PH - Disease Information FAQs

It depends on where you will be going. Recommendations for travel to specific areas can be obtained from the Centers for Disease Control and Prevention (CDC) on their web site @ www.cdc.gov. For recorded information on the Orange County travel immunization clinic, call (800) 914-4887.

By law animal bites or exposures are reportable to the county's Animal Care Services at (714) 935-6106. Having the following information will help us evaluate the need to recommend post-exposure treatment for rabies. What is the type of animal involved? Is the animal still in your or someone else's possession? When, where and how did the incident occur? If it is a domestic animal such as a dog or cat, has it been vaccinated for rabies?

Public Health will assess the risk of rabies and indications for rabies post-exposure treatment. If treatment is indicated, Public Health will offer the treatment to individuals who do not have medical coverage. We will refer you to your physician if you have medical insurance. We can assist your physician, if needed, to ensure prompt treatment.

The food from the restaurant may or may not be the cause of your illness. If you have concerns about the restaurant, you can file a complaint with the Environmental Health Division at (714) 433-6000 or see instructions on the HCA website: http://ochealthinfo.com/eh/complaints.

If you think you might be seriously ill, we recommend that you get a medical evaluation right away. Many communicable diseases are more common during certain seasons of the year; for example, influenza usually occurs in the winter and early spring, as does chickenpox. Infection with Salmonella is most common in the summer but occurs all year round. Meningococcal infections tend to occur most often in winter. Some diseases are more common among young children, others in adults. For a given individual, it is not possible, or wise, to make assumptions based on general disease occurrence. When outbreaks occur, we make the information public as soon as possible so people can take whatever preventive steps are necessary.

The following is adapted from the 2000 Red Book ( American Academy of Pediatrics, Report of the Committee on Infectious Diseases) page 108, "Recommendations for Inclusion or Exclusion". Note that the policies of individual schools or day cares may be more stringent.

Children need not be excluded from the childcare setting for minor illness except for the following illnesses:

• Illness that prevents the child from participating comfortably in program activities.
• Illness that results in a greater need for care than the staff can provide without compromising the health and safety of other children.
• The child has any of the following conditions: fever, lethargy, irritability, persistent crying, difficult breathing, and/or other manifestations of possible severe illness.
• Diarrhea or stools that contain blood or mucus.
• E. coli 0157:H7 infection, until diarrhea resolves and two stool cultures are negative.
• Vomiting two or more times in the previous 24 hours, unless the vomiting is determined to be caused by a non-communicable condition and the child is not in danger of dehydration.
• Mouth sores associated with drooling, unless the child's physician or local health department authority states that the child is noninfectious.
• Rash with fever or behavior change, until a physician has determined the illness is not communicable
• Purulent conjunctivitis (defined as pink or red conjunctiva) with white or yellow eye discharge, often with matted eyelids after sleep and eye pain or redness of the eyelids or skin surrounding the eye? Until examined by the physician and approved for re-admission, with treatment.
• Tuberculosis, until the health department states that the child is non-infectious.
• Impetigo, until 24 hours after treatment has been initiated.
• Streptococcal pharyngitis (strep throat), until 24 hours after treatment has been initiated.
• Head lice, until after the first treatment (most schools have a "no nits" policy).
• Scabies, until after treatment has been completed.
• Varicella, until all lesions have dried and crusted (usually 6 days).
• Pertussis, until 5 days of the appropriate antibiotic therapy has been completed.
• Mumps, until 9 days after onset of salivary gland swelling.
• Measles, until 5 days after onset of rash.
• Hepatitis A virus infection, until 1 week after onset of jaundice or illness (if no jaundice occurred).

For further information on childcare visit the CDC website: www.cdc.gov/ncidod/hip/abc/abc.htm

Treatment "failures" usually result from the following:

1. incorrect identification (not lice)

2. incomplete combing out or removal of the nits (eggs)

3. not realizing it may take 8-12 hours for the lice to die

4. lice re-infestation, or

5. not strictly following the directions on the medication label

Resistance to the medication could be considered as a possible reason for failure if none of the above apply.

Here are some tips to help with the lice problem:

• Make sure you are using a recommended shampoo. The current recommended treatment is 1% Permethrin (e.g., NIXâ ). An alternative treatment is Pyrethrin (e.g. RIDâ , A-200â , R&C Shampooâ , etc.). Lindane (e.g.,, Kwellâ ) is no longer recommended. Another shampoo, called Ovideâ, is available by prescription.
• Make sure you are using the treatment as recommended and it stays on the hair for the length of time required.
• Check the product to see if re-treatment is recommended.
• Do NOT treat the infested person more than 3 times with the same medication. If it does not seem to work, see your health care provider.
• Do NOT use other products on the hair such as cream rinses, conditioner, etc. before the lice treatment. Do not re-wash the hair for 1-2 days after treatment or use other products on the hair (gel, conditioner). These products may make the lice shampoo less effective.
• The most effective control measure is the thorough removal of nits and lice by hand or with a comb regardless of which product is used for treatment. This can be best accomplished by using a metal nit comb. Although time consuming, combing must be conducted EVERY day until ALL lice and nits are removed. Many brands of combs are available; one model with long teeth available from the National Pediculosis Association (800-446-4672) has been reported to be easier to use than other combs, but costs about $15. Less expensive, but effective devices may be found in pharmacies. A pet flea comb also works well.
• Check the heads of affected persons for 2-3 weeks after treatment to be sure all the lice and nits are gone.
• Machine wash all washable clothing and bed linens that the infested person touched during the 2 days before treatment. Use the hot water and hot dry cycle.
• Store any items that cannot be washed in a sealed plastic bag for 2 weeks (such as pillows, stuffed animals, comforters, hats, etc.)
• Soak combs and brushes for 1 hour in rubbing alcohol or wash with soap and hot water.
• Check the other members of the household for lice and nits every 2-3 days.
• Thoroughly vacuum carpeting and upholstered furniture.
• Fumigation, sprays and pest control "bombs" are NOT recommended.
• Discuss the lice problem with your child's school or daycare. Other children in the same classroom or group should be checked for lice.

Note: Use of a product name is for identification purposes only and does not constitute endorsement.

• If you are accidently stuck by another person's used needle or other sharp:
  1. Wash the exposed area right away with water and soap or use a skin disinfectant (antiseptic) such as rubbing alcohol or hand sanitizer.
  2. Seek immediate medical attention by calling your physician or local hospital.

Follow these same instructions if you get blood or other bodily fluids in your eyes, nose, mouth, or on your skin.

• For more information on Safely Using Sharps: click here.