COMMUNICABLE DISEASES

Background

The existence of numerous communicable diseases, including Acquired Immune Deficiency Syndrome (AIDS) requires school authorities to establish procedures with regard to the management of infected students and staff. Such procedures reflect both the preservation of the public interest as well as the protection of individual rights and freedoms.
The Charter Board is committed to the humane treatment of students and staff infected with communicable diseases within an environment that protects the health and safety of all students and staff.

Procedures

1. Normally, students with communicable diseases will be dealt with in accordance with the provisions of the Public Health Act.
2. Children with a communicable disease shall be allowed to attend school programs in an unrestricted setting unless, in the opinion of the local Medical Health Officer, special circumstances dictate otherwise.
3. The right of infected students to privacy will be respected by staff, including the confidentiality of records.
4. Information about communicable diseases will be provided to students as part of the regular instructional program as specified within the Alberta Program of Studies and related Curriculum Guides.
5. Employees infected with communicable diseases shall be allowed to continue normal duties unless:
5.1 In the opinion of the local Medical Health Officer, special circumstances dictate otherwise; or
5.2 The job of the employee requires that the employee be free from any communicable diseases.
6. The right of infected employees to privacy will be respected and their identity will remain confidential.
7. Employees who are unable to continue their duties as a result of having a communicable disease shall have full access to sick leave, long term disability and other medical benefits provided for by the various agreements and benefit plans.
8. Procedures for dealing with employees who may be exposed to HIV (AIDS virus) will be consistent with Occupational Health and Safety requirements as outlined in Appendix A.
9. In the event that an employee indicates that they have been infected with a communicable disease, the Principal shall immediately contact the Superintendent to review procedures to be followed.
10. If, in the opinion of the attending physician, an infected employee is no longer capable of working, the matter will be dealt with in the same way as other illnesses that impair an employee’s capacity to work.
11. In all cases, the confidentiality of the persons affected by the disease shall be reserved for those who need to know on the basis of providing appropriate programs or services for the persons affected.

References: Section 25, 26, 33, 52, 53, 196, 197, 222, 225 Education Act Emergency Medical Aid Act
Freedom of Information and Protection of Privacy Act Health Information Act
Occupational Health and Safety Act Public Health Act
Charter of Rights and Freedoms (Canada) Communicable Disease Regulation (AR 238/85) Occupational Health and Safety Code Occupational Health and Safety Regulations
Ministerial Directive 4.1.1 – HIV / AIDS in Educational Settings

