Clarksville Independent School District INFECTIOUS DISEASE/EBOLA GUIDELINES AND PROTOCOLS FOR THE SCHOOL NURSE STANDARD PROTOCOLS Utilize appropriate personal protective equipment (PPE) during health assessments. Use proper disposal of assessment supplies and materials. Regular trash disposal using double bagging of school clinic/contaminated waste. Two trash bags in at all times and two out when the trash is emptied. Routine daily cleaning of classrooms, restrooms, and school nurses office using recommended products under CISD Infectious Disease/Flu Prevention Guidelines (approved 10-21-14). Adequate hand washing supplies in all hand washing areas. Medical referral form provided to parent, the Texas Department of State Health Services, and the Center for Disease Control as determined necessary. Continue communicable disease reporting procedures with exceptions noted below.
LEVEL 1: STUDENT ENROLLMENT OBTAIN TRAVEL HISTORY by asking the following questions and documenting the responses. Have you recently traveled? Where? When? If NO travel history, enroll with routine assessment of general health using information recorded on the health inventory and other available assessment information. If YES AND travel was within the past 21 days to countries currently designed by the CDC including Liberia, Nigeria, Guinea (information updated on the CDC website at http://www.cdc.gov/vhf/ebola/) or had possible exposure to Ebola, and assessment should be conducted for level of exposure: o Low-Risk Exposure Household members of an Ebola Virus Disease (EVD) patient or others who had brief direct contact (e.g., shaking hands) with an EVD patient without appropriate PPE. ACTION: Enroll. Monitor for fever at schools daily for 21 days since date they left the Ebola affected area. Contact the local Texas Department of State Health Services. o High-Risk Exposure Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids from an EVD patient. Direct skin contact with skin, blood, or body fluids from and EVD patient. Processing blood or body fluids from an EVD patient without appropriate PPE. Direct contact with a dead body in an Ebola-affected area without appropriate PPE. ACTION: DO NOT ENROLL. REFER to Health Care Provider, TDSHS, and CDC for further screening and release. Maintain record of name, date, and other pertinent information.
LEVEL 2: SCHOOL DAY ASSESSMENT OF ALL INDIVIDUALS REPORTING TO THE SCHOOL NURSE WITH A REPORT OF ILLNESS ASSESSMENT for symptoms of illness. Fever of 101 or greater? (CISD protocol aligns with Texas DSHS with exclusion at 100 degrees F, based on RN assessment). o If No, continue physical assessment. o If Yes, EXCLUDE until fever free UNLESS also answering yes to either b. or c. below. In this case, exclude until released by health care provider. EVD compatible symptoms such as headache, weakness, muscle pain, vomiting, diarrhea, abdominal pain, hemorrhage? o If No, continue physical assessment. o If Yes, EXCLUDE until released by health care provider. Travel history to an effected area in last 21 days? o If No, treat/refer per usual protocols. o If Yes, EXCLUDE until released by health care provider if yes to either a. or b. If excluded for symptoms of EVD: 1) Immediately notify Principal to engage other resources for isolation and cleaning of area and parent notification. 2) Notify the Superintendent. 3) Contact the Texas Department of State Health Services (DSHS) AND Center for Disease Control (CDC) 4) Submit Communicable Disease Forms to Texas DSHS and CDC. 5) Retain copies of the Communicable Disease Forms onsite.
LEVEL 3: INTERVENTION FOR SUSPECTED/CONFIRMED CASE OF EBOLA Maintain a log of all potential contacts. Submit Communicable Disease Form and contact Texas Department of State Health Services and Center for Disease Control directly. Confer with Principal regarding isolation and cleaning of effected areas. Follow exposure control protocol for other low incidence (rare) communicable diseases (i.e. meningococcal disease). Texas DSHS, CISD Superintendent and CISD School Nurse conference/decision regarding school closure and utilize district notification protocols.
Pam Bryant Clarksville ISD Superintendent 903-427-3891 ext 702 (701 or 700) James Johnson Clarksville High/Middle School Principal 903-427-3891 ext 570 (500) Marianne Whitehouse Cheatham Elementary School Principal 903-427-3891 ext 375 (300) Terri Gaines Clarksville ISD School Nurse 903-427-3891 ext 313 Chris McCoin Clarksville ISD/Detroit ISD HeadStart Nurse 903-427-3891 ext 363 PROTOCOL CONTACTS Tammie Hastings Texas Department of State Health Services (Clarksville office) 903-428-3909 Ashley Watkins Texas Department of State Health Services (Paris office) 903-737-0293 January Smith Texas Department of State Health Services (Tyler office) 903-533-5210 903-533-1271 (cell) Approved by the Clarksville ISD Board of Trustees on October 21, 2014.