpes zoster) • Fever the blisters appear and until one person to another. It is a Exclude until well enough
Virus • Headache the blisters are crusted over. reactivation of the chickenpox to participate in activities.
• Burning/painful, red rash with virus from a previous infection.
Parents and staff
fluid-filled blisters, usually on one A person who has never had (especially pregnant or
side of the body or face chickenpox can develop immunocompromised
chickenpox from direct contact persons) should be
with the blister fluid of a person notified of shingles in
with shingles. They do not develop the classroom. Pregnant
shingles. women should consult
their health care provider
promptly.

Strep Throat Commonly seen 2-5 days after Untreated individuals are By breathing in contaminated air Exclude until at least No
(Streptococcus) exposure: most contagious for from an infected person who is 12 hours after start of
Bacteria • Fever 2-3 weeks after the start of sneezing, coughing, or speaking. appropriate treatment and
• Sore throat and maybe a red (or the infection. Person-to-person via direct child is well enough to
strawberry) tongue contact with a person’s saliva, participate in activities.
• Younger children: irritability and nasal, or wound discharges.
loss of appetite
Swallowing contaminated food or
• Swollen tonsils and lymph nodes
water.

Thrush • Whitish-grey patches on the While symptoms are present. Though person-to-person No No
(Candidiasis) inside of the cheek, the roof of transmission occurs rarely, it can
Yeast the mouth or on the tongue be spread through contact with
secretions of mouth.

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
20 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 *RECOMMENDED SCHOOL REPORTABLE
INFECTION SIGNS / SYMPTOMS CONTAGIOUS PERIOD HOW IT SPREADS
EXCLUSION DISEASE
Whooping Commonly seen 9-10 days after A person is most contagious By breathing in contaminated air Exclude at the direction of Yes
cough exposure, but can range from from the start of symptoms from an infected person who is the Health Unit.
(Pertussis) 6-20 days: until the beginning of the sneezing, coughing, or speaking. People in contact with
Bacteria • Usually starts with cold-like worsening cough (first Direct contact with a person’s infected person may need
symptoms, including a 2 weeks). saliva and nasal excretions. antibiotics or a vaccine.
mild cough A person is no longer
• After 1-2 weeks, cough worsens contagious after 5 days of
with numerous bursts of effective treatment is taken.
explosive coughing that can
interrupt breathing, eating, and
sleeping. This is when a high-
pitched whooping sound may
occur when inhaling, commonly
followed by vomiting.

Yersinosis Commonly seen 3-7 days after A person is contagious for as Person-to-person by fecal-oral Exclude until symptom free Yes
Bacteria exposure: long as the germ is present route (e.g., unwashed hands). for 24 hours.
• Diarrhea in the feces and symptoms Swallowing contaminated food or OR
(sometimes bloody or mucousy) persist, which is usually 2 to water.
3 weeks. 48 hours after completion
• Abdominal pain/cramps
Contact with infected animals. of antibiotic or anti-
• Fever If untreated, a person may diarrheal medications.
spread the germ for as long
as 2 to 3 months.

*Note: Provincial public health restrictions supersede the recommended exclusion criteria in this guide.
References:
Canadian Paediatric Society. (2022). Caring for kids. Retrieved from [Link] Kimberlin, D.W., Brady, M.T., Jackson, M.A., & Long, S.S. (Eds.). (2018). Red Book: 2018-2012 Report of the Committee on
Centers for Disease Control and Prevention. (2022). Centers for Disease Control and Prevention. Retrieved from https:// Infectious Diseases. Itasca, IL: American Academy of Pediatrics.
[Link]/. Ontario Ministry of Health. (2022). Ontario Ministry of Health. Retrieved from [Link]
Cummings, C., Finlay, J.C., & MacDonald, N.E. (2018). Health lice infestations: A clinical update. Retrieved from http:// Ontario Ministry of Health and Long-Term Care. (2020). Infectious Diseases Protocol. Toronto, ON: Queen’s Printer for
[Link]/documents/position/head-lice. Ontario.
Government of Canada. (2017). Health. Retrieved from [Link] Public Health Agency of Canada. (2022). Public Health Agency of Canada. Retrieved from [Link]
Heymann, D.L., (Ed.). (2015). Control of communicable diseases manual (20th ed.). Washington, DC: American Public [Link].
Health Association.
CONTACT INFORMATION
The Windsor-Essex County Health Unit has a variety of help lines that can be For more information on infectious disease, consider the following resources:
called during business hours with questions, comments, or concerns. The
complete list of numbers can be found at [Link] under Contact Us. Ministry of Health and Long-Term Care [Link]