Administrative Procedure 161 Appendix A

PREVENTION OF BLOOD BORNE DISEASES

The following School standard applies mainly to diseases that are transmitted through blood but are also to be followed when handling other body fluids such as sputum, vomit, urine or faeces. It also describes how to dispose of used needles and what to do in the event of a bite or blood exposure.
1. What is a blood borne disease?
A blood borne disease is an illness caused by harmful biological organisms or pathogens that live primarily in blood. Blood borne pathogens that cause disease include viruses such as hepatitis B, hepatitis C and human immune-deficiency virus (HIV)-AIDS.
2. How are blood borne diseases transmitted?
Generally, most school staff and students are not at high risk of exposure to blood borne pathogens. Blood borne pathogens are not transmitted through casual contact, however they can develop if infected blood enters the body through cuts or breaks in the skin, and through the mucus membranes of the eyes, nose or mouth.
3. What is the risk of disease transmission in a school setting?
Staff is at potential risk when there is a possibility of blood contact when cleaning up blood or vomit, providing personal care (e.g. toileting) giving first aid or working with children who are known biters. Staff that may be at most risk include first aid personnel, special needs support staff, physical education teachers and playground supervisors.
Blood and body fluids visually contaminated with blood present the highest risk for disease transmission. The greatest risk is from a penetrating injury such as a needle stick. Saliva and other body fluids may contain viruses but in low concentrations compared to blood. The risk of transmission from biting is far less than the risk from exposure due to a penetrating injury such as a needle stick.
Biting however can pose a risk to the person who is bitten as well as the person who bites if there is a break in the skin. The risk is higher if there is visible blood to the wound. In addition bites if not properly treated can result in infection with organisms that do not cause serious diseases.
4. How do I know if a person has a blood borne disease?
You won’t unless this information has been voluntarily given to you. Carriers of blood borne diseases do not generally exhibit symptoms. For confidentiality reasons, health professionals cannot disclose the medical status of individuals without their permission. This is why we treat everyone as potentially infectious.
Blood borne diseases are notifiable diseases under the Public Health Act. If a staff member or student becomes infected, physicians and laboratories must report this to health officials. Public health nurses will notify individuals who may have close contact with the infected person and advise of any special precautions.
5. How can the spread of blood borne diseases be prevented in the workplace?
Since we do not usually know whose blood is infected, the safest approach is to treat all blood and body fluids as if it contains pathogens. Originally developed for hospitals, universal precautions have been adapted to a wide range of work settings. They apply to all situations where staff or students have risk of exposure to blood or body fluids.
Universal Precautions includes:
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● The use of disposable gloves, eye protection and a respirator to provide a barrier to blood and body fluids.
● Washing hands when gloves are removed or whenever the skin contacts potentially infectious fluids.
● Using barrier masks when performing artificial respiration.
● Training staff on proper precautions and blood clean up procedures.
● Ensuring emergency eyewash stations are maintained and all staff is aware of their location(s).
● Immunization of staff that may frequently be in contact with blood or work with higher-risk populations such as children with biting behaviors.
● In some cases specialized protective equipment such as gloves, arm guards and special bite protection clothing may prevent punctures to the skin.
6. What is considered an exposure to blood and body fluids?
Situations in order of risk:
● Punctures of the skin with blood-contaminated needles, lancets, scalpels, or other sharp instruments.
● Splashes to non-intact skin bearing minute scratches, abrasions, burns, or even minor rashes.
● Splashes to mucous membranes of the mouth, nose, or eyes.
● Biting injury where visible blood is present.
7. Follow up protocol for blood or body fluid exposure incidents:
7.1 STAY CALM
7.2 Treat all exposures as potentially infectious.
7.3 Encourage bleeding of the injury site (gently squeeze) and wash thoroughly with soap and running water. If direct contact with eyes is involved, flush with eyewash or water for fifteen (15) minutes.
7.4 Apply an antiseptic and band-aid to the site.
7.5 If the exposure involves a needle stick, ensure the needle is disposed of in a tamper/puncture proof container. Keep available in case it needs to be tested by a health professional.
