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Chapter 4: Handling of suspected outbreak of communicable diseases

Guidelines on Prevention of Communicable Diseases in Schools/Kindergartens/Kindergartens-cum-Child Care Centres/Child Care Centres

Chapter 4  
Handling suspected outbreak of communicable diseases

When children or staff develop similar symptoms one after another

and the incidence is higher than usual,

an outbreak of communicable diseases is suspected

To judge whether there is an outbreak in a school or centre, rate of absence and condition of cases have to be monitored daily

For example, two or more persons develop symptoms of gastroenteritis at about the same time after eating together

may indicate a food poisoning outbreak.

Children studying in the same room or on the same floor

develop similar symptoms in clusters within a short period of time may suggest an outbreak of communicable diseases.

When the rate of absence is higher than usual, a school or centre should take the initiative to contact parents of sick children.

An isolated case sometimes may warrant outbreak investigation.  For instance, occurrence of a novel disease or one posing major impact to the public health system.

Examples are avian influenza and severe acute respiratory syndrome (SARS).

Management of suspected outbreak of respiratory tract infection

First, take care of sick children.

If a child develops symptoms of influenza such as fever, sore throat or cough, he or she should be put on a mask

and taken to a designated room for rest.

Inform parent or guardian immediately to collect the sick child

While the sick child is resting,

turn on exhaust fans

and open windows for better ventilation

Staff taking care of a sick child should also put on a mask

and perform hand hygiene before and after contact with the sick child.

Second, prompt notification

Complete outbreak notification form promptly after taking care of the sick children. Persons-in-charge of Child Care Centres should notify both CHP and Child Care Centres Advisory Inspectorate of Social Welfare Department.

Persons-in-charge of schools/kindergartens/kindergartens-cum-child care centres should notify both CHP and School Development Sections in their respective districts or Joint Office for Pre-primary Services of Education Bureau.

Third, Environmental Hygiene and Disinfection

Turn on exhaust fans and open windows for better ventilation.

When handling vomitus and secretions, first use highly absorbent disposable materials to wrap up visible contaminants.

After the sick child  has left the room,

disinfect it with 1 in 49 diluted household bleach

School bus should also be disinfected by the same method after carrying a sick child.

Staff should use appropriate personal protective equipment (PPE) while disinfecting the environment.

After completing the task, take off PPE carefully and perform hand hygiene immediately.

Fourth, Monitoring Communicable Diseases

Schools and centres should provide attendance records of staff and children, a list of suspected sick children, and contact details of parents and guardians to facilitate epidemiological investigation by CHP.

Enhance health surveillance for children and staff by measuring body temperature, etc

Maintain close communication with parents

Staff and children should notify school or centre promptly if they develop symptoms of communicable diseases or are admitted to hospital.

School or centre should also notify CHP.

Sick person should stay at home until symptoms and fever have subsided for at least 2 days before returning to school or centre.

For recommendations on sick leave duration for common childhood infections, please refer to ¡§Guidelines on Prevention of Communicable diseases in Schools/ Kindergartens/ Kindergartens-cum-Child Care Centres/ Child Care Centres¡¨ at

Medical officers and nurses of CHP will come to school or centre to collect preliminary information or specimen.

Preliminary information required by CHP includes:
Name and address of school or centre in Chinese and English
Name, position and telephone number of contact person of the school or centre
Number of sick persons and number of those admitted to hospitals
Symptoms and onset dates of sick persons
Total number of children and staff, etc

Further information may be required if needed, for example
Personal information and sick leave records of sick persons
Name list of children and staff
Floor plan, timetable and menu of the school or centre