Public Health Agency of Canada [Link]

RELEVANT WINDSOR-ESSEX COUNTY
HEALTH UNIT DEPARTMENTS Public Health Ontario [Link]
519-258-2146 | 1-800-265-5822 Canadian Paediatric Society [Link]
Healthy Schools Department Immunize Canada [Link]
Health Promotion 1555
Centers for Disease Control [Link]
Immunization 1222
Infectious Disease Prevention 1420 Canadian Food Inspection Agency [Link]

To report or have a consultation regarding an Hospital for Sick Kids [Link]

increase in school absenteeism,
please call your school nurse or extension 1555. Health Canada [Link]
To report a communicable disease, World Health Organization [Link]
please call extension 1420.
Telehealth Ontario 1-866-797-0000

22 WINDSOR-ESSEX COUNTY HEALTH UNIT | WINDSOR | LEAMINGTON | [Link] A GUIDE TO COMMON INFECTIONS
 DISEASES OF PUBLIC HEALTH SIGNIFICANCE
REPORT DISEASES LISTED BELOW TO: Phone: 519-258-2146 or Fax: 226-783-2132 (8:30 a.m. to 4:30 p.m., Monday to Friday)
After hours, weekends, and holidays phone: 519-973-4510
Timely reporting of communicable diseases is essential for their control. If you suspect or have confirmation of the following specified “Diseases of Public
Health Significance” or their “etiologic agents,” (as per Ontario Reg 135/18 and amendments under the Health Protection and Promotion Act), please
report them to the local Medical Officer of Health.

REPORT IMMEDIATELY REPORT BY THE NEXT WORKING DAY

Anthrax Hepatitis, viral Acquired Immunodeficiency Echinococcus Multiocularis Influenza Respiratory infection
1. Hepatitis A Syndrome (AIDS) infection outbreaks in institutions and
Botulism Legionellosis
public hospitals
Measles Acute flaccid paralysis (AFP) Encephalitis, including:
Brucellosis Leprosy
1. Post-infectious Rubella
Meningococcal disease, Amebiasis
Creutzfeldt-Jakob Disease, 2. Vaccine-related Listeriosis
invasive Rubella, congenital syndrome
all types Blastomycosis 3. Subacute sclerosing
Lyme Disease
Novel coronavirus diseases, panencephalitis Salmonellosis
Diphtheria Campylobacter enteritis
including: Meningitis, acute
4. Unspecified Shigellosis
Group A Streptococcal disease, 1. Severe Acute Respiratory Carbapenemase-producing 1. viral
invasive Syndrome (SARS) Enterobacteriaceae (CPE), 5. Primary, viral 2. other Syphilis
2. Middle East Respiratory infection or colonization 3. bacterial
Haemophilus influenzae Food poisoning, all causes Tetanus
Syndrome (MERS)
disease, all types, invasive Chancroid Mumps
3. Coronavirus disease Gastroenteritis outbreaks Trichinosis
Hantavirus Pulmonary (COVID-19) Chickenpox (Varicella) in institutions and public Ophthalmia neonatorum
Tuberculosis
Syndrome hospitals
Plague Chlamydia trachomatis Paralytic shellfish poisoning
Tularemia
Hemorrhagic fevers, including: infections Giardiasis, except (PSP)
Poliomyelitis, acute
1. Ebola virus disease asymptomatic cases Typhoid Fever
Cholera Paratyphoid Fever
2. Marburg virus disease Q Fever
Gonorrhea Verotoxin-producing E.
3. Lassa Fever Clostridium difficile Infection Pertussis (Whooping Cough)
Rabies coli infection including:
4. Other viral causes (CDI) outbreaks in public Group B Streptococcal disease,
Pneumococcal disease, Haemolytic Uraemic
Smallpox hospitals neonatal
invasive Syndrome (HUS)
and other Orthopoxviruses
Cryptosporidiosis Hepatitis, viral
including Monkeypox Psittacosis/Ornithosis West Nile Virus Illness
1. Hepatitis B
Cyclosporiasis
2. Hepatitis C Yersiniosis

For more information: Windsor-Essex County Health Unit

519-258-2146 | [Link] © Windsor-Essex County Health Unit, June 2022.