7.6 Immediately report the incident to your Principal. The Principal is to immediately notify the Superintendent to discuss the circumstances of the exposure and whether further medical attention and follow up is warranted. The Superintendent may consult with the Alberta Health Services – Needle Stick Response Team for further advice.
7.7 Higher risk situations include a needle stick injury or a bite where skin is broken and visible blood is seen. In these cases the staff member is advised to get a baseline blood test (for Hepatitis B, C and HIV) on the same day as the incident. In the case of bites if the source of the exposure is known (i.e. student) the parent is also to be advised to obtain a blood test for their child on the same day of the incident. This is because the biter can also be at risk of contracting a blood borne disease. If the source student is negative no further testing or follow up of the employee is necessary. If the source of blood exposure is unknown or the student does not get a blood test then further follow up testing for the employee may be required in higher risk situations. In these cases post exposure immunization and counseling may be recommended by a health professional. The Superintendent would work with Alberta Health Services- Needle Stick Response team (780-480-6598) or the employee’s health care provider to coordinate follow up.
7.8 Document the exposure incident on a School Incident/Injury Record. Send a copy to the Superintendent at and file a copy at the worksite. If the employee is covered by WCB, a Worker’s and Employer’s Report of Injury is also required to be completed if there is time loss associated with the incident. If the incident occurs after hours contact Alberta Health Link at 780 408-5465 for advice.
7.9 Any bills associated with follow up, testing or immunization are to be forwarded to the Superintendent.
8. What do you do with a used needle, lancet or epipen?
● Never throw needles or sharps down drains, toilets or in the regular garbage.
● Never reach into garbage bags or containers with bare or gloved hands.
● If you find a used needle, carefully pick it up with tweezers or wearing thin disposable gloves then wash hands
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immediately after disposing.
To safely dispose:
● Drop the needle or sharp into commercially available tamper proof sharps collectors.
● If a sharps container is unavailable use an empty, resalable, hard-surfaced (puncture proof) container such as a coffee can or bleach bottle labeled “Sharps – Not for Recycling”.
● Keep the container out of reach of children or pets.
● Do not fill the container right to the top. Commercial containers will have a clearly defined fill line.
● When the container is full, seal the lid securely.
● Contact the Safety Coordinator to arrange for safe disposal.
9. General Disinfection of Surfaces (e.g. change tables)
9.1 Wear the appropriate protective equipment.
9.2 Review the Material Safety Data Sheet (MSDS) for cleaning and disinfection products before use.1
9.3 If surfaces are visually soiled with dirt, grit or body fluids (e.g. sticky or gritty to the touch) both cleaning and disinfection is required. This requires two (2) separate applications of the disinfectant solution. One to clean away organic debris and the second to disinfect. Disinfection will not be properly completed if soil or body fluids are not cleaned away first.
9.4 For surfaces that have not been soiled, a single wipe with the disinfectant solution and air drying is acceptable.
9.5 Ensure the entire surface to be cleaned and/or disinfected is covered with solution (not partial coverage). A firm rubbing and wiping motion must be used.
9.6 Allow to air dry for at least five (5) minutes (or as indicated on the instructions) after the last application of the disinfectant. This will allow the necessary contact time for the disinfectant to work. No rinsing is required.
9.7 If spray bottles are used, avoid misting on to surfaces. Hold a cloth close to the spray nozzle and spray directly onto cloth first. (Note: Paper towels are not as absorbent as cloths and may cause solution to drip). Hold towel and bottle over the equipment to be disinfected to catch drips or use more absorbent cloths that can be laundered and reused.
9.8 A small 12 oz boat mop can be used to apply the solution from a bucket to larger areas such as floor mats. The mop head however must be dedicated for this purpose and cleaned/laundered after each use.
9.9 Disinfectant solutions are to be mixed fresh daily to ensure maximum effectiveness (the product becomes less stable in its diluted form). Try to dispense only what you would typically use in a day.
9.10 Disinfectants are not to be used on food surfaces (unless used as a sanitizing solution- see label for dilution requirements). Rinsing the food surfaces with potable water is required after sanitizing.
10. Where can I obtain more information on blood borne pathogens and diseases?
For additional information, contact Alberta Health Link at 780 408-5465.

