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4020-R1 - Procedures for the Monitoring of Communicable Disease


Snohomish Health District provides disease surveillance and guidelines for monitoring communicable disease. Their function in the county includes infection control and support for communicable disease issues.

Snohomish Health District’s Communicable Disease Department is to be notified at 425-339-5278 if any of the following occur:

  1. Absenteeism of the school population greater than 10% due to illness. The School Absenteeism Report form provided by Snohomish Health District is to be used to report in this situation.
  2. Any reported disease found on the current Department of Health Reportable Disease Poster: “Notifiable Conditions and the Health Care Provider.”
  3. Any food borne illness causing vomiting and diarrhea.
  4. More than one student reacting adversely to any possible toxic substance.
  5. High incidence of any disease.

General Communicable Disease School Nurse/EHS functions:

  1. Consult and follow recommendations in the OSPI “Infectious Disease Control Guide for School Staff” for suspected communicable disease situations.
  2. Use nursing judgment, in collaboration with the school administrator, about when and how to notify school parents of communicable disease outbreaks.

·Confidentiality and judicious dissemination of information are to be guiding principles.

·Edmonds School District School Nurses have developed “parent friendly” handouts for a number of common communicable diseases; these handouts are available in the School Nurse/EHS handbook; these are appropriate to use for community notification in appropriate circumstances.

·Guidance is always available from Snohomish Health District’s Communicable Disease Department when questions arise.

    1. Note: Snohomish Health District, under the direction of the Health Officer, may determine that either a staff member or students need to be excluded from the school setting if they are contagious and are potentially exposing others at schools. This determination is made according to CDC disease investigation protocols.

3. A School Nurse/EHS will consult with the Health Services Department Chairperson when an unusual situation arises about whether or not to confer with the Health District on communications that go out to parents. (Snohomish Health District appreciates a copy of parent communications along with information about when and how it is disseminated.) This allows them advance information about what information the public is receiving and allows them to appropriately prepare to respond to public inquiries.

  1. Notify the Health Services Department Chairperson of any outbreaks of diseases on the DOH list as well as disease outbreaks that have high probability of creating a community reaction (e.g., Viral Meningitis)—this information will be communicated to the Program Administrator and Community Relations.
  2. Ensuring students are compliant with Immunizations is a team effort among staff members responsible for registering students. The Registrar and School Nurse work in collaboration on Immunization Compliance.

Disease Surveillance and Schools

Disease Surveillance: An Overview

What is disease surveillance?

Disease surveillance is the ongoing collection, analysis, interpretation, and dissemination of health data. Disease Surveillance is also a core public health function. Communicable disease surveillance monitors patterns of disease occurrence and assesses the heath status of Snohomish County’s population. Surveillance activities are linked to public health actions, such as investigation, control and prevention, evaluation, or planning and allocating resources to address the diseases affecting the population.

Why is it important to conduct disease surveillance?

ü To identify cases for investigation and follow-up

ü Estimate the magnitude of a health problem and follow trends in its incidence and distribution

ü Formulate and evaluate control and prevention measures

ü Detect outbreaks or epidemics and generate appropriate interventions

ü Monitor changes in infectious agents (e.g., antibiotic resistance, emerging infections)

ü Facilitate epidemiologic and laboratory research

ü Detect changes in health practice (e.g., impact of use of new diagnostic methods on case counts)

ü Facilitate planning (e.g., allocation of program resources, policy development)

How does Disease Surveillance Apply to the School Setting?

Disease surveillance is an essential protective function implemented and coordinated by school nurses in collaboration with the health department. The school is the sentinel population that the health department relies on to monitor the greater community population’s response to communicable disease.


Washington Administration Code (WAC) 246-101-420 Responsibilities of Schools

Schools shall:

  1. Notify the local health department of cases or suspected cases, or outbreaks and suspected outbreaks of disease that may be associated with the school.
  2. Cooperate with the local health department in monitoring influenza.
  3. Consult with a health care provider or the local health department for information about the control and prevention of infectious or communicable disease, as necessary.
  4. Cooperate with public health authorities in the investigation of cases and suspected cases, or outbreaks and suspected outbreaks of disease that may be associated with the school.
  5. Personnel in schools who know of a person with a notifiable condition shall release identifying information only to other individuals responsible for protecting the health and well-being of the public through control of disease.
  6. Schools shall establish and implement policies and procedures to maintain confidentiality related to medical information in their possession.

[Statutory Authority: RCW 43.20.050. 00-23-120, § 246-101-420, filed 11-22-00, effective 12-23-00.]

RCW 28A.210.060

Immunization program — Purpose/School Nurse Function

Per Chapter 256-110 WAC-contagious disease-school districts and daycare centers, all facilities responsible for children are required to establish policies and procedures for preventing and controlling the spread of communicable diseases in children, employees and volunteer staff. Ensuring students are compliant with immunizations is a team effort.

The staff member responsible for registering students is responsible for reviewing Certificate of Immunization forms for compliance. The registrar and the School Nurse work together to address immunization compliance. (Immunization 6-6 Health Services Handbook)

In enacting RCW 28A.210.060through 28A.210.170, it is the judgment of the legislature that it is necessary to protect the health of the public and individuals by providing a means for the eventual achievement of full immunization of school-age children against certain vaccine-preventable diseases.

[1990 c 33 § 190; 1984 c 40 § 3; 1979 ex.s. c 118 § 1. Formerly RCW 28A.31.100.]


Severability -- 1984 c 40: See note following RCW 28A.195.050.

Effective date -- 1979 ex.s. c 118: "This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect on September 1, 1979." [1979 ex.s. c 118 § 13.]

Severability -- 1979 ex.s. c 118: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [1979 ex.s. c 118 § 16.]

Immunization plan: RCW 43.70.525.


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