Administrative Procedure 161 Appendix B

BLOOD AND BODY FLUID CLEAN UP PROTOCOL

For safe and effective clean up of vomit or small blood spills pre- assembled kits are available from janitorial or safety supply companies or you can easily assemble one and keep it in a Ziploc bag near the first aid kit.
Basic Body Fluid Spill Kit:
● Disposable gloves (Latex free)
● Commercial absorbent1 (1/2cup) (including product Material Safety Data Sheet)
● 2 plastic disposable waste bags with twist tie
● Disposable wiping cloth or paper towels
● Thin piece of cardboard or plastic scoop/scraper
● Protective eye goggles
● Labeled spray bottle for dispensing Disinfectant Solution2
● Clean up protocol instruction sheet
Optional:
● 1 disposable N-95 respirator (if there is risk of splashing or aerosol generation)
● 1 pair of disposable shoe covers
● Disposable pre-packaged disinfectant wipes/towelettes
Blood/body Fluid Clean Up Procedure:
● Isolate the spill area to prevent other people from contacting it.
● Put on protective gloves, eye goggles and respirator.
● Gather towels and spray bottles of disinfectant solution (mixed fresh).
● If using a sorbent, apply over the spill and wait for it to gel.
● Remove all visible debris/material using paper towels and/or scraper tools working from least to most soiled area. Pre-clean the area with the disinfectant and wipe clean. Place the towels and debris in a plastic bag.
● Apply a second application of the disinfectant and allow it to remain wet for the minimum contact time required by the product and let air dry. If using EP-50 the minimum contact time is five
(5) minutes. (Note: consult with the custodian if the spill is on a carpet or soft furnishings)
● Place soiled paper towels and disposable equipment in a plastic bag.
1 “Super-Sorb” or similar product is available through custodial suppliers
2 Avmor EP-50 Disinfectant in proper dilutions is available on site from the custodian. This should be mixed fresh. This is preferred over bleach. If bleach is the only product available, mix a fresh 10% solution (1 part bleach to 9 parts water). Contact time for bleach is a minimum of 10 minutes.
● Remove gloves (folding inside out) and respirator and place in a plastic bag with soiled towels.
● Close plastic bags and place in a second plastic bag and dispose of as general waste.
● Wash hands thoroughly with soap and water.
● Wash non-disposable equipment with soap and water and rinse in disinfectant solution.

Administrative Procedure 161 Appendix C

LIST OF COMMUNICABLE DISEASES

Note: This list may not be exhaustive but is provided as a quick reference.

Acquired Immunodeficiency Syndrome (AIDS) Q-Fever
Amebiasis Rabies
Anthrax Rye Syndrome
Arboviral Infections (including Dengue) Rickettsial Infections
Botulism Rocky Mountain Spotted Fever
Brucellosis Rubella (including Congenital Rubella)
Campylobacter Rubeola
Cerebrospinal Fluid Isolates Salmonella Infections
Chickenpox Shigella Infections
Cholera *Stool Pathogens, all types
Congenital Infections (includes Cytomegalovirus, Tetanus
Hepatitis B, Herpes Simplex, Rubella, Toxoplasmosis, Varicella-Zoster)
Dengue
Toxic Shock Syndrome
Diphtheria Tuberculosis
Encephalitis (specified or unspecified) Tularemia
*Enteric Pathogens Typhoid
*Foodborne Illness Typhus
*Gastroenteritis, epidemic Varicella
Giardiasis Viral Hemorrhagic Fevers (including Marburg,
Ebola,
Haemophilus Influenzae Infections (invasive) Lassa, Argentinean, African Hemorrhagic Fevers) Hemolytic Uremic Syndrome *Waterborne Illness (all causes)
Hepatitis A, B, Non-A, Non-B Yellow Fever Kawasaki Disease
Lassa Fever * Enteric Pathogens, Foodborne Illness,
Legionella Infections Leprosy Leptospirosis Malaria
Measles
Meningitis (all causes) Meningococcal Infections Mumps
Neonatal Herpes Nosocomial Infections
Ophthalmia Neonatorum (all causes) Paratyphoid
Pertussis Plague Poliomyelitis Psittacosis Giardiasis
Gastroenteritis, epidemic and Waterborne Illness include the following and any other identified or unidentified cause: Aeromonas; Bacillus cereus; Campylobacter; Clostridium botulinum and; perfringens; Salmonella;
Shigella; Staphylococcus; Viruses such as Norwalk and Rotavirus; Yersinia

100 - General Administration

200 - Instructional Programs & Materials

300 - Students

400 - Personnel and Employee Relations

500 - Business Administration

Administrative Procedure 161

COMMUNICABLE DISEASES

Background

Administrative Procedure 161 Appendix A

PREVENTION OF BLOOD BORNE DISEASES

Administrative Procedure 161 Appendix B

BLOOD AND BODY FLUID CLEAN UP PROTOCOL

Administrative Procedure 161 Appendix C

LIST OF COMMUNICABLE DISEASES

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